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ASCP Hematology Review Questions
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Name the locations of active marrow in adults: ✔✔sternum, skull, ribs, pelvis, vertebrae
Where does hematopoiesis take place during the first 2 months of gestation? ✔✔yolk sac
Where does the majority of hematopoiesis take place during the 2nd through 7th month of gestation? ✔✔spleen
When does the bone marrow take over hematopoiesis? ✔✔after birth
What are the stages in order of the erythrocyte lineage? ✔✔(1)rubriblast, (2)prorubricyte, (3)rubricyte, (4)metarubricyte, (5)reticulocyte, (6)erytrocyte
What are the stages in order of the granulocyte (neutrophil, eosinophil, basophil) lineage? ✔✔(1)myeloblast, (2)promyelocyte, (3)myelocyte, (4)metamyelocyte, (5)band, (6)segmented (7)eos/baso
What are the stages in order of the macrophage lineage? ✔✔(1)monoblast, (2)promonocyte, (3)monocyte, (4)macrophage
What are the stages in order of the platelet lineage? ✔✔(1)megakaryoblast, (2)promegakaryocyte, (3)megakaryocyte, (4)platelet
What are the stages in order of the lymphocyte lineage? ✔✔(1)lymphoblast, (2)prolymphocyte, (3)lymphocyte
Which growth factors stimulate the erythrocyte lineage? ✔✔GM-CSF, EPO, IL- 3
Which growth factors stimulate the granulocyte lineages? ✔✔GM-CSF, IL- 3
Which growth factors stimulate the platelet lineage? ✔✔GM-CSF, IL-3, TPO
Which growth factors stimulate the lymphocyte lineage? ✔✔IL-2, IL-4, IL-6, IL- 7
Which protein functions in the transport of Fe? ✔✔transferrin
What is the major storage form of Fe? ✔✔ferritin
What is the long-term (H20) insoluble Fe storage form called? ✔✔hemosiderin
Excess Iron is stored where? What does this cause? ✔✔tissues and body organs, hemosiderosis, hemochromatosis
What type of hemoglobin is rarely seen in adults as well as newborns? ✔✔Hgb A
What hemoglobin types are seen in embryos but not in adults or newborns? ✔✔gower I, gower II, portland
All non-embryonic hemoglobin types are comprised of what type of globin chain? ✔✔alpha
Hemoglobin A2 is composed of what types of globin chains? ✔✔alpha, beta
Hemoglobin A is composed of what types of globin chains? ✔✔alpha, delta
Hemoglobin F is composed of what types of globin chains? ✔✔alpha, gamma
Multiple transfusions can cause what kind of shift in the hemoglobin-oxygen dissociation curve? ✔✔left shift
An increase in hemoglobin F can cause what kind of shift in the hemoglobin-oxygen dissociation curve? ✔✔left shift
A left shift in the hemoglobin-oxygen dissociation curve causes what changes in the following substances: CO2, pH, 2,3-DPG? ✔✔increased pH, decreased CO2, decreased 2,3-DPG
A right shift in the hemoglobin-oxygen dissociation curve causes what changes in the following substances: CO2, pH, 2,3-DPG? ✔✔decreased pH, increased CO2, increased 2,3-DPG
How does EDTA work as an anticoagulant? ✔✔it chelates Ca++
How does heparin work as an anticoagulant? ✔✔it is an anti-thrombin agent
Hemoglobin is measured by its conversion to what? By? ✔✔cyanomethemoglobin, potassium cyanide, potassium ferricyanide
What are potential sources of error in the measurement of hemoglobin? ✔✔lipemia, icterus, high white count, resistant hemoglobins (SS, CC)
What is the normal reference range of hemoglobin for males? ✔✔14-18 g/dL
What is the normal reference range of hemoglobin for females? ✔✔12-16 g/dL
Methemoglobin carries iron in what state? ✔✔oxidized (Fe3+)
What color is methemoglobin? ✔✔brown
What is the calculation used for manual cell counts? ✔✔# of cells counted X 1/total volume X dilution factor
What is the reference range for a WBC? ✔✔5000-10000 ul
What is the reference range for platelets? ✔✔150 - 400 X 10^
What is the reference range for MCV? ✔✔80-100 fl
What is the reference range for MCH? ✔✔28-32 pg
What is the reference range for MCHC? ✔✔32-36% g/dl
What is the reference range for RDW? ✔✔11.5-14.5%
The function of what cell is to transport O2 to tissues and remove CO2 from tissues? ✔✔RBC
The function of what cell is a phagocytic response to bacteria? ✔✔neutrophil
The function of what cell is in humoral and cell mediated immunity? ✔✔lymphocyte
The function of what cell is an inflammatory response mediator? ✔✔basophil
The function of what cell is an allergic response regulator? ✔✔eosinophil
The function of what cell is in clotting? ✔✔platelet
What are the dyes used in a Wright stain? ✔✔eosin, methylene blue
What is the pH of the phosphate buffer used in a Wright stain? ✔✔6.
