UAMS Hematology Exam #3 UPDATED
ACTUAL Exam Questions and CORRECT
Answers
Sickle cell anemia. Hemoglobin S is produced instead of A, due to valine being substituted for
glutamic acid on the 6th position of the Beta chain. Hemoglobin S aggregates to form a tactoid
structure that forms a sickle shape at low O2 tensions. - CORRECT ANSWER - What is a
chronic hemolytic anemia resulting from an inherited alteration of the globin chain? What
characterizes it?
Bone marrow. 4% - CORRECT ANSWER - What is one of the largest organs in the body?
What % does it comprise of body weight?
Posterior superior iliac crest. Sternum, but is more dangerous because it is thinner and can be
punctured easier. Top of tibia below the knee. - CORRECT ANSWER - What is the most
common site for bone marrow sampling in adults? What is the site used when this cannot be
reached? Site for infants and kids?
All bones in infants, only flat bones in adults. - CORRECT ANSWER - Where is bone
marrow in infants and adults?
Main artery enters and branches to the periphery to form vascular sinuses. Sinuses combine to
form veins to reenter to circulation. Just outside the sinuses are hematopoietic cords containing
cells. - CORRECT ANSWER - What is the structure of the bone marrow?
Through fenestrations in the lining cells of the sinus, which are basically adjustable holes
between epithelial cells. - CORRECT ANSWER - After maturation, how do cells enter the
sinus?
Macrophages bring iron to the RBCs. - CORRECT ANSWER - RBCs are inside a sinus,
around a macrophage. Why?
,Stromal cells. Reticulum that extends into the marrow cords, fat, histiocytes, and endothelial
cells. - CORRECT ANSWER - What forms the formation and support network inside the
bone? What is it comprised of?
Osteoblasts. Osteoclasts. Core biopsy. - CORRECT ANSWER - Which cells are bone
forming? Bone destroying? Where can both of these be seen?
Around a spicule - CORRECT ANSWER - Where should a differential be done on a bone
marrow slide?
It supplies mature cells for circulation in a steady state or for increased demand. Maintained by
pluripotent stem cells. Cells proliferate according to the stimulus they receive. - CORRECT
ANSWER - What is the function of bone marrow? What is bone marrow self renewal
maintained by? How do cells what to proliferate into?
RBCs - 120 days. WBCs - 5-20 days. - CORRECT ANSWER - What is the lifespan of
RBCs and WBCs?
Only when it is necessary to diagnose them or treat them. - CORRECT ANSWER - When
should you aspirate a patient?
Anemia, polycythemia, leukopenia, and thrombocytosis. - CORRECT ANSWER - Which
diseases affect bone marrow composition?
Metastasizing tumors that have spread to the bone marrow such as Hodgkin's lymphoma. Causes
a spot of BM to not be able to produce and will prevent a sample being taken from that area. A
fever of unknown origin will also affect BM production. Hereditary diseases such as Gaucher (a
storage pool disease) will also affect. - CORRECT ANSWER - What diseases would
affect the production of bone marrow?
Try to match the site by going to other side. Only aspirate sternum if absolutely necessary. -
CORRECT ANSWER - If a tumor is present on the posterior superior iliac crest, what
should you try to do when trying to obtain an aspirate?
, Aspirate represents the red marrow and is only used for the differential. The biopsy represents
the actual structure of the bone marrow by bringing cell to fat ratio into contemplation. A
differential cannot be performed on a biopsy. - CORRECT ANSWER - What does the
aspirate represent? What does the biopsy represent?
Make sure it is actually BM by looking for a spicule, find a good area, avoid bare nuclei, look for
megakaryocytes and any abnormal cells. - CORRECT ANSWER - When examining BM
under low power, what should be looked for?
80% during childhood. 50% age 30-70. If over the age of 70, reduced cellularity will have to be
calculated. For a 70 year old, 100-70=30%. 30% plus or minus 10% = 20-40%/ - CORRECT
ANSWER - What percentage of cellularity should BM have during childhood? Age 30-
70? Age above 70? How do you calculate reduced cellularity?
500-1000, both RBCs and WBCs. Myeloid to erythrocyte ratio, normal is 3:1. Lymphocytes,
monocytes, and plasma cells are not included. There are more myeloid cells in the ratio due to
their shorter lifespan, they require replacement more often. - CORRECT ANSWER -
When examining BM under oil power, how many cells should be counted? Which cells? What
ratio should be determined and what is normal? What is NOT included in the ration count? How
is this ratio determined?
50% - CORRECT ANSWER - What percent of the differential count will be comprised of
neutrophilic myelocytes, metamyelocytes, bands, and segs?
Each specific nRBC and WBC class and the percentage of each. - CORRECT ANSWER -
What should be reported for each cell type counted?
Only myeloid granulocytic cells are counted. Divide that number by the number of erythroid
cells. Ex. 350 neutrophils/75=4.7:1 - CORRECT ANSWER - How to calculate M:E ratio?
