UAMS HEMATOLOGY LAB FINAL EXAM 200 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
LATEST 2026 ALREADY GRADED A+
This comprehensive 200-question UAMS Hematology Lab exam bank
provides a rigorous review of essential hematology concepts for medical
laboratory science students and professionals. Each question is uniquely
crafted with clinical scenarios, multiple-choice options, a definitive correct
answer, and a detailed rationale explaining the underlying pathophysiology,
laboratory methodology, and diagnostic significance. Content spans
peripheral smear preparation, erythrocyte morphology, anemias (microcytic,
macrocytic, hemolytic), leukemias (acute and chronic), myeloproliferative
neoplasms, platelet disorders, coagulation defects, hemoglobinopathies, bone
marrow interpretation, immunophenotyping, and special stains. Designed to
align with UAMS Hematology curriculum standards, this resource promotes
critical thinking, identifies knowledge gaps, and enhances test-taking
strategies for successful examination performance and clinical application in
hematology laboratory practice.
1. What is the smear preparation process for a peripheral blood smear?
A) Place a drop of blood on the frosted end, spread with a coverslip at 15 degrees
B) Place a drop of blood 1/2 inch from the frosted end of a slide, use a spreader
slide at 30-45 degrees, pull back into the drop, allow blood to spread, then push
forward smoothly
C) Place a drop of blood in the center of the slide, tilt the slide to allow blood to
run to the edge
D) Place a drop of blood on a coverslip, invert onto a slide, and pull apart
Correct Answer: B) Place a drop of blood 1/2 inch from the frosted end of a slide,
use a spreader slide at 30-45 degrees, pull back into the drop, allow blood to
spread, then push forward smoothly
Rationale: Proper smear preparation requires a drop of EDTA blood placed 1/2
inch from the frosted end, with a spreader slide angled at 30-45 degrees pulled
back into the drop, allowing blood to spread across the width, then pushed
smoothly forward .
2. What tools are needed to prepare a peripheral blood smear?
A) Glass slides, blood, coverslip
,B) Glass slides, blood, spreader slide, coverslip
C) Glass slides, blood, spreader slide, coverslip, pipette
D) Glass slides, blood, spreader slide only
Correct Answer: A) Glass slides, blood, coverslip
Rationale: The basic tools needed for preparing a peripheral blood smear are glass
slides, blood, and a coverslip. The coverslip is used as the spreader device .
3. Which of the following causes a false increase in MCV on an automated
hematology analyzer?
A) Spherocytosis
B) Cold agglutinins
C) Microcytosis
D) Iron deficiency anemia
Correct Answer: B) Cold agglutinins
Rationale: Cold agglutinins cause red blood cells to agglutinate at room
temperature, leading to erroneous elevation of MCV on automated analyzers as the
instrument counts agglutinated cell clumps as single enlarged cells .
4. Which stain is best for visualizing Heinz bodies?
A) Wright-Giemsa stain
B) Leishman stain
C) Supravital stain (e.g., crystal violet or brilliant cresyl blue)
D) Prussian blue stain
Correct Answer: C) Supravital stain (e.g., crystal violet or brilliant cresyl blue)
Rationale: Heinz bodies are denatured hemoglobin precipitates that are not visible
with routine Wright-Giemsa stain. They require supravital staining with dyes such
as crystal violet or brilliant cresyl blue for visualization .
5. A 60-year-old man presents with weight loss, night sweats, marked leukocytosis
with left shift and basophilia, and a low LAP score. What is the most likely
diagnosis?
A) Chronic myeloid leukemia
B) Leukemoid reaction
C) Acute myeloblastic leukemia
D) Polycythemia vera
Correct Answer: A) Chronic myeloid leukemia
Rationale: CML presents with marked leukocytosis, left shift, basophilia, and a
low leukocyte alkaline phosphatase (LAP) score. The Philadelphia chromosome
t(9;22) is characteristic. Leukemoid reaction would have a high LAP score .
,6. What is the minimum percentage of blasts in bone marrow required for a
diagnosis of acute leukemia according to WHO?
A) 10%
B) 15%
C) 20%
D) 30%
Correct Answer: C) 20%
Rationale: The WHO classification requires 20% or more blasts in the bone
marrow for the diagnosis of acute leukemia. This threshold distinguishes acute
from chronic leukemias .
7. Which chromosomal translocation is characteristically associated with chronic
myeloid leukemia (CML)?
A) t(15;17)(q22;q12)
B) t(11;14)(p15;q11)
C) t(9;22)(q34;q11.2)
D) t(8;21)(q22;q22)
Correct Answer: C) t(9;22)(q34;q11.2)
Rationale: The Philadelphia chromosome, t(9;22)(q34;q11.2), is characteristic of
CML. This translocation creates the BCR-ABL fusion gene leading to uncontrolled
myeloid proliferation .
8. A patient presents with evidence of hemolytic anemia with spherocytes,
polychromasia, and macrocytosis. Which test would best distinguish the cause?
