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CLINICAL HEMATOLOGY AND FUNDAMENTALS OF HEMOSTASIS, 6TH
EDITION BY DENISE M. HARMENING — EXAM QUESTIONS AND
CORRECT ANSWERS LATEST EDITION 2026
Clinical Hematology and Fundamentals of Hemostasis, 6th Edition by Denise M. Harmening —
Questions
Section 1: Hematopoiesis and Blood Cell Maturation
1. What is meant by medullary hematopoiesis?
A) Hematopoiesis in the spleen
B) Hematopoiesis in marrow
C) Hematopoiesis in liver
D) Hematopoiesis in thymus
Answer: B
Rationale: Medullary hematopoiesis refers to blood cell production occurring in the bone
marrow, which is the primary site of hematopoiesis in adults .
2. The hematopoietic system consists of all the following except:
A) Thymus
B) Bone marrow
C) Kidneys
D) Spleen
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Answer: C
Rationale: The hematopoietic system includes the bone marrow, thymus, spleen, and lymph
nodes. The kidneys are not part of the hematopoietic system, although they produce
erythropoietin .
3. What is the sequence of maturity for the erythrocyte?
A) Pronormoblast, basophilic normoblast, polychromatophilic normoblast, orthochromatic
normoblast, reticulocyte, erythrocyte
B) Basophilic normoblast, pronormoblast, orthochromatic normoblast, reticulocyte, erythrocyte
C) Orthochromatic normoblast, pronormoblast, reticulocyte, erythrocyte, basophilic normoblast
D) Polychromatophilic normoblast, orthochromatic normoblast, pronormoblast, erythrocyte
Answer: A
Rationale: The correct sequence of erythrocyte maturation is: pronormoblast → basophilic
normoblast → polychromatophilic normoblast → orthochromatic normoblast → reticulocyte →
erythrocyte .
4. By increasing hematopoiesis, the hematopoietic system can respond to stimuli such as:
A) Homeostasis
B) Hypoxia
C) Clotting
D) Hyperplasia
Answer: B
Rationale: Hypoxia (decreased oxygen) stimulates increased hematopoiesis, particularly
erythropoiesis, to improve oxygen-carrying capacity .
5. In which immature erythroid cell are nucleoli most visible?
A) Basophilic normoblast
B) Orthochromatic normoblast
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C) Pronormoblast
D) Polychromatic normoblast
Answer: C
Rationale: Nucleoli are most prominent in the pronormoblast (proerythroblast), the earliest
recognizable erythroid precursor .
6. What is the average diameter of a normal erythrocyte?
A) 3–5 µm
B) 2–4 µm
C) 8–10 µm
D) 7–8 µm
Answer: D
Rationale: Normal erythrocytes have an average diameter of 7–8 µm, which allows them to
pass through capillaries .
7. What percentage of erythrocytes is functional in peripheral blood after release from the
bone marrow?
A) 70%
B) 50%
C) 80%
D) 100%
Answer: D
Rationale: After release from bone marrow, 100% of erythrocytes are functional in peripheral
blood. Reticulocytes mature within 24–48 hours .
8. Which growth factor is primarily responsible for stimulating erythropoiesis?
A) G-CSF
B) GM-CSF
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C) Erythropoietin
D) Thrombopoietin
Answer: C
Rationale: Erythropoietin, produced primarily by the kidneys, is the primary growth factor
stimulating red blood cell production.
9. Where does hematopoiesis occur in the fetus?
A) Liver and spleen
B) Bone marrow only
C) Thymus only
D) Kidneys
Answer: A
Rationale: Fetal hematopoiesis initially occurs in the yolk sac, then the liver and spleen, before
transitioning to bone marrow.
10. What is the first recognizable cell in the granulocytic lineage?
A) Myeloblast
B) Promyelocyte
C) Myelocyte
D) Metamyelocyte
Answer: A
Rationale: The myeloblast is the first recognizable cell in the granulocytic series.
