MLT ASCP Practice 2023 with verified questions and answers

Standard precautions apply to all of the following except: a. Blood b. Cerebrospinal fluid c. Semen d. Concentrated acids d. Concentrated acids The most important practice in preventing the spread of disease is: a. Wearing masks during patient contact b. Proper hand washing c. Wearing disposable laboratory coats d. Identifying specimens from known or suspected HIV- and HBV-infected patients with a red label b. Proper hand washing The appropriate dilution of bleach to use in laboratory disinfection is: a. 1:2 b. 1:5 c. 1:10 d. 1:100 d. 1:10 How frequently should fire alarms and sprinkler systems be tested? a. Weekly b. Monthly c. Quarterly d. Annually c. Quarterly Where should alcohol and other flammable chemicals be stored? a. In an approved safety can or storage cabinet away from heat sources b. Under a hood and arranged alphabetically for ease of identification in an emergency c. In a refrigerator at 2 C to 8 C to reduce volatilization d. On a low shelf in an area protected from light a. In an approved safety can or storage cabinet away from heat sources The most frequent cause of needle punctures is: a. Patient movement during venipuncture b. Improper disposal of phlebotomy equipment c. Inattention during removal of needle after venipuncture d. Failure to attach needle firmly to syringe or tube holder b. Improper disposal of phlebotomy equipment What class fire extinguisher would be appropriate to use on a fire in a chemical cabinet? a. Class A b. Class B c. Class C d. Class D b. Class B Select the needle most commonly used in standard venipuncture in an adult: a. One inch, 18 gauge b. One inch, 21 gauge c. One-half inch, 23 gauge d. One-half inch, 25 gauge b. One inch, 21 gauge The process of formation and development of blood cells is termed: a. Hematopoiesis b. Hematemesis c. Hematocytometry d. Hematorrhea a. Hematopoiesis During the second trimester of fetal development, the primary site of blood cell production is: a. Bone marrow b. Spleen c. Lymph nodes d. Liver d. Liver Which of the following organs is responsible for the maturation of T lymphocytes and regulation of their expression of CD4 and CD8? a. Spleen b. Liver c. Thymus d. Bone marrow c. Thymus The best source of active bone marrow from a 20-year-old would be: a. Iliac crest b. Femur c. Distal radius d. Tibia a. Iliac crest Physiologic programmed cell death is termed: a. Angiogenesis b. Apoptosis c. Aneurysm d. Apohematics b. Apoptosis Which organ is the site of sequestration of platelets? a. Liver b. Thymus c. Spleen d. Bone marrow c. Spleen Which one of the following cells is a product of the CLP? a. Megakaryocyte b. T lymphocyte c. Erythrocyte d. Granulocyte b. T lymphocyte What growth factor is produced in the kidneys and is used to treat anemia associated with kidney disease? a. EPO b. TPO c. G-CSF d. KIT ligand a. EPO Which one of the following cytokines is required very early in the differentiation of a hematopoietic stem cell? a. IL-2 b. IL-8 c. EPO d. FLT3 ligand d. FLT3 ligand Hematopoietic stem cells produce all lineages of blood cells in sufficient quantities over the lifetime of an individual because they: a. Are unipotent b. Have the ability of self-renewal by asymmetric division c. Are present in large numbers in the bone marrow niches d. Have a low mitotic potential in response to growth factors b. Have the ability of self-renewal by asymmetric division Which of the following is an erythrocyte progenitor? a. Pronormoblast b. Reticulocyte c. CFU-E d. Orthochromic normoblast c. CFU-E Which of the following is the most mature normoblast? a. Orthochromic normoblast b. Basophilic normoblast c. Pronormoblast d. Polychromatic normoblast a. Orthochromic normoblast Which of the following is not related to the effects of erythropoietin? a. The number of divisions of a normoblast b. The formation of pores in sinusoidal endothelial cells for marrow egress c. The time between mitoses of normoblasts d. The production of antiapoptotic molecules by erthroid progenitors b. The formation of pores in sinusoidal endothelial cells for marrow egress Hypoxia stimulates RBC production by: a. Inducing more pluripotent stem cells into erythroid lineage b. Stimulating EPO production by the kidney c. Increasing the number of RBC mitoses d. Stimulating the production of fibronectin by macrophages of the bone marrow b. Stimulating EPO production by the kidney In the bone marrow, RBC precursors are located: a. In the center of the hematopoietic cords b. Adjacent to megakaryocytes along the adventitial cell lining c. Surrounding fat cells in apoptotic islands d. Surrounding macrophages in erythroid islands d. Surrounding macrophages in erythroid islands What single feature of normal RBCs is most responsible for limiting their life span? a. Loss of