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Hematology TB Flashcards Unit 4
1) Normal hemostasis depends on all of the following except
A. an intact vascular system
B. inadequate numbers of platelets
C. appropriate coagulation factors
D. fibrinolysis
2) The sequence of events following injury to a small blood
vessel is
A. Contact between damaged blood vessel, blood platelets,
and coagulation proteins
B. Formation of a platelet plug
C. Fibrinolysis and reestablishment of vascular integrity
D. Development of a blood clot around the injury
E. Blood vessel spasm (vasoconstriction)
3) Which blood vessels have the thickest walls?
4) All blood and lymphatic vessels are lined with
5) Blood passes from the arterial to the venous system via
6) The initiating stimulus to blood coagulation following
injury to a blood vessel is
7) Endothelium is involved in the metabolism and clearance of
molecules such as
A. serotonin
B. angiotensin
C. bradykinin
D. all of the above
8) What is not correct?
A. Vasoconstriction reduces blood flow and promotes
contact activation of platelets and coagulation factors
B. Platelets adhere to exposed endothelial connective tissues
C. Aggregation of platelets releases thromboxane A2 and
vasoactive amines (serotonin and epinephrine)
D. None of the above
9) What is (are) true of endoreduplication?
A. Duplicates DNA without cell division
B. Results in cells with ploidy values of 4n, 8n, 16n, and 32n
C. Is unique to the megakaryocytic type of blood cell
D. All of the above
10) What is (are) true of thrombopoietin?
A. Thought to stimulate the production and maturation of
megakaryocytes
B. Is influenced by various cytokines, which increase
megakaryocyte size
C. Is influenced by various cytokines, which impact
maturational stage and ploidy
D. All of the above
11) What is not a characteristic of platelets?
1
B
E
B
A
D
C
Arteries
endothelium
capillaries
contact activation with
collagen
D
D
D
D
The presence of a nucleus
Hematology TB Flashcards Unit 4
12) The cellular ultrastructural component(s) unique to the
platelet is (are)
13) Choose the incorrect statement regarding storage granules
related to hemostasis in the mature platelet.
14) At all times, approximately _____ of the total number of
platelets are in the systemic circulation.
15) The reference range of platelets in the systemic circulation
is
16) The functions of platelets in response to vascular damage
include
A. maintenance of vascular integrity by sealing minor defects of
the endothelium
B. formation of a platelet plug
C. promotion of fibrinolysis
D. all of the above
17) If vascular injury exposes the endothelial surface and
underlying collagen, platelets ___(1) _____ to the collagen
fibers and _(2) _
18) Agents that are capable of aggregating platelets include
A. collagen
B. thrombin
C. serotonin
D. all of the above
19) Examination of a Wright-stained peripheral blood smear
provides an estimate of platelet numbers. Using 100× (oil)
immersion in the areas of erythrocytes just touching each
other, the upper limit of the number of platelets seen per
field should not exceed
20) If 10 platelets are seen per oil immersion field, what is the
approximate platelet count?
21) Aspirin ingestion has the following hemostatic effect in a
normal person.
22) The bleeding time test measures
23) The clot retraction test is
2
Glycocalyx
Lysosomes contain
actomyosin, myosin, and
filamin
two thirds
150 to 450 × 109/L
D
1. adhere
2. aggregate
D
20 to 25
200 × 109/L
Prolongs the bleeding time.
Please review the difference
between bleeding time and
clotting time
platelet adhesion and
aggregation on locally
injured vascular
subendothelium
a reflection of the quantity
and quality of platelets and
other factors
Hematology TB Flashcards Unit 4
Match the following.
A. Factors II, VII, IX, and X
B. Factors I, V, VIII, and XIII
C. Factors XI, XII, prekallikrein, and high–molecular weight
kininogen
24) Fibrinogen group
25) Prothrombin group
26) Contact group
27) The fibrinogen group of coagulation factors is
A. known to increase during pregnancy
B. known to increase in conditions of inflammation
C. known to increase subsequent to the use of oral
contraceptives
D. all of the above
28) The prothrombin group of coagulation factors is
A. dependent on vitamin K for production
B. considered to be stable
C. well preserved in stored plasma
D. all of the above
29) Warfarin acts by
Match the name of the coagulation factor with the appropriate
symbolic designation.
30) _____ Thrombin
31) _____ Tissue thromboplastin
32) _____ Antihemophilic factor
33) _____ Hageman factor
34) Arrange the four stages of coagulation in their proper
sequence.
A. Fibrinolysis
B. Formation of thrombin from prothrombin
C. Generation of plasma thromboplastin
D. Formation of fibrin from fibrinogen
35) The extrinsic pathway of coagulation is triggered by the
entry of _____ into the circulation.