Redcued RBC production, it would cause the M:E ratio to increase with myeloids. 5:1
ACTUAL Exam Questions and CORRECT
Answers
Sickle cell anemia. Hemoglobin S is produced instead of A, due to valine being substituted for
glutamic acid on the 6th position of the Beta chain. Hemoglobin S aggregates to form a tactoid
structure that forms a sickle shape at low O2 tensions. - CORRECT ANSWER - What is a
chronic hemolytic anemia resulting from an inherited alteration of the globin chain? What
characterizes it?
Bone marrow. 4% - CORRECT ANSWER - What is one of the largest organs in the body?
What % does it comprise of body weight?
Posterior superior iliac crest. Sternum, but is more dangerous because it is thinner and can be
punctured easier. Top of tibia below the knee. - CORRECT ANSWER - What is the most
common site for bone marrow sampling in adults? What is the site used when this cannot be
reached? Site for infants and kids?
All bones in infants, only flat bones in adults. - CORRECT ANSWER - Where is bone
marrow in infants and adults?
Main artery enters and branches to the periphery to form vascular sinuses. Sinuses combine to
form veins to reenter to circulation. Just outside the sinuses are hematopoietic cords containing
cells. - CORRECT ANSWER - What is the structure of the bone marrow?
Through fenestrations in the lining cells of the sinus, which are basically adjustable holes
between epithelial cells. - CORRECT ANSWER - After maturation, how do cells enter the
sinus?
Macrophages bring iron to the RBCs. - CORRECT ANSWER - RBCs are inside a sinus,
around a macrophage. Why?
,Stromal cells. Reticulum that extends into the marrow cords, fat, histiocytes, and endothelial
cells. - CORRECT ANSWER - What forms the formation and support network inside the
bone? What is it comprised of?
Osteoblasts. Osteoclasts. Core biopsy. - CORRECT ANSWER - Which cells are bone
forming? Bone destroying? Where can both of these be seen?
Around a spicule - CORRECT ANSWER - Where should a differential be done on a bone
marrow slide?
It supplies mature cells for circulation in a steady state or for increased demand. Maintained by
pluripotent stem cells. Cells proliferate according to the stimulus they receive. - CORRECT
ANSWER - What is the function of bone marrow? What is bone marrow self renewal
maintained by? How do cells what to proliferate into?
RBCs - 120 days. WBCs - 5-20 days. - CORRECT ANSWER - What is the lifespan of
RBCs and WBCs?
Only when it is necessary to diagnose them or treat them. - CORRECT ANSWER - When
should you aspirate a patient?
Anemia, polycythemia, leukopenia, and thrombocytosis. - CORRECT ANSWER - Which
diseases affect bone marrow composition?
Metastasizing tumors that have spread to the bone marrow such as Hodgkin's lymphoma. Causes
a spot of BM to not be able to produce and will prevent a sample being taken from that area. A
fever of unknown origin will also affect BM production. Hereditary diseases such as Gaucher (a
storage pool disease) will also affect. - CORRECT ANSWER - What diseases would
affect the production of bone marrow?
Try to match the site by going to other side. Only aspirate sternum if absolutely necessary. -
CORRECT ANSWER - If a tumor is present on the posterior superior iliac crest, what
should you try to do when trying to obtain an aspirate?
, Aspirate represents the red marrow and is only used for the differential. The biopsy represents
the actual structure of the bone marrow by bringing cell to fat ratio into contemplation. A
differential cannot be performed on a biopsy. - CORRECT ANSWER - What does the
aspirate represent? What does the biopsy represent?
Make sure it is actually BM by looking for a spicule, find a good area, avoid bare nuclei, look for
megakaryocytes and any abnormal cells. - CORRECT ANSWER - When examining BM
under low power, what should be looked for?
80% during childhood. 50% age 30-70. If over the age of 70, reduced cellularity will have to be
calculated. For a 70 year old, 100-70=30%. 30% plus or minus 10% = 20-40%/ - CORRECT
ANSWER - What percentage of cellularity should BM have during childhood? Age 30-
70? Age above 70? How do you calculate reduced cellularity?
500-1000, both RBCs and WBCs. Myeloid to erythrocyte ratio, normal is 3:1. Lymphocytes,
monocytes, and plasma cells are not included. There are more myeloid cells in the ratio due to
their shorter lifespan, they require replacement more often. - CORRECT ANSWER -
When examining BM under oil power, how many cells should be counted? Which cells? What
ratio should be determined and what is normal? What is NOT included in the ration count? How
is this ratio determined?
50% - CORRECT ANSWER - What percent of the differential count will be comprised of
neutrophilic myelocytes, metamyelocytes, bands, and segs?
Each specific nRBC and WBC class and the percentage of each. - CORRECT ANSWER -
What should be reported for each cell type counted?
Only myeloid granulocytic cells are counted. Divide that number by the number of erythroid
cells. Ex. 350 neutrophils/75=4.7:1 - CORRECT ANSWER - How to calculate M:E ratio?
Redcued RBC production, it would cause the M:E ratio to increase with myeloids. 5:1