mitochondria b. Increased flexibility of the cell membrane c. Reduction of hemoglobin iron d. Loss of the nucleus d. Loss of the nucleus Intravascular or fragmentation hemolysis is the result of trauma to RBCs in the circulation. True or false. True Extravascular hemolysis can occur when: a. RBCs are mechanically ruptured b. RBCs extravasate for the blood vessels into the tissues c. Splenic macrophages ingest senescent cells d. Erythrocytes are trapped in blood clots outside the blood vessels c. Splenic macrophages ingest senescent cells Which RBC process does not require energy? a. Oxygen transport b. Cytoskeletal protein deformability c. Preventing the peroxidation of proteins and lipids d. Maintaining cytoplasm cationic electrochemical gradients a. Oxygen transport What pathyway anaerobically generates energy in the form of ATP? a. Hexose monophosphate pathway b. Rapoport-Luebering pathway c. Embden-Meyerhof pathway d. 2,3-BPG pathway c. Embden-Meyerhof pathway To survive, the RBC must detoxify peroxides. What hexose-monophosphate shunt product(s) accomplishes detoxification? a. ATP b. 2,3 BPG c. Pyruvic acid and lactic acid d. NADPH and reduced glutathione d. NADPH and reduced glutathione Which of the following helps maintain RBC shape? a. Membrane phospholipids b. Cytoskeletal proteins c. GPI anchor d. Glycocalyx b. Cytoskeletal proteins The glycolipids of the RBC membrane: a. Provide flexibility b. Carry RBC antigens c. Constitute ion channels d. Attach the cytoskeleton to the lipid layer b. Carry RBC antigens Which of the following is an example of a transmembrane or integral membrane protein? a. Glycophorin A b. Ankyrin c. Spectrin d. Actin ... RBC phospholipids are arranged: a. In a hexagonal lattice b. In chains beneath a protein exoskeleton c. In two layers whose composition is asymmetric d. So that hydrophobic portions are facing the plasma c. In two layers whose composition is asymmetric A hemoglobin molecule is composed of: a. One heme molecule and four globin chains b. Ferrous iron, protoporphyrin IX, and a globin chain c. Protoporphyrin IX and four globin chains d. Four heme molecules and four globin chains d. Four heme molecules and four globin chains Which of the following forms of hemoglobin molecule has the lowest affinity for oxygen? a. Tense b. Relaxed a. Tense The predominant hemoglobin found in a healthy newborn is: a. Gower-1 b. Gower-2 c. A d. F d. F Which of the following is a description of the structure of oxidized hemoglobin? a. Hemoglobin carrying oxygen on heme; synonymous with oxygenated hemoglobin b. Hemoglobin with iron in the ferric state (methemoglobin) and not able to carry oxygen c. Hemoglobin with iron in the ferric state so that carbon dioxide replaces oxygen in the heme structure d. Hemoglobin carrying carbon monoxide; hence "oxidized" refers to the single oxygen b. Hemoglobin with iron in the ferric state (methemoglobin) and not able to carry oxygen In the quaternary structure of hemoglobin, the globin chains associate into: a. a tetramers in some cells and B tetramers in others b. A mixture of a tetramers and B tetramers c. a dimers and B dimers d. Two aB dimers d. Two aB dimers Iron is transported in plasma via: a. Hemosiderin b. Ferritin c. Transferrin d. Hemoglobin c. Transferrin What is the major metabolically available storage form of iron in the body? a. Hemosiderin b. Ferritin c. Transferrin d. Hemoglobin b. Ferritin The total iron-binding capacity (TIBC) of the serum is an indirect measure of which iron-related protein? a. Hemosiderin b. Ferritin c. Transferrin d. Hemoglobin c. Transferrin For a patient with classic iron study values that are equivocal for iron deficiency, which of the following tests would be most helpful in determining whether iron deficiency is present or not? a. Zinc protoporphyrin b. Peripheral blood sideroblast assessment c. Soluble transferrin receptor d. Mean cell hemoglobin c. Soluble transferrin receptor What membrane-associated protein in enterocytes transports iron from the intestinal lumen into the enterocyte? a. Transferrin b. Ferroportin c. DMT1 d. Ferrochelatase c. DMT1 Iron is transported out of macrophages, hepatocytes, and enterocytes by what membrane protein? a. Transferrin b. Ferroportin c. DMT1 d. Ferrochelatase b. Ferroportin What is the fate of the transferrin receptor when it has completed its role in the delivery of iron to a cell? a. It is recycled to the plasma membrane and released into the plasma b. It is recycled to the plasma membrane, where it can bind its ligand again c. It is catabolized and the amino acids are returned to the metabolic pool d. It is retained in the endosome for the life span of the cell b. It is recycled to the plasma membrane, where it can bind its ligand again The transfer of iron from the enterocyte into the plasma is regulated by: a. Transferrin