Professional Documents
Culture Documents
Part 1 HEMA
Part 1 HEMA
24. Which of the following organs is responsible for the “pitting process” for RBCs?
a. liver b. spleen c. kidney d. lymph nodes
25. Which of the following disorders has an increase in osmotic fragility?
a. iron deficiency anemia c. hereditary stomatocytosis
b. hereditary elliptocytosis d. hereditary spherocytosis
26. What is the major hemoglobin found in the RBCs of patients with sickle cell trait?
a. hgb S b. hgb F c. hgb A2 d. Hgb A
27. Select the amino acid substitution that is responsible for sickle cell anemia?
a. lysine is substituted for glutamic acid at the sixth position of the alpha chain
b. valine is substituted for glutamic acid at the sixth position of the beta chain
c. valine is substituted for glutamic acid at the sixth position of the alpha chain
d. glutamine is substituted for glutamic acid at the sixth position of the beta chain
28. All of the following are usually found in hemoglobin C disease, except:
a. Hemoglobin C crystals c. lysine substituted for glutamic acid at sixth position of β-chain
b. Target cells d. fast mobility of hemoglobin C at pH 8.6
29. Which of the following hemoglobins migrates to the same position as hgb A2 at pH 8.6?
a. hgb H b. hgb F c. hgb C d. hgb S
30. Which of the following electrophoretic results is consistent with a diagnosis of sickle cell trait?
a. hgb A: 40%, hgb S 35%, hgb F 5% c. hgb A: 0%, hgb A2 5%, hgb F 95%
b. hgb A: 60%, hgb S 40%, hgb A2 2% d. hgb A: 80%, hgb S 10%, hgb A2 10%
31. Which of the following is true of paroxysmal nocturnal hemoglobinuria (PNH)?
a. it is an acquired hemolytic anemia c. it is inherited as an autosomal dominant trait
b. it is inherited as a sex-linked trait d. it is inherited as an autosomal recessive trait
32. Hemolytic uremic syndrome (HUS) is characterized by all of the following, except:
a. hemorrhage b. thrombocytopenia c. hemoglobinuria d. reticulocytopenia
33. An autohemolysis test is positive in all of the following except:
a. G6PD deficiency b. HS c. pyruvate kinase deficiency d. PNH
34. Which antibody is associated with paroxysmal cold hemoglobinuria (PCH)?
a. anti-I b. anti-i c. anti-M d. anti-P
35. All of the following are associated with hemolytic anemia except:
a. methemoglobinemia c. hemoglobinemia
b. hemoglobinuria d. increased haptoglobin
36. Bite cells are usually seen in patients with:
a. Rh null trait b. CGD c. G6PD deficienct d. PK deficiency
37. The morphological classification of anemias is based on which of the following?
a. M:E ratio b. Prussian blue stain c. RBC indices d. reticulocyte count
38. Microangioathic hemolytic anemia is characterized by:
a. target cells and Cabot rings c. Pappenheimer bodies and basophilic stipplings
b. toxic granules and Dohle bodies d. schistocytes and nucleated RBCs
39. Which antibiotic is most often implicated in the development of aplastic anemia?
a. sulfonamides b. penicillin c. tetracycline d. chloramphenicol
40. Which of the following conditions may produce spherocytes in a peripheral smear?
a. Pelger-Huet anomaly c. autoimmune hemolytic anemia
b. perncious anemia d. sideroblastic anemia
41. Reticulocytosis usually indicates:
a. response to inflammation c. aplastic anemia
b. neoplastic process d. red cell regeneration
42. The OFT result in a patient with thalassemia major would most likely be:
a. increased b. decreased c. normal d. all of these
43. Iron deficiency anemia may be distinguished from anemia of chronic infection by:
a. serum iron level c. red cell indices
b. red cell morphology d. total iron binding capacity
44. Which anemia has red cell morphology similar to that seen in IDA?
a. sickle cell anemia b. thalassemia syndrome c. pernicious anemia d. HS
45. Which morphological classification is characteristic of megaloblastic anemia?
a. normocytic, normochromic c. macrocytic, hypochromic
b. microcytic, normochromic d. macrocytic, normochromic
46. All of the following are characteristics of megaloblastic anemia except:
a. pancytopenia c. hypersegmented neutrophil
b. elevated reticulocyte count d. macrocytic erythrocyte indices
47. Which of the disorders below causes ineffective erythropoiesis?
a. G6PD deficiency b. liver disease c. Hgb C disease d. pernicious anemia
3
48. Which of the following may be seen in the peripheral blood smear of a patient with obstructive liver disease?
a. schistocytes b. macrocytes c. Howell-Jolly bodies d. microcytes
49. The macrocytes typically seen in megaloblastic processes are:
a. creascent-shaped b. teardrop-shaped c. ovalocytic d. pencil-shaped
50. Which inclusions may be seen in leukocytes?
a. Dohle bodies b. basophilic stippling c. malarial parasite d. Howell-Jolly bodies