What can cause a Wright stained slide to appear more blue? ✔✔prolonged staining, pH too basic
What can cause a Wright stained slide to appear more red? ✔✔prolonged washing, pH too acidic
Neutrophil counts are increased in what conditions? ✔✔bacterial infections
Lymphocyte counts are increased in what conditions? ✔✔viral infections
Monocyte counts are increased in what conditions? ✔✔TB, syphilis, malignancies
Eosinophil counts are increased in what conditions? ✔✔allergies, parasites
Basophil counts are increased in what conditions? ✔✔immediate hypersensitivies
What type of cells are expected to be seen with a high MCHC (<32) ✔✔hyperchromic
Acanthocytes are commonly seen in what condition(s)? ✔✔severe liver disease, abetalipoproteinemia
Another word for sickle cells is? ✔✔drepanocyte
Echinocytes are commonly seen in what condition(s)? ✔✔uremia (can also be an artifact)
Spherocytes are commonly seen in what condition(s)? ✔✔hereditary spherocytosis, increased MCHC, ABO HDN, other hemolytic processes
Elliptocytes are commonly seen in what condition(s)? ✔✔hereditary elliptocytosis, iron deficiency, thalassemia
Stomatocytes are commonly seen in what condition(s)? ✔✔hereditary stomatocytosis, liver disease
Macroovalocytes are commonly seen in what condition(s)? ✔✔megaloblastic anemia
Target cells are commonly seen in what condition(s)? ✔✔liver disease, Hb C, thalassemia, other hemoglobinopathies
Helmet cells are seen in what condition(s)? ✔✔hemolytic processes
Another name for helmet cells is? ✔✔keratocyte
Teardrop drop cells are seen in what condition(s)? ✔✔extramedullary hematopoiesis, thalassemias, pernicious anemia
Schistocytes are seen in what condition(s)? ✔✔DIC, hemolytic processes
Howell-Jolly bodies are composed of? ✔✔DNA
What condition(s) are howell-jolly bodies seen in? ✔✔disturbed erythropoiesis, hemolytic anemias, megaloblastic anemia, post-splenectomy
The inclusions seen in basophilic stippling are composed of? ✔✔RNA
What condition(s) is basophilic stippling seen in? ✔✔thalassemia, lead poisoning
What stains are utilized to see basophilic stippling? ✔✔wright, new methyene blue
Pappenheimer bodies are composed of? ✔✔iron
An increased MCV with MCHC and decreased RBC is associated with what condition? ✔✔cold agglutinin disease
What can be done to circumvent interference from cold agglutinin disease? ✔✔warming the sample
What does the erythrocyte sedimentation rate measure? ✔✔rate of fall of red cells through plasma
What is the normal reference range of the ESR for women? ✔✔0-20 mm/hr
What is the normal reference range of the ESR for men? ✔✔0-15 mm/hr
An increase in the ESR value is see in conditions involving? ✔✔the presence of abnormal plasma proteins (inflammatory conditions)
A falsely elevated ESR can be attributed to? ✔✔tilting tube, standing too long, increased temperature, excess EDTA
A falsely decreased ESR can be attributed to? ✔✔QNS specimen, decreased temperature
What types of stains are used to view reticulocytes? ✔✔supra vital (new methylene blue, brilliant cresyl blue)
Reticulocyte counts are used to monitor? ✔✔erythropoiesis
What is the normal reference range for a reticulocyte count? ✔✔0.5-1.5%
A reticulocyte production > 2 indicates? ✔✔adequate bone marrow response to anemia
A reticulocyte production < 2 indicates? ✔✔inadequate bone marrow response to anemia
Retic counts are increased in which of the following conditions> ✔✔hemolytic anemias, post- acute blood loss, following therapy (iron, folate, B12)
What is the normal amount of megakaryocytes seen per lpf in a bone marrow prep? ✔✔ 5
What is the normal reference range for the myeloid to erythroid ratio? ✔✔3:1-4:
Dry bone marrow taps are associated with what pathological condition(s)? ✔✔myelofibrosis, aplastic anemia