A) Osmotic fragility
B) Direct antiglobulin test (DAT)
C) G6PD activity assay
D) Vitamin B12 level
Correct Answer: B) Direct antiglobulin test (DAT)
Rationale: The DAT detects antibodies or complement bound to red cells. It
distinguishes immune-mediated hemolytic anemia (DAT positive) from hereditary
spherocytosis or other non-immune causes (DAT negative) .
9. Hereditary elliptocytosis results from defects in which of the following?
A) Ankyrin
B) Band 3 protein
C) Spectrin
D) Pyruvate kinase
Correct Answer: C) Spectrin
, Rationale: Hereditary elliptocytosis is caused by defects in spectrin, a cytoskeletal
protein essential for maintaining red blood cell shape. Mutations in spectrin lead to
elliptically shaped erythrocytes .
10. In a patient with chronic renal failure presenting with normocytic,
normochromic anemia and low reticulocyte count, what best explains the anemia?
A) Decreased erythropoietin production
B) Hemolysis
C) Iron deficiency
D) Megaloblastic anemia
Correct Answer: A) Decreased erythropoietin production
Rationale: The kidney produces erythropoietin in response to hypoxia. In chronic
renal failure, reduced erythropoietin production leads to normocytic,
normochromic anemia with an inappropriately low reticulocyte response .
11. A patient has a hemoglobin of 7.0 g/dL, hematocrit of 21%, MCV of 68 fL,
MCH of 22 pg, and MCHC of 28 g/dL. What is the morphological classification of
this anemia?
A) Normocytic, normochromic
B) Macrocytic, normochromic
C) Microcytic, hypochromic
D) Microcytic, normochromic
Correct Answer: C) Microcytic, hypochromic
Rationale: This patient has a low MCV (<80 fL) indicating microcytic anemia and
low MCHC (<32 g/dL) indicating hypochromic anemia. This pattern is
characteristic of iron deficiency anemia, thalassemia, or anemia of chronic disease
.
12. A 5-year-old girl with a history of chronic infections, easy bruising, and poor
wound healing has a platelet count of 40,000/µL. Her platelets are small on the
smear. What is the most likely diagnosis?
A) Idiopathic thrombocytopenic purpura
B) Wiskott-Aldrich syndrome
C) Bernard-Soulier syndrome
D) Glanzmann's thrombasthenia
Correct Answer: B) Wiskott-Aldrich syndrome
Rationale: Wiskott-Aldrich syndrome is an X-linked recessive disorder
characterized by thrombocytopenia with small platelets, eczema, and recurrent
infections due to immune deficiency. Bernard-Soulier syndrome also has
thrombocytopenia with giant platelets, not small platelets .
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
LATEST 2026 ALREADY GRADED A+
This comprehensive 200-question UAMS Hematology Lab exam bank
provides a rigorous review of essential hematology concepts for medical
laboratory science students and professionals. Each question is uniquely
crafted with clinical scenarios, multiple-choice options, a definitive correct
answer, and a detailed rationale explaining the underlying pathophysiology,
laboratory methodology, and diagnostic significance. Content spans
peripheral smear preparation, erythrocyte morphology, anemias (microcytic,
macrocytic, hemolytic), leukemias (acute and chronic), myeloproliferative
neoplasms, platelet disorders, coagulation defects, hemoglobinopathies, bone
marrow interpretation, immunophenotyping, and special stains. Designed to
align with UAMS Hematology curriculum standards, this resource promotes
critical thinking, identifies knowledge gaps, and enhances test-taking
strategies for successful examination performance and clinical application in
hematology laboratory practice.
1. What is the smear preparation process for a peripheral blood smear?
A) Place a drop of blood on the frosted end, spread with a coverslip at 15 degrees
B) Place a drop of blood 1/2 inch from the frosted end of a slide, use a spreader
slide at 30-45 degrees, pull back into the drop, allow blood to spread, then push
forward smoothly
C) Place a drop of blood in the center of the slide, tilt the slide to allow blood to
run to the edge
D) Place a drop of blood on a coverslip, invert onto a slide, and pull apart
Correct Answer: B) Place a drop of blood 1/2 inch from the frosted end of a slide,
use a spreader slide at 30-45 degrees, pull back into the drop, allow blood to
spread, then push forward smoothly
Rationale: Proper smear preparation requires a drop of EDTA blood placed 1/2
inch from the frosted end, with a spreader slide angled at 30-45 degrees pulled
back into the drop, allowing blood to spread across the width, then pushed
smoothly forward .
2. What tools are needed to prepare a peripheral blood smear?
A) Glass slides, blood, coverslip
,B) Glass slides, blood, spreader slide, coverslip
C) Glass slides, blood, spreader slide, coverslip, pipette
D) Glass slides, blood, spreader slide only
Correct Answer: A) Glass slides, blood, coverslip
Rationale: The basic tools needed for preparing a peripheral blood smear are glass
slides, blood, and a coverslip. The coverslip is used as the spreader device .
3. Which of the following causes a false increase in MCV on an automated
hematology analyzer?