36) The intrinsic pathway of coagulation begins with the
activation of _____ in the early stage.
37) The final common pathway of the intrinsic-extrinsic
pathway is
38) Prothrombin to thrombin conversion is accelerated by
39) Fibrinogen is converted to fibrin monomers by
40) The inactive plasminogen is activated to ____ by proteolytic
enzymes.
3
29. B
30. A
31. C
D
D
acting as a vitamin K
antagonist
30. IIa
31. III
32. VIII
33. XII
C
B
D
A
tissue thromboplastin
factor XII
factor X activation
factor V and ionized
calcium
thrombin
Plasmin
Hematology TB Flashcards Unit 4
41) What statements are true of the fibrinolytic system?
A. Plasmin digests fibrin and fibrinogen
B. The active enzyme of the system is plasmin
C. Inactive plasminogen circulates in the plasma until an injury
occurs
D. All of the above
42) If a pediatric preoperative patient has a family history
of bleeding but has never had a bleeding episode herself,
what test should be included in a coagulation profile in
addition to the PT, aPTT, and platelet count?
43) A patient with a severe decrease in factor X activity would
demonstrate normal
44) Neither the aPTT nor the PT detects a deficiency of
45) The function of thromboplastin in the prothrombin test is to
provide _____ to the assay.
46) An abnormally prolonged aPTT may indicate
A. a severe depletion of fibrinogen
B. the presence of a circulating anticoagulant
C. factor VIII deficiency
D. all of the above
47) If a child ingested rat poison, what tests should be
performed to test the effect of the poison on the child’s
coagulation mechanism?
48) What conditions can cause an increased thrombin time?
A. Fibrin split products
B. High concentrations of immunoglobulins
C. Heparin therapy
D. All of the above
49) Heparin inhibits the clotting of blood by neutralizing the
effect of
50) A patient has a prolonged aPTT and a normal PT. The aPTT
is not corrected by factor VIII–deficient plasma but is
corrected by factor IX–deficient plasma. In which factor
does the patient appear to be deficient?
51) The normal protective mechanisms against thrombosis
include
A. the flow of blood
B. the action of antithrombin III.
C. protein C and protein S
D. all of the above
52) If heparin therapy is initiated in a patient, a decreased
anticoagulant response can be caused by decreased levels of
4
D
Bleeding time
bleeding time
platelet factor 3
phospholipoprotein
D
PT
D
thrombin
Factor VIII
D
platelet factor 4
Hematology TB Flashcards Unit 4
53) What is (are) characteristic of protein C?
A. It is not vitamin K dependent
B. It is formed in response to thrombin generation
C. It inactivates factors Va and VIIIa
D. Both B and C
54) What characteristics is (are) true of protein S?
A. It is a cofactor of protein C
B. It increases the rate of inactivation of factor Va
C. It enhances the binding of APC to phospholipids
D. All of the above
55) Antithrombin III is the principal physiological inhibitor of
56) What is not correct regarding cellular proteases?
57) Select whether or not lack of the following processes is
involved in hemostasis.
Blood vessel spasm
58)
Lysis of a platelet plug
59) Development of a clot at the site of the injury.
60) Fibrinolytic removal of excess hemostatic material.
61) Capillaries are the __1__ walled vessel and __2__ numerous
of the blood vessels.
62) Match each of the endothelial-associated factors with its
function
Platelet-activating factor
63) Match each of the endothelial-associated factors with its
function
Prostacyclin
64) Match each of the endothelial-associated factors with its
function
Thrombomodulin
65) The Weibel-Palade body (WPB) represents storage granule
for ____.
66) Match the endothelial vasoconstrictor–vasodilator balance
with action
Prostaglandin
Match the endothelial vasoconstrictor–vasodilator balance with
action
Endothelin I
67) Match the endothelial vasoconstrictor–vasodilator balance
with action
Prostacyclin
68)
Endothelin I
69)
5
Endothelin II
D
D
thrombin
They participate in clot
formation
Yes
No
Yes
Yes
1. Thinnest
2. Most
Prothrombotic
Antithrombotic
Antithrombotic
von Willebrand factor
Constrictor
Constrictor
Dilator
Is produced in endothelial
cells
Has no unique physiologic
function
Hematology TB Flashcards Unit 4
70)
Endothelin III
71) Vasoconstriction can last for up to
72) A unique characteristic of a platelet is
73) The average number of platelets in 10 different fields is
multiplied by a factor of ____ to estimate the approximate
total platelet count
74) What is the fibrinogen coagulation factor?
75) What is the prothrombin coagulation factor?
76) Antihemophiliac factor is which coagulation factor?