11. What is the last cell in the granulocytic lineage that can undergo cell division?
A) Myeloblast
B) Promyelocyte
C) Myelocyte
D) Metamyelocyte
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CLINICAL HEMATOLOGY AND FUNDAMENTALS OF HEMOSTASIS, 6TH
EDITION BY DENISE M. HARMENING — EXAM QUESTIONS AND
CORRECT ANSWERS LATEST EDITION 2026
Clinical Hematology and Fundamentals of Hemostasis, 6th Edition by Denise M. Harmening —
Questions
Section 1: Hematopoiesis and Blood Cell Maturation
1. What is meant by medullary hematopoiesis?
A) Hematopoiesis in the spleen
B) Hematopoiesis in marrow
C) Hematopoiesis in liver
D) Hematopoiesis in thymus
Answer: B
Rationale: Medullary hematopoiesis refers to blood cell production occurring in the bone
marrow, which is the primary site of hematopoiesis in adults .
2. The hematopoietic system consists of all the following except:
A) Thymus
B) Bone marrow
C) Kidneys
D) Spleen
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,Page 2 of 75
Answer: C
Rationale: The hematopoietic system includes the bone marrow, thymus, spleen, and lymph
nodes. The kidneys are not part of the hematopoietic system, although they produce
erythropoietin .
3. What is the sequence of maturity for the erythrocyte?
A) Pronormoblast, basophilic normoblast, polychromatophilic normoblast, orthochromatic
normoblast, reticulocyte, erythrocyte
B) Basophilic normoblast, pronormoblast, orthochromatic normoblast, reticulocyte, erythrocyte
C) Orthochromatic normoblast, pronormoblast, reticulocyte, erythrocyte, basophilic normoblast
D) Polychromatophilic normoblast, orthochromatic normoblast, pronormoblast, erythrocyte
Answer: A
Rationale: The correct sequence of erythrocyte maturation is: pronormoblast → basophilic
normoblast → polychromatophilic normoblast → orthochromatic normoblast → reticulocyte →
erythrocyte .
4. By increasing hematopoiesis, the hematopoietic system can respond to stimuli such as:
A) Homeostasis
B) Hypoxia
C) Clotting
D) Hyperplasia
Answer: B
Rationale: Hypoxia (decreased oxygen) stimulates increased hematopoiesis, particularly
erythropoiesis, to improve oxygen-carrying capacity .
5. In which immature erythroid cell are nucleoli most visible?
A) Basophilic normoblast
B) Orthochromatic normoblast
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C) Pronormoblast
D) Polychromatic normoblast
Answer: C
Rationale: Nucleoli are most prominent in the pronormoblast (proerythroblast), the earliest
recognizable erythroid precursor .
6. What is the average diameter of a normal erythrocyte?
A) 3–5 µm
B) 2–4 µm
C) 8–10 µm
D) 7–8 µm
Answer: D
Rationale: Normal erythrocytes have an average diameter of 7–8 µm, which allows them to
pass through capillaries .
7. What percentage of erythrocytes is functional in peripheral blood after release from the
bone marrow?
A) 70%
B) 50%
C) 80%
D) 100%
Answer: D
Rationale: After release from bone marrow, 100% of erythrocytes are functional in peripheral
blood. Reticulocytes mature within 24–48 hours .
8. Which growth factor is primarily responsible for stimulating erythropoiesis?
A) G-CSF
B) GM-CSF
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C) Erythropoietin
D) Thrombopoietin
Answer: C
Rationale: Erythropoietin, produced primarily by the kidneys, is the primary growth factor
stimulating red blood cell production.
9. Where does hematopoiesis occur in the fetus?
A) Liver and spleen
B) Bone marrow only
C) Thymus only
D) Kidneys
Answer: A
Rationale: Fetal hematopoiesis initially occurs in the yolk sac, then the liver and spleen, before
transitioning to bone marrow.
10. What is the first recognizable cell in the granulocytic lineage?
A) Myeloblast
B) Promyelocyte
C) Myelocyte
D) Metamyelocyte
Answer: A
Rationale: The myeloblast is the first recognizable cell in the granulocytic series.
11. What is the last cell in the granulocytic lineage that can undergo cell division?
A) Myeloblast
B) Promyelocyte
C) Myelocyte
D) Metamyelocyte
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