Medical Laboratory Science Review (Hematology) 1

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HEMATOLOGY I
1. Insufficient centrifugation will result in: 
A. A false increase in hematocrit (Hct) value 
B. A false decrease in Hct value 
C. No effect on Hct value 
D. All of these options, depending on the patient 

2. Variation in red cell size observed on the peripheral smear is described as: 
A. Anisocytosis 
B. Hypochromia 
C. Poikilocytosis 
D. Pleocytosis  

3. Which of the following is the preferable site for bone marrow aspiration and biopsy in an adult? 
A. Iliac crest 
B. Sternum 
C. Tibia 
D. Spinous processes of a vertebra  

4. Mean cell volume (MCV) is calculated using the following formula: 
A. (Hgb ÷ RBC) × 10 
B. (Hct ÷ RBC) × 10 
C. (Hct ÷ Hgb) × 100 
D. (Hgb ÷ RBC) × 100 

5. What term describes the change in shape of erythrocytes seen on a Wright’s-stained peripheral blood smear? 
A. Poikilocytosis 
B. Anisocytosis 
C. Hypochromia 
D. Polychromasia 

6. Calculate the mean cell hemoglobin concentration (MCHC) using the following values: Hgb: 15 g/dL (150 g/L) RBC: 4.50 × 106/μL (4.50 × 1012/L) Hct: 47 mL/dL (0.47) 
A. 9.5% (.095) 
B. 10.4% (.104) 
C. 31.9% (.319) 
D. 33.3% (.333) 

7. A manual white blood cell (WBC) count was performed. A total of 36 cells were counted in all 9-mm2 squares of a Neubauer-ruled hemacytometer. A 1:10 dilution was used. What is the WBC count? 
A. 0.4 × 109/L 
B. 2.5 × 109/L 
C. 4.0 × 109/L 
D. 8.0 × 109/L  

8. When an erythrocyte containing iron granules is stained with Prussian blue, the cell is called a: 
A. Spherocyte 
B. Leptocyte 
C. Schistocyte 
D. Siderocyte 

9. A 7.0-mL ethylenediaminetetraacetic acid (EDTA) tube is received in the laboratory containing only 2.0 mL of blood. If the laboratory is using manual techniques, which of the following tests will most likely be erroneous? 
A. RBC count 
B. Hemoglobin (Hgb) 
C. Hct 
D. WBC count 

10. A 1:200 dilution of a patient’s sample was made and 336 red cells were counted in an area of 0.2 mm2. What is the RBC count? 
A. 1.68 × 1012/L 
B. 3.36 × 1012/L 
C. 4.47 × 1012/L 
D. 6.66 × 1012/L

11. What phagocytic cells produce lysozymes that are bacteriocidal? 
A. Eosinophils 
B. Lymphocytes 
C. Platelets 
D. Neutrophils

12. If a patient has a reticulocyte count of 7% and an Hct of 20%, what is the corrected reticulocyte count? 
A. 1.4% 
B. 3.1% 
C. 3.5% 
D. 14% 

13. A decreased osmotic fragility test would be associated with which of the following conditions? 
A. Sickle cell anemia 
B. Hereditary spherocytosis 
C. Hemolytic disease of the newborn 
D. Acquired hemolytic anemia 

14. What effect would using a buffer at pH 6.0 have on a Wright’s-stained smear? 
A. Red cells would be stained too pink 
B. White cell cytoplasm would be stained too blue C. Red cells would be stained too blue 
D. Red cells would lyse on the slide 

15. Which of the following erythrocyte inclusions can be visualized with supravital stain but cannot be detected on a Wright’s-stained blood smear? 
A. Basophilic stippling 
B. Heinz bodies 
C. Howell–Jolly bodies 
D. Siderotic granules 

16. A falsely elevated Hct is obtained. Which of the following calculated values will not be affected? 
A. MCV 
B. MCH 
C. MCHC 
D. Red cell distribution width (RDW)  

17. A Miller disk is an ocular device used to facilitate counting of: 
A. Platelets 
B. Reticulocytes 
C. Sickle cells 
D. Nucleated red blood cells (NRBCs)