77) The INR
78) The extrinsic pathway of coagulation is triggered by the
entry of ___into the circulation
79) AT III is the principal physiological inhibitor of
80) Heparin inhibits the clotting of blood by neutralizing the
effect of
81) What is a condition associated with purpura?
A. Direct endothelial damage
B. Inherited disease of the connective tissue
C. Mechanical disruption of small venules
D. All of the above
82) Match the following platelet disorders with the appropriate
morphology: Wiskott-Aldrich syndrome
83) Match the following platelet disorders with the appropriate
morphology: May-Hegglin anomaly
84) Match the following platelet disorders with the appropriate
morphology: Bernard-Soulier syndrome
85) Match the etiologies of these platelet dysfunctions with the
appropriate associated disorder: Acquired
86) Match the etiologies of these platelet dysfunctions with the
appropriate associated disorder: Drug induced
87) Match the etiologies of these platelet dysfunctions with the
appropriate associated disorder: Hereditary
88) What parameters can be abnormal in classic von Willebrand
disease type I?
89) The most common form of von Willebrand disease is
90) Laboratory results in acute DIC reflect abnormalities in
what coagulation components?
91) Primary fibrinolysis is characterized by
A. gross activation of the fibrinolytic mechanism
B. consumption of fibrinogen
C. consumption of coagulation factors
D. all of the above
6
May regulate proliferation
and development in neurons
30 minutes
Anuclear
20,000
Factor I
Factor II
Factor VIII
Corrects for variability in PT
results
Tissue thromboplastin
Thrombin
Thrombin
D
Smallest platelets seen
Large platelets
Giant platelets
Uremia
Aspirin
von Willebrand disease
Bleeding time
type I
Excessive clotting and
fibrinolysis
D
Hematology TB Flashcards Unit 4
92) The hallmark of secondary fibrinolysis is the presence of
A. fibrin split products
B. fibrin degradation products
C. fibrin monomers
D. all of the above
93) DIC is characterized by
A. microvascular thrombosis
B. fibrin deposition
C. active fibrinolysis
D. all of the above
94) What factors can contribute to hypercoagulation?
D
D
Vascular endothelial damage
95) Antithrombin III deficiency
Primary hypercoagulable
state
96) Oral contraceptives
Secondary hypercoagulable
state
Primary hypercoagulable
state
Secondary hypercoagulable
state
Secondary hypercoagulable
state
Acquired inhibitors of
clotting proteins
Also known as
antiphospholipid or
Anticardiolipin
The most common specific
factor inhibitor
Hemorrhages into the skin
97) Protein C deficiency
98) Cancer
99) Pregnancy
100) Circulating anticoagulants
101) LA
102) Factor VIII inhibitor
103) Purpura is characterized by
104) The difference between petechiae and purpura is that
petechiae appear as
Hemorrhagic spots on the
skin or mucous membranes
105) Thrombocytopenia can be caused by
106) Thrombocytopenia can be associated with
A) Deep venous thrombosis (DVT)
B) DIC
C) Pulmonary embolism
D) All of the above
107) Thrombocytopenia due to hypoproliferation can be
caused by factors such as
108) Ineffective thrombopoiesis leading to platelet production
may be a manifestation of
Heparin
D
7
Insecticides
Nutritional disorder
Hematology TB Flashcards Unit 4
109) Patients treated with heparin may develop
A) Thrombocytopenia
B) Thrombosis
C) Afibrinogenemia
D) Both A and B
110) What hereditary platelet function disease has adhesion
defects ?
111) What hereditary platelet function disease has primary
aggregation defects?
112) What hereditary platelet function disease has secondary
aggregation defects?
113) Severe coagulation factor deficiencies.
114) The most common drug-induced cytopenia is ____
induced.
115) One of the most frequently encountered forms of
increased consumption of platelets is
116) The new standard nomenclature (term) for ITP is
117) A characteristic of ITP is
118) In acute ITP, the mechanism of platelet destruction is
thought to be
A) Absorption of viral antigen onto the platelet surface followed
by antibody binding
B) Formation of an immune complex on the surface of platelets
via the platelet Fc receptors
C) Auto antiplatelet antibodies attachment to platelet membrane
GPs
D) Either A or B
119) Clinical conditions that can cause thrombocytopenia
include
A) DIC
B) Microbial sepsis
C) Trauma
D) All the above
120) Thrombotic thrombocytopenic purpura (TTP) is
characterized by
121) Laboratory manifestation of TTP include
122) What is a characteristic of Idiopathic TTP?
123) What is a characteristic of Secondary TTP?
124) What is a characteristic of Inherited TTP?
125) What is the appropriate characteristic for familial
thrombocytosis?
