Rodak's Hematology Practice Exam

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• Which molecule binds to iron for cellular uptake once it is released from the enterocyte?
• What is the correct angle and direction for inserting a venipuncture needle?
• The acceptable hemoglobin control value range is 13.6 ± 0.4 g/dL. If the control is assayed five times with results 12.0, 12.3, 12.0, 12.2, and 12.1 g/dL, these results are?
• What effect does a decrease in pH have on the hemoglobin-oxygen dissociation curve?
• Which of the following tubes is used for hematologic testing?
• For evaluating bone marrow red blood cell production, which measure provides the most accurate information?
• A patient presenting with swelling in the left big toe and a WBC count of 2543/mL suggests:
• Which cells are crucial in immune regulation and destruction of helminths?
• Which of the following is not an indication for a bone marrow examination?
• What characterization would be given to a serous fluid with a clear appearance, specific gravity of 1.010, and protein concentration of 1.5 g/dL?
• Which statement describes the structure of oxidized hemoglobin?
• What does the reticulocyte count assess?
• What procedure is used to validate a new assay?
• Which component gathers, organizes, and directs light through the specimen in a microscope?
• Using linear regression to compare assay calibrator results, if the slope is 0.99 and the y intercept is 110%, what type of error is present?
• What is considered the most important step in the phlebotomy process?
• According to OSHA standards, which of the following is NOT a requirement for laboratory coats?
• What agency provides continuing medical laboratory education?
• What is the value used for monitoring the precision of hemoglobin measurements?
• Which megakaryocyte progenitor undergoes endomitosis?
• You require your laboratory staff to annually perform manual lupus anticoagulant profiles on a set of plasmas with known values. This exercise is known as:
• The process through which blood cells are formed and developed is known as:
• How are globin chain genes organized?
• What is typically evaluated in a peripheral blood film examination?
• Which of the following describes the primary role of eosinophils?
• You purchase a preserved whole blood specimen from a distributor who provides the mean values for several complete blood count analytes. What is this specimen called?
• For an anemic adult patient with an absolute reticulocyte count of 20 3 109/L and an MCV of 65 fL, which condition could be included in the differential diagnosis?
• What characteristic change occurs to normoblasts as they mature?
• Which type of cells should be reported when many large cells with basophilic cytoplasm are seen in a slide from peritoneal fluid?
• During the second trimester of fetal development, where is the primary site of blood cell production?
• Needle-shaped crystals found in a fluid aspirated from a patient's toe, which appear yellow on the y-axis when polarized, are indicative of:
• What type of white blood cells are involved in allergen response and protection against parasites?
• Which technique uses diffraction, reflection, and refraction of light waves?
• Cyclins and CDKs play a crucial role in regulating which process?
• Based on the cell counts in the spinal fluid, how would you describe the appearance of the fluid?
• Which of the following describes the function of the Sysmex XN-1000?
• What is the predominant hemoglobin found in a healthy newborn?
• The total iron-binding capacity (TIBC) is an indirect measure of which iron-related protein?
• What is the primary limitation when utilizing optical scatter techniques?
• What is the calculated nucleated cell count per mL if 6 nucleated cells are counted after a 1:2 dilution?
• Which cytokine is required very early in the differentiation of a hematopoietic stem cell?
• What class of fire extinguisher is recommended for a fire in a chemical cabinet?
• The organelle involved in packaging and trafficking of cellular products is the:
• Which of the following is primarily responsible for the physiological change in RBCs during hypoxia?
• What is the correct order of steps from iron absorption to incorporation into heme?
• Where is an acceptable site for skin puncture on infants?
• Standard precautions apply to all of the following except?
• Which step in the CLSI procedure for venipuncture is considered part of standard precautions?
• The mechanism of anemia resulting from an autoimmune reaction that destroys hematopoietic stem cells is best described as:
• Common clinical symptoms of anemia include:
• An increase in which of the following suggests a shortened life span of RBCs and hemolytic anemia?
• In the quaternary structure of hemoglobin, globin chains associate into what?
• In a bone marrow aspirate, which of the following cell types would be the least likely to be found?
• What are the initial laboratory tests performed for the diagnosis of anemia?