b. Ferroportin c. Hephaestin d. Hepcidin d. Hepcidin Neutrophils and monocytes are direct descendants of a: a. CLP b. GMP c. MEP d. HSC b. GMP The stage in neutrophilic development in which the nucleus is indented in a kidney bean shape and the cytoplasm has secondary granules that are lavender in color is the: a. Band b. Myelocyte c. Promyelocyte d. Metamyelocyte d. Metamyelocyte Type II myeloblasts are characterized by: a. Presence of fewer than 20 primary granules per cell b. Basophilic cytoplasm with many secondary granules c. Absence of granules d. Presence of a folded nucleus a. Presence of fewer than 20 primary granules per cell Which one of the following is a function of neutrophils? a. Presentation of antigen to T and B lymphocytes b. Protection against reexposure by same antigen c. Nonspecific destruction of foreign organisms d. Initiation of delayed hypersensitivity response c. Nonspecific destruction of foreign organisms Which of the following cells are important in immune regulation, allergic inflammation, and destruction of tissue invading helminths? a. Neutrophils and monocytes b. Eosinophils and basophils c. T and B lymphocytes d. Macrophages and dendritic cells b. Eosinophils and basophils Basophils and mast cells have high-affinity surface receptors for which immunoglobulin? a. A b. D c. E d. G c. E Which of the following cell types is capable of differentiating into osteoclasts, macrophages, or dentritic cells? a. Neutrophils b. Lymphocytes c. Monocytes d. Eosinophils c. Monocytes Macrophages aid in adaptive immunity by: a. Degrading antigen and presenting it to lymphocytes b. Ingesting and digesting organisms that neutrophils cannot c. Synthesizing complement components d. Storing iron from senescent red cells a. Degrading antigen and presenting it to lymphocytes Which of the following is the final stage of B cell maturation after activation by antigen? a. Large, granular lymphocyte b. Plasma cell c. Reactive lymphocyte d. Immunoblast b. Plasma cell The following is unique to both B and T lymphocytes and occurs during their early development: a. Expression of surface antigens CD4 and CD8 b. Maturation in the thymus c. Synthesis of immunoglobulins d. Rearrangement of antigen receptor genes d. Rearrangement of antigen receptor genes The megakaryocyte progenitor that undergoes endomitosis is: a. MK-I b. BFU-Meg c. CFU-Meg d. LD-CFU-Meg d. LD-CFU-Meg The growth factor that is produced in the kidney and induces growth and differentiation of committed megakaryocyte progenitors is: a. IL-3 b. IL-6 c. IL-11 d. TPO d. TPO What platelet organelle sequesters ionic calcium and binds a series of enzymes of the eicosanoid pathway? a. G protein b. Dense granules c. DTS d. SCCS c. DTS What platelet membrane phospholipid flips from the inner surface to the plasma surface on activation and serves as the assembly point for coagulation factors? a. Phosphatidyletanolamine b. Phosphatidylinositol c. Phosphatidylcholine d. Phosphatidylserine b. Phosphatidylinositol What is the name of the eicosanoid metabolite produced from endothelial cells that suppresses platelet activity? a. TXA2 b. Arachidonic acid c. Cyclooxygenase d. Prostacyclin d. Prostacyclin Which of the following molecules is stored in platelet dense granules? a. Serotonin b. Fibrinogen c. PF4 d. Platelet-derived growth factor a. Serotonin What plasma protein is essential to platelet adhesion? a. VWF b. Factor VIII c. Fibrinogen d. P-selectin a. VWF Reticulated platelets can be enumerated in peripheral blood to detect: a. Impaired production in disease states b. Abnormal organelles associated with diseases such as leukemia c. Increased platelet production in response to need d. Inadequate rates of membrane cholesterol exchange with the plasma c. Increased platelet production in response to need Platelet adhesion refers to platelets: a. Sticking to other platelets b. Releasing platelet granule constituents c. Providing the surface for assembly of coagulation factors d. Sticking to surfaces such as subendothelial collagen d. Sticking to surfacs such as subendothelial collagen What does reticulocyte count assess? a. Inflammation b. Response to infection c. Erythropoietic activity of the bone marrow d. Ability of red blood cells to form rouleaux c. Erythropoietic activity of the bone marrow A patient has a hemoglobin level of 8.0 g/dL. According to the rule of three, what is the expected range for the hematocrit? a. 21% to 24% b. 23.7% to 24.3% c. 24% to 27% d. 21% to 27% d. 21% to 27% Which of the following would be associated with an elevated ESR value? a. Microcytosis b. Polycythemia c. Decreased globulins d. Inflammation d. Inflammation Where is the most hematopoietic tissue found in adults? a. Liver b. Lungs c. Spleen d. Long bones c. Spleen What is the preferred bone marrow collection site in