126) What is the characteristic associated with neoproliferative
neoplasms?
8
D
Bernard-Soulier syndrome
Glanzmann thrombasthenia
Aspirin-like defects
Afibrinogenemia
Heparin
ITP
Immune thrombocytopenia
A chronic disease in adults
D
D
Severe thrombocytopenia
Elevated D-dimer
HMW vWF factor in plasma
History of medications, e.g.,
quinine
Accounts for 5%–10% of
cases
Germline mutation of
thrombopoietin gene
Clonal association with
somatic mutations (JAK2)
Hematology TB Flashcards Unit 4
127) What is the appropriate characteristic for secondary
thrombocytosis?
128) A typical disorder or condition associated with an
acquired platelet dysfunction is
129) Platelet aggregation testing is usually ____ in von
Willebrand disease.
130) One or two aspirin can extend the bleeding time ____.
131) Heredity platelet dysfunction can be a ____ defect in
origin
132) Body fluids usually can be examined for
A) Physical characteristics
B) Cells
C) Microbial organisms
D) All of the above
133) Body fluids under normal conditions are
134) Cerebrospinal fluid is primarily produced in _________.
135) The anatomical structure, the blood–brain barrier, is
composed of
A) Choroid plexus epithelium
B) Endothelium of capillaries in contact with CSF
C) Subarachnoid spaces
D) Both A and B
136) The total normal total leukocyte of cerebrospinal fluid
(CSF) is
137) A grossly bloody CSF specimen suggests
138) If an increased number of segmented neutrophils (PMNs)
is observed in a CSF examination, it suggests
a(n)______________________.
139) Normal CSF may contain
140) A cell count on a CSF specimen should be performed
within _____ of collection.
141) The causes of peritoneal effusion include all of the
following except
A) Bacterial peritonitis
B) Hepatic cirrhosis
C) Congestive heart failure
D) Tuberculosis
142) An extremely increased leukocyte concentration in the
peritoneal fluid can be caused by
143) The normal color of peritoneal fluid is
144) A cause of significant fluid in the pericardium is
145) An increased number of eosinophils in pleural fluid is
9
Also called reactive
thrombocytosis
Uremia
Decreased
Twice the value
Either a structural or
Biochemical
D
Sterile
Choroid plexus
D
0 to 10 × 106/L
Subarachnoid hemorrhage
Bacterial infection
Lymphocytes and
ependymal cells
1 hour
D
Bacterial peritonitis
Pale yellow
Advanced malignant disease
Nonspecific
Hematology TB Flashcards Unit 4
146) Sperm motility can become decreased if the specimen is
A) Stored at room temperature
B) Stored in a plastic container for more than 1 hour
C) Examined after 2 hours of storage
D) All of the above
147) The reference value for fertile semen is ______ × 109/L.
148) An increased percentage of segmented neutrophils
(PMNs) is characteristic of
149) Monosodium urate crystals are found in
___________________.
150) Hemarthrosis can be associated with all of the following
conditions except
A) Sickle cell disease (crisis)
B) Trauma with fracture
C) Aspiration of fluid
D) Metallic joint prostheses
151) The term that gave synovial fluid its name is the
description of _______________.
152) Cholesterol crystals in synovial fluid are
153) Group II synovial fluid is characteristic of a(n)_____
condition.
Match the correct term for the fluid with the clinical state.
154) Fetal fibronectin (fFN) is a protein produced during
pregnancy and ________________.
A) Functions as a biological glue
B) Attaches the fetal sac to the uterine lining
C) Initiates labor
D) Both A and B
155) Amniotic fluid is essential to
_______________________.
A) Hematopoiesis
B) Lung development
C) Protection of the fetus
D) Both B and C
156) Match each of the terms with their appropriate synonyms.
1. _____ CSF
2. _____ Synovial fluid
3. _____ Peritoneal fluid
4. _____ Pericardial fluid
5. _____ Pleural fluid
A. Lumbar puncture fluid
B. Joint fluid
C. Chest fluid
D. Ascitic fluid
E. Fluid from around the heart
10
D
60–150
Septic arthritis
Acute gouty arthritis
C
Viscosity
Nondiagnostic
Inflammatory
167. Transudate
168. Exudate
D
D
1.A
2.B
3.D
4.E
5.C
Hematology TB Flashcards Unit 4
157) Match the fluids with the appropriate normal
characteristics.
6. _____ CSF
7. _____ Synovial fluid
8. _____ Seminal fluid
A. Clear and yellow
B. Turbid and viscous
C. Clear and colorless
158) Match the fluids and normal total leukocyte or total
sperm count.