• The "control center" of the cell is the:
• What plasma protein is essential to platelet adhesion?
• What is the M:E ratio if RBC precursors account for 40% of cells and granulocyte precursors account for 60%?
• What function do macrophages serve in the context of RBCs in the bone marrow?
• A hemoglobin value of 14.5 g/dL would indicate anemia in which of the following patients?
• What hexose monophosphate shunt product aids in the detoxification of peroxides in RBCs?
• The patient's painful big toe is most likely caused by:
• How would you assess Mary’s safety practice when she handled the EDTA tube?
• Which process does NOT require energy in RBCs?
• What is a potential hazard of using the basilic vein for venipuncture?
• What large cells with multiple nuclei are noted in bone marrow core biopsy close to the endosteum?
• If the observed reticulocyte count is 6% and HCT is 30%, what is the calculated RPI?
• Functions of the cell membrane include all of the following except:
• What can be inferred if a cell has an N:C (nucleus to cytoplasm) ratio of 4:1?
• Under low power, the aspirate should be examined for all of the following except:
• Which normoblast is considered the most mature?
• What growth factor is produced in the kidney and induces growth and differentiation of committed megakaryocyte progenitors?
• Which instrument is known for measuring volume, conductivity, and light scatter using five angles?
• What does the presence of a clot in a specimen indicate?
• What finding may indicate chronic blood loss in anemia?
• Where are RBC precursors primarily located in the bone marrow?
• What is the correct order of draw for the evacuated tube system?
• A hemoglobin molecule is composed of how many heme molecules and globin chains?
• What is the expected outcome of using an acidic buffer when preparing blood films for staining?
• In which scenario would polychromasia in reticulocytes most likely be observed?
• Review of laboratory report integrity is an example of:
• What is the MCV given the following values: RBCs 5.00 x 10^12/L, HGB 9 g/dL, HCT 30?
• Which factor is most likely associated with an elevated ESR value?
• Which compound is produced when potassium cyanide and potassium ferricyanide are used in hemoglobin determination?
• Which of the following regulates the transfer of iron from the enterocyte into the plasma?
• The most important practice in preventing the spread of disease is?
• What role do cytoskeletal proteins play in RBCs?
• Which iron-related condition can be inferred if TIBC levels are significantly elevated?
• Ribosomes are synthesized by the:
• What is the main purpose of measuring bone marrow reticulocyte counts?
• What is the primary function of hematopoietic stem cells?
• Which option is an example of a transmembrane or integral membrane protein?
• Which erythroid precursor has a medium size compared to other normoblasts and an N:C ratio of nearly 1:1?
• The most frequent cause of needle punctures is?
• Where should alcohol and other flammable chemicals be stored?
• What process is unique to both B and T lymphocytes during their early development?
• What agency provides external quality assurance (proficiency) surveys and laboratory accreditation?
• In which situation should a medical laboratory scientist wear gloves?
• Which cell type is a product of the Common Lymphoid Progenitor (CLP)?
• Which condition is indicated by increased soluble transferrin receptor and decreased ferritin with normal hemoglobin content of reticulocytes?
• On a cytocentrifuge slide prepared from peritoneal fluid, cells appearing like "fried eggs" with basophilic cytoplasm should be identified as:
• The cell cycle is primarily regulated by which of the following components?
• In a patient with chronic intestinal bleeding due to aspirin use, what does a ferritin level of 25 ng/mL and a TIBC of 405 mg/dL indicate?
• What regulates the transition from the G1 to S stage of the cell cycle?
• What is the MCHC for a patient with the provided hemoglobin of 9 g/dL and HCT of 30?
• In which situation would the MCV typically be decreased?
• What polypeptide chains are found in normal adult hemoglobin A?
• A serous fluid sample with fewer than 500 mononuclear cells/mL is categorized as:
• Which morphologic change occurs during normal blood cell maturation?
• Protein synthesis occurs in the:
• After adjusting the microscope for Koehler illumination, how should light intensity be regulated when viewing with an oil immersion objective lens?
• What does an elevated reticulocyte count suggest regarding erythropoietic activity?
• Iron is primarily transported in plasma by which of the following proteins?
• Which of the following molecules is stored in platelet dense granules?