adults? a. Second intercostal space on the sternum b. Anterior or posterior iliac crest c. Any of the thoracic vertebrae d. Anterior head of the femur b. Anterior or posterior iliac crest The aspirate should be examined under low power to assess all of the following except: a. Cellularity b. Megakaryocyte numbers c. Morphology of abnormal cells d. Presence of tumor cell clusters c. Morphology of abnormal cells Which are the most common erythrocytic stages found in normal marrow? a. Pronormoblasts b. Pronormoblasts and basophilic normoblasts c. Basophilic and polychromatophilic normoblasts d. Polychromatophilic and orthochromic normoblasts d. Polychromatophilic and orthochromic normoblasts What cells, occasionally seen in bone marrow biopsy specimens, are responsible for the formation of bone? a. Macrophages b. Plasma cells c. Osteoblasts d. Osteoclasts c. Osteoblasts What is the largest hematopoietic cell found in a normal bone marrow aspirate? a. Osteoblast b. Myeloblast c. Pronormoblast d. Megakaryocyte d. Megakaryocyte All of the following cells are normally seen in CSF, serous fluids, and synovial fluids except: a. Lining cells b. Neutrophils c. Lymphocytes d. Monocytes/histiocytes (macrophages) b. Neutrophils Which of the following patients would be considered anemic with a hemoglobin value of 14.5 g/dL? Refer to reference intervals inside the front cover of this text. a. An adult man b. An adult woman c. A newborn boy d. A 10-year-old girl c. A newborn boy Common clinical symptoms of anemia include: a. Splenomegaly b. Shortness of breath and fatigue c. Chills and fever d. Jaundice and enlarged lymph nodes b. Shortness of breath and fatigue Which of the following are important to consider in the patient's history when investigating the cause of an anemia? a. Diet and medications b. Occupation, hobbies, and travel c. Bleeding episodes in the patient or in his or her family members d. All of the above d. All of the above Which of the following is reduced as an adaptation to long-standing anemia? a. Heart rate b. Respiratory rate c. Oxygen affinity of hemoglobin d. Volume of blood ejected from the heart with each contration c. Oxygen affinity of hemoglobin What are the initial laboratory tests that are performed for the diagnosis of anemia? a. CBC, iron studies, and reticulocyte count b. CBC, reticulocyte count, and peripheral blood film examination c. Reticulocyte count and serum iron, vitamin B12, and folate assays d. Bone marrow study, iron studies, and peripheral blood film examination b. CBC, reticulocyte count, and peripheral blood film examination An increase in which one of the following suggests a shortened life span of RBCs and hemolytic anemia? a. Hemoglobin b. Hematocrit c. Reticulocyte count d. Red cell distribution width `c. Reticulocyte count Which of the following is only detectable by examination of a peripheral blood film? a. Microcytosis b. Anisocytosis c. Hypochromia d. Poikilocytosis d. Poikilocytosis Schistocytes, ovalocytes, and acanthocytes, are examples of abnormal changes in RBC: a. Volume b. Shape c. Inclusions d. Hemoglobin concentration b. Shape In men and postmenopausal women whose diets are adequate, iron deficiency anemia most often results from: a. Increased need associated with aging b. Impaired absorption in the gastric mucosa c. Chronic gastrointestinal bleeding d. Diminished resistance to hookworm infections c. Chronic gastrointestinal bleeding In what situation will increased levels of free erythrocyte protoporphyrin be present? a. Gain of function mutation to one of the enzymes in the heme synthesis pathway b. A mutation that prevents heme attachment to globin so that protoporphyrin remains free c. Any condition that prevents iron incorporation into protoporphyrin IX d. When red blood cells lyse, freeing their contents into the plasma c. Any condition that prevents iron incorporation into protoporphyrin IX Sideroblastic anemia result from: a. Sequestration of iron in hepatocytes b. Inability to incorporate heme into apohemoglobin c. Sequestration of iron in myeloblasts d. Failure to incorporate iron into protoporphyrin IX d. Failure to incorporate iron into protoporphyrin IX In general, the hereditary hemochromatoses result from mutations that impair: a. The manner in which developing red cells acquire and manage iron b. The hepcidin-ferroportin iron regulatory system c. The TfR-Tf endocytic iron acquisition process for body cells other than blood cells d. The function of divalent metal transporter in enterocytes and macrophages b. The hepcidin-ferroportin iron regulatory system In the erythropoietic prophyrias, mild anemia may be accompanied by what distinctive clinical finding? a. Gallstones b. Impaired night vision c. Unintentional nighttime lef movements d. Heightened propensity for sunburn d. Heightened propensity for sun