9. _____ CSF
10. _____ Synovial fluid
11. _____ Seminal fluid
A. 0 to 10 × 106/L
B. 60 to 150 × 109/L
C. Less than 200/mL
159) The anatomical structures associated with the circulation
of CSF are
160) CSF production is associated with the
6.C
7.A
8.B
9.A
10.C
11.B
ventricles and subarachnoid
spaces
choroid plexus and
ependymal lining
161) CSF is collected from an intervertebral space between the L4, L5
_____ and _____ vertebrae.
162) Match the following test tube aliquots of CSF with the
15.C
typical type of testing that should be performed.
16.B
15. _____ Tube 1
17.A
16. _____ Tube 2
17. _____ Tube 3
A. Gross examination, cell count, and morphology
B. Microbial examination
C. Chemical and serological examination
163) Match the following gross examination findings of CSF
18.D
with the appropriate diagnosis.
19.B
18. _____ Cloudy and turbid
20.C
19. _____ Grossly bloody specimen
21.A
20. _____ Xanthochromia (yellow color)
21. _____ Gel formation
A. Increased fibrinogen
B. Subarachnoid hemorrhage
C. Subarachnoid hemorrhage (more than 12 hours
after the bleed)
D. Pleocytosis
11
Hematology TB Flashcards Unit 4
164) Match the following microscopic findings of CSF with
the associated condition.
22. _____ Intraventricular rupture of brain abscess
23. _____ Viral infection
24. _____ 0 to 5 × 106/L
25. _____ Bacterial infection
26. _____ CNS leukemia or lymphoma
A. Lymphocytosis
B. Increased polymorphonuclear segmented
neutrophils (PMNs)
C. Macrophages
D. Extremely elevated leukocyte count in CSF
E. Normal leukocyte reference range for CSF
165) Normal CSF contains
166) The cell count on a CSF specimen should be performed
within _____ of collection.
167) Clotting in CSF may be caused by
168) An increased total leukocyte count in a CSF specimen
can be caused by
A. bacterial meningitis
B. viral meningoencephalitis
C. intravascular rupture of a brain abscess
D. both A and C
169) An increase in the number of lymphocytes in a CSF
specimen can be caused by
A. multiple sclerosis
B. viral meningoencephalitis
C. fungal meningitis
D. all of the above
170) What is (are) characteristic of an effusion?
A. Abnormal accumulation of fluid
B. Can be a transudate
C. Can be an exudate
D. All of the above
171) A transudate can be described as
172) Match the term with the appropriate physical description.
34. _____ Pleura
35. _____ Peritoneum
36. _____ Pericardium
A. Covers abdominal walls and viscera of the abdomen
B. Covers the lungs
C. A fibrous sac around the heart
12
22.D
23.A
24.E
25.B
26.C
lymphocytes and ependymal
cells
1 hour
increased protein
concentration
D
D
D
specific gravity <1.016, pH
7.4 to 7.5, and lactic
dehydrogenase <200 IU/L
34.B
35.A
36.C
Hematology TB Flashcards Unit 4
173) Match the representative exudate appearance with a
typical associated disorder.
38. _____ Yellow and turbid
39. _____ Milky
40. _____ Bloody
41. _____ Clearly visible pus
42. _____ Foul odor
A. Empyema
B. Infectious process
C. Anaerobic bacterial infection
D. Chylothorax
E. Malignancy in the absence of trauma
174) Pleural fluid can have a white supernatant fluid after
centrifugation owing to
175) Conditions not associated with pleural effusion include
176) An extremely elevated leukocyte concentration in pleural
fluid is typically associated with
177) An extremely increased leukocyte concentration in
peritoneal fluid can be caused by
178) What cells can be seen in pleural fluid?
A. LE cells
B. Mononuclear phagocytes
C. Mesothelial cells
D. All of the above
179) All of the following describe the characteristics of
malignant cells except
A. multiple round aggregates of cells
B. high N:C ratio
C. large, irregular nucleoli
D. smooth chromatin
180) Match the cellular abnormality encountered in pleural
and peritoneal fluids with a representative disorder .
47. _____ Many neutrophils, histiocytes, and mesothelial cells
48. _____ Abundant, multinuclear cells and clusters of cells
49. _____ Many malignant cells (in clusters)
50. _____ Many lymphocytes, mesothelial, histiocytes, and
plasma cells
A. Viral infection
B. Acute bacterial inflammation
C. Metastatic adenocarcinoma
D. Malignant mesothelioma
E. Chronic granulomatous inflammation
181) In a pleural effusion, the percentage of (51) _____ is
extremely high in pneumonia and the percentage of (52)
_____ is extremely high in viral peritonitis.
51.