• What condition might be diagnosed from a bone marrow biopsy that has increased granulocyte precursors?
• What type of cells are osteoclasts responsible for in the bone marrow?
• How frequently should fire alarms and sprinkler systems be tested?
• When a blood film appears excessively red, with eosinophils bright orange, which is the most likely cause?
• What is the expected hematocrit range for a patient with a hemoglobin level of 8.0 g/dL?
• What is a potential characteristic of blood films made by an inexperienced technician?
• Which term describes the variation in size of red blood cells?
• When using a microscope, what should a student do if they move the 100x objective out of place before adding oil?
• What type of container is used for collecting blood samples for coagulation tests?
• A laboratorian using the 403 objective lens sees WBC counts of 8, 4, 7, 5, 4, 7, 8, 6, 4, and 6 in 10 fields. Which WBC count most closely correlates with the estimate?
• A laboratory science student is making blood films that are too long and thin. What change in technique would most likely improve the films?
• Orthogonal light scatter is used to measure which of the following?
• What is the significance of stromal cells in the hematopoietic microenvironment?
• What determines the timing of egress of RBCs from the bone marrow?
• How does hypoxia stimulate RBC production?
• What is likely the primary result when splenic macrophages engulf senescent RBCs?
• What is one body's response to severe anemia when bone marrow cannot produce enough red blood cells?
• What does impedance measurement in hematology detect?
• When handling blood samples, what is a necessary safety procedure Mary should follow?
• Which of the following is an erythrocyte progenitor?
• Which white blood cell type primarily responds to viral infections?
• You perform a clinical efficacy test and get the following results: Assay is negative - Unaffected by Disease or Condition: 40, Affected by Disease or Condition: 5. Assay is positive - Unaffected by Disease or Condition: 10, Affected by Disease or Condition: 45. What is the number of false-negative results?
• Which finding is characteristic of thrombocytopenia in a blood film?
• What should a technician do if a patient expresses anxiety about the venipuncture process?
• Which printout indicates to the user that results are acceptable with no manual work needed?
• How might a stained blood film appear if it has been inadequately rinsed?
• If a laboratory professional switches from a 40x objective to a 10x objective and the specimen remains in focus, how are these microscopes described?
• Which are the most common erythrocytic stages found in normal marrow?
• Why do hematopoietic stem cells produce all lineages of blood cells in sufficient quantities over an individual's lifetime?
• For a patient with total serum iron of 63 mg/dL and TIBC of 420 mg/dL, what is their percent transferrin saturation?
• Basophils and mast cells have high-affinity receptors for which immunoglobulin?
• What likely caused the presence of several nucleated RBCs after centrifugation of a spinal fluid sample in a 56-year-old woman?
• What growth factor produced in the kidneys treats anemia associated with kidney disease?
• If undiluted spinal fluid shows a total of 105 RBCs counted, what is the concentration of RBCs per mL in a total volume counted?
• The glycocalyx is composed of membrane:
• Which cell stage is responsible for producing mature erythrocytes?
• Regular review of blood specimen collection quality is an example of:
• Should a manual differential count be performed if immature granulocytes are present in a sample?
• What is the normal distribution of hemoglobins in healthy adults?
• What practice should be prioritized to minimize infection risk in a clinical lab setting?
• Which type of objective lens causes the center of the microscope field to be in focus while the periphery is blurred?
• In hemolytic anemia, which of the following can result from increased red blood cell destruction?
• What is the primary function of the glycolipids in the RBC membrane?
• What is the nature of the interaction between 2,3-BPG and hemoglobin?
• Which component is essential for maintaining RBC shape?
• The ability of an assay to distinguish the targeted analyte from interfering substances within the specimen matrix is called?
• Iron is released from macrophages, hepatocytes, and enterocytes into circulation by which membrane protein?
• What is a significant source of energy for RBC in the absence of mitochondria?
• Which type of microscopy is useful for identifying crystals that are double refractive?
• When might a patient’s RBC count be falsely elevated?
• What form of iron is considered to be the major metabolically available storage form in the body?
• What might abnormalities in the linkages of transmembrane and cytoskeletal RBC membrane proteins result in?
• Which information is essential for labeling a blood specimen tube?