A) Spherocytosis
B) Cold agglutinins
C) Microcytosis
D) Iron deficiency anemia
Correct Answer: B) Cold agglutinins
Rationale: Cold agglutinins cause red blood cells to agglutinate at room
temperature, leading to erroneous elevation of MCV on automated analyzers as the
instrument counts agglutinated cell clumps as single enlarged cells .
4. Which stain is best for visualizing Heinz bodies?
A) Wright-Giemsa stain
B) Leishman stain
C) Supravital stain (e.g., crystal violet or brilliant cresyl blue)
D) Prussian blue stain
Correct Answer: C) Supravital stain (e.g., crystal violet or brilliant cresyl blue)
Rationale: Heinz bodies are denatured hemoglobin precipitates that are not visible
with routine Wright-Giemsa stain. They require supravital staining with dyes such
as crystal violet or brilliant cresyl blue for visualization .
5. A 60-year-old man presents with weight loss, night sweats, marked leukocytosis
with left shift and basophilia, and a low LAP score. What is the most likely
diagnosis?
A) Chronic myeloid leukemia
B) Leukemoid reaction
C) Acute myeloblastic leukemia
D) Polycythemia vera
Correct Answer: A) Chronic myeloid leukemia
Rationale: CML presents with marked leukocytosis, left shift, basophilia, and a
low leukocyte alkaline phosphatase (LAP) score. The Philadelphia chromosome
t(9;22) is characteristic. Leukemoid reaction would have a high LAP score .
,6. What is the minimum percentage of blasts in bone marrow required for a
diagnosis of acute leukemia according to WHO?
A) 10%
B) 15%
C) 20%
D) 30%
Correct Answer: C) 20%
Rationale: The WHO classification requires 20% or more blasts in the bone
marrow for the diagnosis of acute leukemia. This threshold distinguishes acute
from chronic leukemias .
7. Which chromosomal translocation is characteristically associated with chronic
myeloid leukemia (CML)?
A) t(15;17)(q22;q12)
B) t(11;14)(p15;q11)
C) t(9;22)(q34;q11.2)
D) t(8;21)(q22;q22)
Correct Answer: C) t(9;22)(q34;q11.2)
Rationale: The Philadelphia chromosome, t(9;22)(q34;q11.2), is characteristic of
CML. This translocation creates the BCR-ABL fusion gene leading to uncontrolled
myeloid proliferation .
8. A patient presents with evidence of hemolytic anemia with spherocytes,
polychromasia, and macrocytosis. Which test would best distinguish the cause?
A) Osmotic fragility
B) Direct antiglobulin test (DAT)
C) G6PD activity assay
D) Vitamin B12 level
Correct Answer: B) Direct antiglobulin test (DAT)
Rationale: The DAT detects antibodies or complement bound to red cells. It
distinguishes immune-mediated hemolytic anemia (DAT positive) from hereditary
spherocytosis or other non-immune causes (DAT negative) .
9. Hereditary elliptocytosis results from defects in which of the following?
A) Ankyrin
B) Band 3 protein
C) Spectrin
D) Pyruvate kinase
Correct Answer: C) Spectrin
, Rationale: Hereditary elliptocytosis is caused by defects in spectrin, a cytoskeletal
protein essential for maintaining red blood cell shape. Mutations in spectrin lead to
elliptically shaped erythrocytes .
10. In a patient with chronic renal failure presenting with normocytic,
normochromic anemia and low reticulocyte count, what best explains the anemia?
A) Decreased erythropoietin production
B) Hemolysis
C) Iron deficiency
D) Megaloblastic anemia
Correct Answer: A) Decreased erythropoietin production
Rationale: The kidney produces erythropoietin in response to hypoxia. In chronic
renal failure, reduced erythropoietin production leads to normocytic,
normochromic anemia with an inappropriately low reticulocyte response .
11. A patient has a hemoglobin of 7.0 g/dL, hematocrit of 21%, MCV of 68 fL,
MCH of 22 pg, and MCHC of 28 g/dL. What is the morphological classification of
this anemia?
A) Normocytic, normochromic
B) Macrocytic, normochromic
C) Microcytic, hypochromic
D) Microcytic, normochromic
Correct Answer: C) Microcytic, hypochromic
Rationale: This patient has a low MCV (<80 fL) indicating microcytic anemia and
low MCHC (<32 g/dL) indicating hypochromic anemia. This pattern is
characteristic of iron deficiency anemia, thalassemia, or anemia of chronic disease
.
12. A 5-year-old girl with a history of chronic infections, easy bruising, and poor
wound healing has a platelet count of 40,000/µL. Her platelets are small on the
smear. What is the most likely diagnosis?
A) Idiopathic thrombocytopenic purpura
B) Wiskott-Aldrich syndrome
C) Bernard-Soulier syndrome
D) Glanzmann's thrombasthenia
Correct Answer: B) Wiskott-Aldrich syndrome
Rationale: Wiskott-Aldrich syndrome is an X-linked recessive disorder
characterized by thrombocytopenia with small platelets, eczema, and recurrent
infections due to immune deficiency. Bernard-Soulier syndrome also has
thrombocytopenia with giant platelets, not small platelets .