13
38.B
39.D
40.E
41.A
42.C
presence of chylomicrons
viral pneumonia
empyema
bacterial peritonitis
D
D
47.B
48.C
49.D
50.A
51.A
52.D
Hematology TB Flashcards Unit 4
A. polymorphonuclear segmented neutrophils
B. eosinophils
C. basophils
D. monocytes
52.
A. polymorphonuclear segmented neutrophils
B. eosinophils
C. basophils
D. lymphocytes
182) An abnormal-appearing peritoneal effusion can be caused
by all of the following except
A. bacterial peritonitis
B. pancreatitis
C. neoplasm
D. tuberculous peritonitis
183) Match the following peritoneal effusion colors with the
respective condition (use each answer once).
55. _____ Pale yellow
56. _____ Straw colored
57. _____ Bloody
A. Normal
B. Pulmonary infarct
C. Congestive heart failure
184) Match an increase in the following cells in peritoneal
fluid with the representative abnormality.
59. _____ Eosinophils
60. _____ Lymphocytes
61. _____ Mesothelial cells
A. Chronic peritoneal dialysis
B. Congestive heart failure, cirrhosis, and nephrotic syndrome
C. Tuberculous peritonitis
185) Match the various types and respective causes of
pericardial effusion.
62. _____ Infectious agents
63. _____ Collagen vascular disease
64. _____ Neoplastic disease
A. Rheumatic disease
B. Mesothelioma
C. Dressler post infarction syndrome
D. Coxsackie group viruses
186) A cause of an increased concentration of cells in
pericardial fluid is
A. microbial infection
B. malignancy
C. congestive heart failure
D. both A and B
14
D
55.A
56.C
57.B
59.A
60.B
61.C
62.D
63.A
64.B
D
Hematology TB Flashcards Unit 4
187) Match the following male reproductive structures with
their constituents.
66. _____ Testicle
67. _____ Seminal vesicles
68. _____ Prostate
69. _____ Cowper glands
A. Fructose and prostaglandins
B. Unknown
C. Sperm
D. p30 glycoprotein
188) Sperm motility can become decreased if the specimen is
A. stored at room temperature
B. stored in a plastic container for more than 1 hour
C. examined after 2 hours of storage
D. all of the above
66.C
67.A
68.D
69.B
189) Match the normal values or appropriate term.
72. _____ Motility (fresh specimen)
73. _____ Sperm morphology
74. _____ Viability (fresh specimen)
75. _____ Agglutination
76. _____ Artificial insemination
A. At least 50%
B. 40% to 90% (mature and oval headed)
C. Test for infectious disease
D. Prostatitis or sperm-agglutinating antibodies
E. Greater than 60%
190) The normal value of sperm cells is _____ × 109/L.
191) Arthrocentesis is
192) Disorders that can be diagnosed definitively by synovial
fluid analysis are
193) What would not be an aspiration site for synovial fluid?
194) If a synovial fluid aspirate is very turbid and septic
arthritis is suspected, a _____ should definitely be
performed.
195) Crystals that are in multiple three-dimensional forms are
196) An increased percentage of polymorphonuclear
segmented neutrophils (PMNs) is characteristic of
72.E
73.B
74.A
75.D
76.C
15
D
60 to 150
a liquid biopsy
gout, CPPD deposition
disease, and septic arthritis
Posterior iliac crest
Gram stain and culture
CPPD crystals
septic arthritis
Hematology TB Flashcards Unit 4
197) Match the following crystals with an associated disorder
(use each answer once).
83. _____ MSU
84. _____ Calcium oxalate
85. _____ Cholesterol
86. _____ Lipid liquid “maltese cross”
A. Chronic renal disease
B. Chronic rheumatoid effusions
C. Acute and chronic arthritis
D. Acute gouty arthritis
198) Important parts of the CLSI format include all of the
following sections except
A) Test principle
B) Type of safety equipment to wear
C) Specimen collection and preparation
D) Reagents, supplies, and equipment
199) The stain for a reticulocyte count is
200) The Westergren method ___.
201) Hemolysis of whole blood specimen will produce an
error in the result of a hematocrit reading.
202) Refractile bodies can produce a false-positive observation
in a platelet count
203) Excessive anticoagulant will produce a decreased
reticulocyte count.
204) The correct reference value for an erythrocyte count for
an adult male is
205) The average reference value for a total WBC count for a
newborn is
206) The correct reference value for a reticulocyte for an adult
is
207) The reference value for the total platelet count in an adult
is
208) The clinical or specimen condition that will produce a
significantly increased total leukocyte count is
Match the following procedures with a clinical or specimen
condition that will produce an increased test result.