What is the order of migration of hemoglobin from the cathode to the anode in celluose acetate? ✔✔(1)C, (2)S, (3)F, (4)A
What is the order of migration of hemoglobin from the cathode to the anode in citrate agar? ✔✔(1)F, (2)A, (3)S, (4)C
What other hemoglobin types migrate to the same position as A2? ✔✔C, E, O, CHarlem
What other hemoglobin types migrate to the same position as S? ✔✔D, G, L
Hemoglobinopathies are the result of? ✔✔structural changes to the globin chains
What hemoglobin chain is most commonly affected by hemoglobinopathies? ✔✔beta
What is the mutation that results in the formation of hemoglobin S? Which globin chain is affected? ✔✔valine for glutamic acid (6th position), beta chain
What is the mutation that results in the formation of hemoglobin C? Which globin chain is affected? ✔✔lysine for glutamic acid (6th position), beta chain
Individuals who are heterozygous for hemoglobin S are said to? ✔✔carry the sickle cell trait
True or False: Individuals who are heterozygous for hemoglobin S have few sickle cells on their blood slides? ✔✔false
Sickle dex is a reducing agent that does what? ✔✔it causes Hgb S to precipitate producing turbidity
Individuals who are homozygous for hemoglobin C suffer from what condition? ✔✔mild chronic anemia
What is commonly seen in the blood smear of individuals who have hemoglobin C? ✔✔Hgb C crystals (bar shaped), target cells
In what condition is there a decrease or absence of the production of either beta or alpha globin chains? ✔✔thalassemia
What type of anemia is seen in individuals with beta thalassemia? ✔✔microcytic hypochromic anemia
In individuals with beta thalassemia, what other hemoglobin types are produced to make up for the lack of beta chain synthesis? What type of hemoglobin is decreased in production (or absent)? ✔✔A2 and F are increased, A is decreased or absent
What lab findings are commonly seen in lead poisoning leading to a microcytic hypochromic anemia? ✔✔basophilic stippling, increased blood Pb
What lab findings are commonly seen in individuals who have the thalassemia trait? ✔✔normal serum iron and TIBC, increased A2 and F
What lab findings are commonly seen in individuals who have macrocytic anemia? ✔✔decreased folate/B12, retics and increased MMA, homocysteine
What types of cells and inclusions are seen in individuals with a folate/B12 deficiency? ✔✔macroovalocytes, hypersegmented neutrophils, howell jolly bodies
A normal schilling test with IF indicates what type of problem or anemia? ✔✔pernicious anemia
An abnormal schilling test with or without IF indicates what type of problem or anemia? ✔✔malabsorption problem
An increase in liver enzymes, target cells, and round macrocytes can indicate what conditions/problems? ✔✔liver disease, alcholism
What lab findings are commonly found in antibody mediated anemia? ✔✔increased bilirubin, decreased haptoglobin, positive DAT
What conditions are associated with antibody mediated anemia? ✔✔PCH, CAD, WAIHA
What type of antibody is associated with WAIHA-related anemia? ✔✔IgG
What type of antibody is associated with CAD-related anemia? ✔✔IgM with anti-I specificity
What type of antibody is associated with PCH-related anemia? ✔✔anti-P
A positive Ham's test and a positive sucrose hemolysis test helps to diagnose what condition ✔✔PNH
A G6PD deficiency is characterized by what lab findings? ✔✔decreased G6PD, heinz bodies
A PK deficiency is characterized by what lab findings? ✔✔decreased PK, no heinz bodies
What lab findings are commonly seen in individuals with aplastic anemia? ✔✔hypocellular bone marrow, decreased retics, panycytopenia
The osmotic fragility test measures? ✔✔salt tolerance
Osmotic fragility is increased in what condition? ✔✔hereditary shperocytosis
