HEMATOLOGY hiral full ascp

The light-colored zone adjacent to the nucleus in a plasmacyte is the: A. ribosome B. chormatin C. mitochondira D. Golgi area - answerD. Golgi area The majority of the iron in an adult is found as a constituent of: A. hemoglobin B. hemosiderin C. myglobin D. transferrin - answerA. hemoglobin The main function of the hexose monophosphate shunt in the erythrocyte is to: A. regulate the level of 2,3-DPG B. provide reduced glutathione to prevent oxidation of hemoglobin C. prevent the reduction of heme iron D. provide energy for membrane maintainance - answerB. provide reduced glutathione to prevent oxidation of hemoglobin Which curve represents the production of alpha polypeptide chains of hemoglobin? A. A B. B C. C D. D - answerB. B Which curve represents the production of beta polypeptide chains of hemoglobin? A. B B. C C. E D. D - answerD. D Which curve represents the production of gamma polypeptide chains of hemoglobin? A. A B. B C. C D. D - answerC. C Which curve represents the production of delta polypeptide chains of hemoglobin? A. B B. C C. D D. E - answerD. E Which curve represents the production of epsilon polypeptide chains of hemoglobin? A. A B. B C. C D. D - answerA. A In order for hemoglobin to combine reversibly with oxygen, the iron must be: A. complexed with haptoglobin B. freely circulating in the cytoplasm C. attached to transferrin D. in the ferrous state - answerD. in the ferrous state In which of the following disease states are teardrop cells and abnormal PLTs most characteristically seen? A. hemolytic anemia B. multiple myeloma C. G-6-PD deficiency D. myeloid metaplasia - answerD. myeloid metaplasia In the normal adult, the spleen acts as a site for: A. storage of RBCs B. production of RBCs C. synthesis of erythropoietin D. removal of imperfect and aging cells - answerD. removal of imperfect and aging cells After the removal of RBCs from the circulation hemoglobin is broken down into: A. iron, porphyrin, and amino acids B. iron, protoporphyrin, and glob in C. heme, protoporphyrin, and amino acids D. heme, hemosiderin, and globin - answerB. iron, protoporphyrin, and globin Heinz bodies are: A. readily identified with polychrome stains B. rarely found in G6PD deficient erythrocytes C. closely associated with spherocytes D. denatured hemoglobin inclusions that are readily removed by the spleen - answerD. denatured hemoglobin inclusions that are readily removed by the spleen Cells for the transport of O2 and CO2 are: A. erythrocytes B. granulocytes C. lymphocytes D. thormbocytes - answerA. erythrocytes Erythropoieten acts to: A. shorten the replication of the granulocytes B. stimulate RNA synthesis of erythroid cells C. increase colony-stimulating factors produced by the B-lymphocytes D. decrease the release of marrow retics - answerB. stimulate RNA synthesis of erythroid cells What cell shape is MOST commonly associated with an increased MCHC? A. teardrop cells B. target cells C. spherocytes D. sickle cells - answerC. spherocytes Which of the following characteristics are common to hereditary spherocytosis, hereditary elliptocytosis, hereditary stomatocytosis, and paroxysmal nocturnal hemoglobinuria? A. autosomal dominant inheritance B. red cell membrane defects C. positive direct antiglobulin test D. meausre PLT count - answerB. red cell membrane defects A patient is admitted with a history of chronic bleeding secondary to peptic ulcer. Hematology workup reveals a severe microcytic, hypochromic anemia. Iron studies were requested. Which of the following would be expected in this case? (chart on picture) A. result A B. result B C. result C D. results D - answerC. results C Which of the following is MOST closely associated with iron deficient anemia? A. iron overload in tissue B. target cells C. basophilic stippling D. chronic blood loss - answerD. chronic blood loss Evidence indicates the genetic defect in thalassemia usually results in: A. the production of abnormal glob in chains B. a quantitative deficiency in RNA resulting in decreased globin chain production C. a structural change in the heme portion of the hemoglobin D. an abnormality in the alpha- or beta-chain binding or affinity - answerB. a quantitative deficiency in RNA resulting in decreased globin chain production An enzyme deficiency associated with a moderate to sever hemolytic anemia after the