• Which of the following is a statistical test that compares means?
• From where is RBC membrane cholesterol replenished?
• Failure to obtain blood by venipuncture may occur due to all of the following except:
• What should be done when a blood sample is hemolyzed?
• What does platelet adhesion refer to?
• What is the best area to perform a differential on a stained blood film?
• What statistical method provides a method for assessing the agreement between two measurement techniques?
• Which platelet membrane phospholipid flips to the plasma surface on activation and serves as the assembly point for coagulation factors?
• What single feature of normal RBCs is most responsible for limiting their life span?
• What is the largest hematopoietic cell found in a normal bone marrow aspirate?
• What is the role of a tourniquet in venipuncture?
• Which of the following would not interfere with hemoglobin determination by the cyanmethemoglobin method?
• A patient’s peripheral blood film shows agglutinated RBCs, and the CBC indicates an elevated MCHC. How will other parameters be affected?
• What is the name of the eicosanoid metabolite produced from endothelial cells that suppresses platelet activity?
• What is low-voltage DC used to measure in cellular analysis?
• If the total WBC count is 9.5 3 10^9/L and there are 37% lymphocytes, what is the absolute count for the lymphocytes?
• On the Beckman Coulter instruments, hematocrit is a calculated value. Which of the following directly measured parameters is used in the calculation of this value?
• What is the total WBC count if a 1:20 dilution of blood is made and 100 cells are counted?
• A blood film showing poorly stained neutrophils may indicate which issue?
• What is the main function of the thymus in the immune system?
• Which objective has the greatest degree of color correction?
• The shape of a cell is maintained by which of the following?
• A blood film for a very anemic patient shows an average of seven platelets per oil immersion field. What value most closely correlates with this estimate per microliter?
• Which of the following is a common clinical symptom that indicates anemia?
• Intravascular or fragmentation hemolysis results from what type of injury?
• Which of the following is not related to the effects of erythropoietin?
• The crystals identified in a cloudy straw-colored fluid from a patient's big toe that appeared needle-shaped are:
• Which type of anemia is characterized by the presence of abnormally large red blood cells?
• What is a primary function of neutrophils?
• Which of the following is the final stage of B cell maturation after activation by antigen?
• For a 20-year-old, the best source of active bone marrow would be located in the:
• What pathway reduces hemoglobin iron to the physiologic 12 valence state?
• Which immune cell type is the main effector in immediate hypersensitivity reactions?
• Which one of the following is reduced as an adaptation to long-standing anemia?
• Which protein primarily delivers iron throughout the bloodstream?
• What is a legal concern for phlebotomists?
• What type of anemia is associated with low reticulocyte count?
• Which blood film finding indicates EDTA-induced pseudothrombocytopenia?
• What is the most commonly used needle size for standard venipuncture in adults?
• Which organ is primarily responsible for the sequestration of platelets?
• What is the purpose of adding an anticoagulant to evacuated tubes?
• Which platelet organelle sequesters ionic calcium and binds enzymes of the eicosanoid pathway?
• Which membrane-associated protein in enterocytes is responsible for transporting iron from the intestinal lumen into the cell?
• Which organ is essential for the maturation of T lymphocytes?
• What term describes physiologic programmed cell death?
• How are RBC membrane phospholipids arranged?
• Which component of the RBC membrane is primarily responsible for facilitating transport of molecules?
• During which stage of neutrophilic development does the nucleus take on a kidney bean shape with lavender secondary granules?
• The nucleus is composed largely of:
• The regulation of the hematopoietic microenvironment is provided by which of the following?
• What is the most likely identification of large, dark-staining cell clusters in a pleural effusion from a woman with a history of breast cancer?
• What is the standard deviation of the WBC count control that has a mean of 6000 / mL?
• What is the primary function of dendritic cells in the immune response?
• What principle does high voltage electrical waves utilize to measure cell complexity?
• What is the preferred bone marrow collection site in adults?
• Under which circumstance would a Safety Data Sheet (SDS) be most helpful?
• Which condition would most likely lead to a high MCHC reading in a CBC?
• Type II myeloblasts are characterized by which feature?
• Which is true concerning 2,3-BPG?
• Which component is NOT part of a safety management plan?