209) Packed cell volume
210) Platelet count
211) Reticulocyte count
212) Westergren ESR method
16
83.D
84.A
85.B
86.C
B
New methylene blue
Is a procedure that measures
the rate of erythrocyte
settling
True
True
False
4.5 to 5.9 × 1012/L
18.1 × 109/L
0.5%–2.0%
150 to 400 × 109/L
Inflammation
Polycythemia
Splenectomy
Hemolytic anemia
Rouleaux formation
Hematology TB Flashcards Unit 4
Match the following leukocyte types with a clinical condition
that will produce an increased value.
213) Neutrophils
Appendicitis
214) Lymphocytes
The flu
215) Monocytes
Tuberculosis
216) Eosinophils
Hay fever
Match the following procedure with a clinical condition that will
produce an increased value.
217) Platelet count
Acute hemorrhage
218) Reticulocyte count
Hemolytic anemia
219) Westergren ESR
Myocardial infarction
220) The packed cell volume procedure can be affected by the D
A) Type of anticoagulant in the evacuated tube
B) Length of time of centrifugation
C) Ratio of anticoagulant to whole blood
D) All of the above
221) The sedimentation rate of erythrocytes can be affected by D
the
A) Ratio of anticoagulant to whole blood
B) Angle of the tube
C) Temperature of the specimen or laboratory
D) All of the above
222) A decreased number of platelets per oil immersion field
5
in an area where the erythrocytes are just touching each
other is
223) What erythrocytic inclusions contain DNA and can be
Howell-Jolly bodies
observed by staining with Wright-Giemsa stain?
224) The average reference range for a prothrombin time
10–15 seconds
result is
225) True or False: the activated partial thromboplastin time
True
is the test of choice for the control of heparin therapy.
226) True or False: the activated partial thromboplastin time is False
abnormal in cases of severe liver disease.
227) What is not a benefit of laboratory instrumentation to the Reduced cost on rarely
hematology laboratory?
performed procedures
Match the following principles of cell counting instrumentation.
A.) The volume of each cell is proportional to the degree of light scatter
B.) Each cell momentarily increases resistance
228) Electrical impedance principle
B
229) Optical detection principle
A
230) The abbreviation laser stands for
light amplified by
stimulated
emission of
radiation
231) A photon is
the basic unit of all
radiation
17
Hematology TB Flashcards Unit 4
232) The major application of flow-cell cytometry is
233) The term parameter means
234) Data output from three-part differential counters includes
A. an erythrocyte histogram
B. a leukocyte histogram
C. a platelet histogram
D. all of the above
235) Applying the optical principle of laser scatter technology to cell
counting and analysis, discrimination between erythrocytes and
platelets depends on the
A. cellular volume
B. cellular refractive index
C. time of flight through the sensing zone
D. all of the above
236) A bimodal histogram distribution is suggestive of
A. cold agglutinin disease
B. posttransfusion of normal red cells to a person with abnormally sized
red cells
C. the presence of RBC fragments
D. all of the above
237) Which parameters are calculated rather than directly measured?
238) In an erythrocyte histogram, the erythrocytes that are larger than
normal will be to the _____ of the normal distribution curve.
Match the formulas to the RBC test.
241) Patient RBC variation – average normal RBC variation
SD of average normal RBC variation
242) (SD/Mean) × 100
243) The RDW and MCV are both quantitative descriptors of
erythrocyte size. If both are increased, the most probable erythrocytic
abnormality would be
244) If the RBC distribution on a histogram demonstrates a
homogeneous pattern and a small SD, the peripheral blood smear
would probably exhibit
18
sorting of cells and
cellular
identification using
monoclonal
antibodies
any numerical
value that
describes an entire
population
D
D
D
Hematocrit and
erythrocyte
distribution width
right
241. Red cell
measurement
index
242. RDW
megaloblastic
anemia
very little
anisocytosis
Hematology TB Flashcards Unit 4
245) The ____ can be determined from a WBC histogram.
A. percent of lymphocytes
B. absolute number of lymphocytes
C. frequency distribution of granulocytes
D. all of the above
The sorting of leukocyte subpopulations in the WBC histogram determined
by electrical impedance reflects the _1____, which is primarily related to
their _2____.
246) The mononuclear cells in a WBC histogram can include
A. blast cells
B. promyelocytes
C. monocytes
D. all of the above
247) A combined scatter histogram measures
248) The MPV is
249) The MPV is often decreased
250) A normal PDW is
251) What can be an application of flow-cell cytometry?
A. Screening erythrocytes for malaria
B. Counting of reticulocytes
C. Quantitation of T and B cells
D. All of the above
252) Major systems in a flow cytometer include all of the following
except
A. fluidics
B. optics
C. computerized electronics
D. gating
253) The restriction of data analysis to one cell population is
accomplished by
254) Which cell surface membrane marker is used for enumeration of
HPC enumeration?