patient is exposed to certain drugs and characterized by red cell inclusions from by denatured hemoglobin is: A. lactate dehydrogenase deficiency B. G-6-PD deficiency C. pyruvate kinase deficiency D. hexokinase deficiency - answerB. G-6-PD deficiency Patients with A(-) type G6PD deficiency are LEAST likely to have hemolytic episodes in which of the following situations? A. following the administration of oxidizing drugs B. following the ingestion of fava beans C. during infections D. spontaneously - answerD. spontaneously A patient has a congenital nonspherocytic hemolytic anemia. After exposure to anti-malarial drugs the patient experiences a severe hemolytic episode. This episode is characterized by red cell inclusions caused by hemoglobin denaturation. Which of the following conditions is MOST consistent with these findings? A. G6PD deficiency B. thalassemia major C. pyruvate kinase deficiency D. paroxysmal nocturnal hemoglobinuria - answerA. G6PD deficiency Peripheral blood smears from patients with untreated pernicious anemia are characterized by: A. pancytopenia and macrocytosis B. leukocytosis and elliptocytosis C. leukocytosis and ovalocytosis D. pancytopenia and microcytosis - answerA. pancytopenia and macrocytosis Lab tests preformed on a patient indicate macrocytosis, anemia, leukopenia and throbocytopenia. Which of the following disorders is the patient most likely to have? A. anemia of chronic disorder B. vitamin B12 deficiency C. iron deficiency D. acute hemorrhage - answerB. vitamin B12 deficiency The characteristic morphologic feature in folic acid deficiency is: A. macrocytosis B. target cells C. serum B12 and folate D. leukocyte alkaline phosphatase - answerA. macrocytosis The most likely cause of the macrocytosis that often accompanies anemia of myelofibrosis is: A. folic acid deficiency B. increased retic count C. inadequate B12 absorption D. pryidoxine deficiency - answerA. folic acid deficiency Which of the following represents characteristics features of iron metabolism in patients with anemia of chronic disorder? A. result A B. result B C. result C D. result D - answerD. result D A characteristic morphologic feature in hemoglobin C disease is: A. macrocytosis B. spherocytosis C. rouleaux formation D. target cells - answerD. target cells Thalassemias are characterized by: A. structural abnormalities in the hemoglobin molecule B. absence of iron in hemoglobin C. decreased rate of heme synthesis D. decreased rate of glob in synthesis - answerD. decreased rate of glob in synthesis Lab findings in hereditary spherocytosis do NOT include: A. decreased osmotic fragility B. increased autohemolysis corrected by glucose C. reticulocytosis D. shorted erythrocyte survival - answerA. decreased osmotic fragility Which of the following types of polycythemia is a severely burned patient MOST likely to have? A. polycythemia vera B. polycythemia, secondary to hypoxia C. relative polycythemia associated with dehydration D. polycythemia associated with renal disease - answerC. relative polycythemia associated with dehydration Which of the following is most likely to be seen in lead poisoning? A. iron overload in tissue B. codocytes C. basophilic stippling D. ringed sideroblasts - answerC. basophilic stippling The characteristic morphologic feature in lead poisoning is: A. macrocytosis B. target cells (codocytes) C. basophilic stippling D. rouleaux formation - answerC. basophilic stippling A 14 y/o boy is seen in the ER complaining of a sore throat, swollen glands and fatigue. The CBC results are: -WBC: 16.0x10^3/µL(16.0x10^9/L) -RBC: 4.37 x 10^6/µL(4.37x10^12/L) -Hgb: 12.8 g/dL (128 g/L) -Hct: 38.4% -Plt: 180x10^3/µL(180x10^9/L) Differential: -absolute neurtophils: 3.9x10^9/L -absolute lymphs: 6.0x10^9/L -absolute monos: 0.5x10^9/L -absolute atypical lymphs: 3.2x10^9/L What is the most likely dx? A. acute lymphoblastic leukemia B. chroni lymphocytic leukemia C. viral hepatitis D. infectious mononucleosis - answerD. infectious mononucleosis Which of the following technical factors will cause a decrease erythrocyte sedimentation rate (ESR)? A. gross hemolysis B. small fibrin clots in the sample C. increased room temp D. tilting of the tube - answerB. small fibrin clots in the sample Which of the RBC indices is a mausre of the amount of hemoglobin in individual RBCs? A. MCHC B. MCV C. Hct D. MCH - answerD. MCH