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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