255) Reticulocytes can be detected by using _____ stain.
A. new methylene blue
B. thiazole orange
C. propidium iodide
D. both A and B
256) The newer clinical instruments for measuring blood clotting are
based on
19
D
1. relative size
2. nuclear size
D
cell size and
granularity
a measurement of
the average
volume of platelets
in megaloblastic
anemia
less than 20%
D
D
gating
CD34
D
changes in optical
density
Hematology TB Flashcards Unit 4
257) The fibrometer relies on the principle of
258) In the photo-optical method, the change in light transmission vs the
_____ is used to determine the activity of coagulation factors/ stages.
259) In measuring platelet aggregation, platelet-rich plasma can be
treated with _____ to aggregate platelets.
A. saline
B. collagen
C. epinephrine
D. both B and C
260) A source of error when using the fibrometer in coagulation studies
can be
A. improper reaction temperature
B. overincubation of the substrate reagent
C. overincubation of the test plasmas
D. all of the above
Match the following principles of cell counting instrumentation
262) As each cell passes through the sensing zone of the flow cell, it
scatters the focused light.
263) The output histogram is a display of the distribution of cell volume
and frequency.
Match the characteristics of light scatter
264) Diffracted light, which relates to the size or volume of the cell
265) Refraction of internal components, which correlates with internal
complexity
266) True or False? Laser light is almost exclusively of one wavelength.
267) True or False? Laser light is multicolored.
268) True or False? Laser has parallel waves that travel in one direction.
261) With a particle-counting instrument, a high background count can
be due to
269) The term parameter means
270) The term, sample, means
271) A statistic is
272) The delta check method of quality control
20
conduction or
impedance of an
electrical current
by fibrin
time
D
D
262. The output
histogram is a
display of the
distribution of cell
volume and
frequency
263. Optical
detection principle
264. Low-angle
light scatter
265. Orthogonal
light scatter
True
False
True
contaminated
diluent
A statistical
A subset of a
population
Any numerical
value describing a
sample
Uses the patient’s
own data to
monitor population
values
Hematology TB Flashcards Unit 4
273) In an erythrocyte histogram, the erythrocytes that are smaller than
normal will be to the _____ of the normal distribution curve.
274) The reticulocyte hemoglobin content (CHr) demonstrates
275) The RDW and MCV are both quantitative descriptors of
erythrocyte size. If the RDW is increased and the MCV is decreased,
the most probable erythrocytic abnormality would be
276) Beckman Coulter instrumentation differs from other hematology
instrumentation because it uses
277) Requires a quality assurance/quality control system.
A) The Joint Commission
B) College of American Pathologists
C) Clinical laboratory Improvement Amendments
D) All of the above
278) The native cell size of a platelet is reflected in platelet counting and
sizing in
A) Electrical impedance method
B) Optical method
C) Only microscopic examination
D) Both A and B
279) The mean platelet volume is
280) In healthy patients, the platelet volume _1_ as platelet count _2_.
281) MPV values should be based on specimens that are _________old.
282) If the platelet count is normal, an MPV between _______ and
_______ is in the normal range.
283) The PDW is a measure of
A) The uniformity of platelet size
B) The number of platelets in a blood specimen
C) The age of platelets
D) Thrombopoiesis
284) The MPV is often decreased in
A) Aplastic anemia
B) Megaloblastic anemia
C) Postchemotherapy
D) All of the above
285) Flow cytometer instrumentation relies on
A) A cytochemical reaction to prepare the blood cells for analysis
B) A cytometer to measure specific cell properties
C) Algorithms to convert these measurements
D) All of the above
21
Left
The functional
state of
erythropoiesis
Iron deficiency
anemia
VCS Technology
D
D
The average
volume of platelets
1. Increases
2. Decreases
Between 1 and 4
hours
9.0 and 9.8 fL
The uniformity of
platelet size
D
D
Hematology TB Flashcards Unit 4
286) Peroxidase staining used in flow cytometry systems is positive in
all of the following except
A) Eosinophils
B) Neutrophils
C) Monocytes
D) Blasts
287) In the basophil/lobularity (nuclear) channel of some instruments,
only the bare nuclei remain for all of the following cells except
A) Neutrophils
B) Lymphocytes
C) Basophils
D) Monocytes
288) All of the following stains can be used in automated reticulocyte
counting except
A) Thiazole orange
B) Oxazine 750
C) New methylene blue
D) Propidium iodide
289) Flow cell cytometry can be used to diagnose PNH and can replace
A) Ham test
B) Acid hemolysis test
C) Sucrose water test
D) All of the above
22
D
C
D
D