18. SITUATION: RBC indices obtained on an anemic patient are as follows: MCV 88 μm3 (fL); MCH 30 pg; MCHC 34% (.340). The RBCs on the peripheral smear would appear: 
A. Microcytic, hypochromic 
B. Microcytic, normochromic 
C. Normocytic, normochromic 
D. Normocytic, hypochromic 

19. All of the following factors may influence the erythrocyte sedimentation rate (ESR) except: 
A. Blood drawn into a sodium citrate tube 
B. Anisocytosis, poikilocytosis 
C. Plasma proteins 
D. Caliber of the tube 

20. What staining method is used most frequently to stain and manually count reticulocytes? 
A. Immunofluorescence 
B. Supravital staining 
C. Romanowsky staining 
D. Cytochemical staining 

21. The Coulter principle for counting of cells is based upon the fact that: 
A. Isotonic solutions conduct electricity better than cells do 
B. Conductivity varies proportionally to the number of cells 
C. Cells conduct electricity better than saline does 
D. Isotonic solutions cannot conduct electricity 

22. A correction is necessary for WBC counts when nucleated RBCs are seen on the peripheral smear because: 
A. The WBC count would be falsely lower 
B. The RBC count is too low 
C. Nucleated RBCs are counted as leukocytes 
D. Nucleated RBCs are confused with giant platelets 

23. Using an electronic cell counter analyzer, an increased RDW should correlate with: 
A. Spherocytosis 
B. Anisocytosis 
C. Leukocytosis 
D. Presence of NRBCs

24. Given the following values, which set of red blood cell indices suggests spherocytosis? 
A. MCV 76 μm3 MCH 19.9 pg MCHC 28.5% 
B. MCV 90 μm3 MCH 30.5 pg MCHC 32.5% 
C. MCV 80 μm3 MCH 36.5 pg MCHC 39.0% 
D. MCV 81 μm3 MCH 29.0 pg MCHC 34.8% 

25. Which of the following statistical terms reflects the best index of precision when comparing two CBC parameters? 
A. Mean 
B. Median 
C. Coefficient of variation 
D. Standard deviation  

26. Which of the following is considered a normal hemoglobin? 
A. Carboxyhemoglobin 
B. Methemoglobin 
C. Sulfhemoglobin 
D. Deoxyhemoglobin 

27. Which condition will shift the oxyhemoglobin dissociation curve to the right? 
A. Acidosis 
B. Alkalosis 
C. Multiple blood transfusions 
D. Increased quantities of hemoglobin S or C 

28. What is the major type of leukocyte seen in the peripheral smear of a patient with aplastic anemia? 
A. Segmented neutrophil 
B. Lymphocyte 
C. Monocyte 
D. Eosinophil 

29. What is the normal WBC differential lymphocyte percentage (range) in the adult population? 
A. 5%–10% 
B. 10%–20% 
C. 20%–44% 
D. 50%–70%

30. In which age group would 60% lymphocytes be a normal finding? 
A. 6 months–2 years 
B. 4–6 years 
C. 11–15 years 
D. 40–60 years 

31. Which of the following results on an automated differential suggests that a peripheral smear should be reviewed manually? 
A. Segs = 70% 
B. Band = 6% 
C. Mono = 15% 
D. Eos = 2% 

32. Which is the first stage of erythrocytic maturation in which the cytoplasm is pink due to the formation of hemoglobin? 
A. Reticulocyte 
B. Pronormoblast 
C. Basophilic normoblast 
D. Polychromatic normoblast 

33. Which of the following can shift the hemoglobin oxygen dissociation curve to the right? 
A. Increases in 2,3 DPG 
B. Acidosis 
C. Hypoxia 
D. All of these options 

34. Which of the following Hgb configurations is characteristic of Hgb H? 
A. γ4 
B. α2-γ2 
C. β4 
D. α2-β2 

35. Autoagglutination of red cells at room temperature can cause which of the following abnormal test results? 
A. Low RBC count 
B. High MCV 
C. Low hematocrit 
D. All of these options







THEN THE NEXT QUESTION WILL BE AVAILABLE ON THE 30TH AUGUST 

© Medical Laboratory Science Review 4th edition by Robert R. Harr

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