• What is the normal M:E ratio range in adults?
• Extravascular hemolysis occurs when which process takes place?
• When performing a receiver operating curve analysis, what parameter assesses the overall efficacy of an assay?
• What is the recommended cleaner for removing oil from microscope objectives?
• What is required for iron to be effectively transported from the gut to the plasma?
• Is the statement true or false? A pronormoblast belongs to the erythron.
• In the case of an anemic adult with an MCV of 125 fL and an RDW of 20%, which of the following could be part of the differential diagnosis?
• What can reticulated platelets indicate when enumerated in peripheral blood?
• Schistocytes, ovalocytes, and acanthocytes are examples of abnormal changes in
• What is the vein of choice for performing venipuncture?
• Which pathway is responsible for anaerobic energy generation in the form of ATP?
• For a patient with ambiguous iron study values, which test can best determine the presence of iron deficiency?
• A laboratory scientist measures prothrombin time for plasma aliquots from 15 healthy males and 15 healthy females. She computes the mean and 95.5% confidence interval and notes that they duplicate the manufacturer's statistics within 5%. This procedure is known as:
• What is the total magnification obtained with a 10x eyepiece and a 100x objective lens?
• What is the advantage of a core biopsy bone marrow sample over an aspirate?
• If a stained blood film is bluer than normal, what microscopic abnormality might be expected?
• The appropriate dilution of bleach to be used in laboratory disinfection is?
• Which technology is associated with the Abbott CELL-DYN Sapphire?
• Which enzyme is identified as the key rate-limiting step in heme synthesis?
• Which of the following is a valid reason for specimen rejection?
• What is the primary focus of the Siemens ADVIA 2120i?
• What progenitor gives rise to both neutrophils and monocytes?
• How do darkfield microscopes create a dark field?
• What condition would lead to an increased desaturation of hemoglobin?
• Which morphological change is indicative of apoptosis?
• Which laboratory finding is expected to be low in cases of anemia caused by insufficient erythropoiesis?
• Which lab value would most directly suggest a hemolytic process in an anemic patient?
• Which cell type can differentiate into osteoclasts, macrophages, or dendritic cells?
• Which of the following conditions is detectable only by examination of a peripheral blood film?
• Which form of hemoglobin has the lowest affinity for oxygen?
• In adjusting the microscope light using Koehler illumination, which statement is true?
• Euchromatin functions as the:
• The laboratory purchases reagents from a manufacturer and develops an assay using standard references. What FDA category is this assay?
• For a complete blood count and measurement of prothrombin time, are lavender stopper and green stopper tubes acceptable specimens?
• What is the likely reason for variation in platelet counting among different instruments?
• What cells, occasionally seen in bone marrow biopsy specimens, are responsible for the formation of bone?
• Given the WBC: 86.3 3 10^9/L, HGB: 9.7 g/dL, HCT: 24.2%, MCV: 87.8 fL, and PLT: 106 3 10^9/L, what is the summary of the blood picture?
• Which leukocyte abnormality is suggested by the presence of roulaeu formation in a blood smear?
• Which cell type is primarily responsible for creating antibodies in response to antigen exposure?
• Which statement is true for a laboratory collection of cerebrospinal fluid?
• What mechanism primarily protects RBCs from oxidative damage?
• What platelet membrane receptor binds fibrinogen and supports platelet aggregation?
• What is a characteristic feature of apoptosis?
• Which instrument printout is known for having a system flag on the platelet count?
• What happens to the transferrin receptor after it has delivered iron to a cell?
• A WBC count control has a mean value of 6000 / mL and a standard deviation of 300 / mL. What is the 95.5% confidence interval?
• Which molecule functions as a buffer for maintaining pH in RBCs?
• When investigating the cause of anemia, which aspect of a patient's history is essential to consider?
• What process primarily regulates systemic iron homeostasis in the body?
• A blood film for a normal RBC count shows an average of 10 platelets per oil immersion field. Which value best correlates with this estimate per microliter?
• Which of the following cells is not normally seen in cerebrospinal fluid (CSF), serous fluids, and synovial fluids?
• The energy source for cells is the:
• Where is most hematopoietic tissue found in adults?
• How do macrophages support adaptive immunity?