51. Which of the following is contained in the primary granules of the neutrophil?
a. lactoferrin b. myeloperoxidase c. histamine d. alkaline phosphatase
52. The morphological characteristic associated with Chediak-Higashi syndrome is:
a. pale blue cytoplasmic inclusiosns c. small, dark staining granules and condensed nuclei
b. giant lysosomal granules d. nuclear hyposegmentation
53. Auer rods may be seen in all of the following except:
a. acute myelomonocytic leukemia (M4) c. acute myeloid leukemia without maturation (M1)
b. acute lymphoblastic leukemia d. acute promyelocytic leukemia (M3)
54. Which type of anemia is usually present in a patient with acute leukemia?
a. microcytic, hyperchromic c. normocytic, normochromic
b. microcytic, hypochromic d. macrocytic, normochromic
55. In leukemia, which term describes a peripheral blood finding of leukocytosis with a shift to the left, accompanied by
occasional nucleated red cells?
a. megaloblastosis b. dysplasia c. leukoerythroblastosis d. none of these
56. DIC is most often associated with which of the following types of acute leukemia?
a. acute myeloid leukemia without maturation c. acute myelomonocytic leukemia
b. acute promyelocytic leukemia d. acute monocytic leukemia
57. A peripheral smear shows 75% blasts. These stain positive for both Sudan black B (SBB) and peroxidase (Px). Given
these values, which of the following disorders is most likely?
a. AML b. CML c. AUL d. ALL
58. Sodium fluoride may be added to the naphthyl ASD acetate (NASDA) esterase reaction. The fluoride is added to
inhibit a positive reaction with:
a. megakaryocytes b. monocytes c. erythrocytes d. granulocytes
59. In essential thrombocythemia, the platelets are:
a. increased in number and functionally abnormal c. decreased number and functional
b. normal in number and functionally abnormal d. decreased in number and functionally abnormal
60. Which of the following cells is considered pathognomonic for Hodgkin’s disease?
a. Niemann-Pick cells b. reactive lymphocytes c. flame cells d. Reed-Sternberg cells
61. In myelofibrosis, the characteristic abnormal red blood cell morphology is that of:
a. target cells b. schistocytes c. teardrop cells d. ovalocytes
62. PV is characterized by:
a. increased plasma volume c. decreased oxygen saturation
b. pancytopenia d. absolute increase in total red cell mass
63. The erythrocytosis seen in relative polycythemia occurs because of:
a. decreased arterial oxygen saturation c. increased erythropoietin levels
b. decreased plasma volume of circulating blood d. increased erythropoiesis in the bone marrow
64. The leukocyte alkaline phosphatase stain of a patient gives the following results: 10 (0); 48(1+); 38(2+); 3(3+); 1(4+).
Calculate the LAP score:
a. 100 b. 117 c. 137 d. 252
65. CML is distinguished from leukomoid reaction by which of the following?
a. CML low LAP; leukomoid high LAP c. CML high WBC; leukomoid normal WBC
b. CML high LAP; leukomoid low LAP d. CML high WBC; leukomoid high WBC
66. What influence does the Philadelphia chromosome have on the prognosis of patients with chronic myelocytic
leukemia?
a. it is not predictive c. prognosis is worse is Ph1 is present
b. prognosis is better if Ph1 is present d. disease usually transforms into AML when Ph1 is present
67. What is the characteristic finding is seen in the peripheral smear of a patient with multiple myeloma?
a. microcytic hypochrmic cells c. rouleaux
b. intracellular inclusion bodies d. hypersegmented neutrophils
68. In which of the following conditions does LAP show the least activity?
a. leukomoid recations b. idiopathic myelofibrosis c. PV d. CML
69. Cells that exhibit a positive stain with acid phosphatase and are not inhibited with tartaric acid are characteristically
seen in:
a. infectious mononucleosis c. hairy cell leukemia
b. infectious lymphocytosis d. T-cell acute lymphoblastic leukemia
70. The anticoagulant of choice for most routine coagulation studies is:
a. sodium oxalate b. sodium citrate c. EDTA d. heparin
4
94. Normal PT and APTT results in a patient with poor wound healing may be associated with:
a. factor VII deficiency b. factor VIII deficiency c. factor XII deficiency d. factor XIII deficiency
95. The lupus anticoagulant is directed against:
a. factor VIII b. factor IX c. factor X d. phospholipid
96. What test is used to monitor heparin therapy?
a. INR b. APTT c. PT d. none of these
97. What test is commonly used to monitor warfarin therapy?
a. INR b. APTT c. TT d. BT
98. Which clotting factors (cofactors) are inhibited by protein S?
a. V and X b. Va and VIIIa c. VIII and IX d. VIII and X
99. Which of the following tests is most likely to be abnormal in patients taking aspirin?
a. platelet morphology b. platelet count c. bleeding time d. prothrombin time
100. A prolonged thrombin time and a normal reptilase time are indicative of:
a. afibrinogenemia b. hypofibrinogenemia c. aspirin therapy d. heparin therapy