HEMATOLOGY LECTURE E.

None of the choices

Quiz #5 Finals - RBC Abnormalities
6. Basophilic stippling can be associated with
1. Which of the following inclusions is linked with abnormal heme synthesis. Which of the following
exposure to oxidant drugs and chemicals? conditions is NOT typically associated with basophilic
A. Basophilic stippling stippling?
B. Howell-Jolly bodies A. Lead intoxication
C. Heinz bodies B. Arsenic poisoning
D. Pappenheimer bodies C. Iron deficiency anemia
E. None of the choices D. Thalassemia
E. None of the choices
2. What is the key difference between Echinocytes
and Acanthocytes? 7. A patient with hereditary spherocytosis presents
A. Acanthocytes have uniform spicules while with jaundice. Which of the following laboratory results
Echinocytes have irregular spicules would you expect to confirm this diagnosis?
B. Acanthocytes are caused by osmotic imbalance A. Normocytic RBCs with MCV between 80-100 fL
while Echinocytes are caused by trauma B. Hyperchromic RBCs with MCHC >36%
C. Both result from hereditary defects C. Macrocytic RBCs with MCV >100 fL
D. Both have spicules of uniform size and shape D. Hypochromic RBCs with MCHC <32%
E. None of the choices E. None of the choices

3. Which of the following correctly describes the 8. What is the characteristic morphology of Cabot
clinical relevance of the detection of Howell-Jolly rings in red cells?
bodies? A. Dark blue, round granules
A. Indicative of thalassemia minor B. Dark, loop-shaped or figure-eight structures
B. Sign of G6PD deficiency C. Fine granules spread throughout the cell
C. Hallmark of megaloblastic anemia due to impaired D. Blue-gray inclusions resembling a glove
nuclear maturation E. None of the choices
D. Evidence of impaired spleen
E. None of the choices 9. Which condition would most likely present with the
presence of schistocytes in a peripheral blood smear?
4. A patient presents with cold agglutinin disease and A. Hereditary spherocytosis
autoagglutination is noted. Which of those following B. Hemoglobin C disease
conditions is the most likely underlying cause of this C. Chronic liver disease
presentation? D. Transplant rejection
A. Pernicious anemia E. None of the choices
B. Mycoplasma pneumoniae infection
C. Acute blood loss 10. In a PBS, the presence of rouleaux formation is
D. Chronic blood loss noted. What is the most likely explanation for this
E. None of the choices abnormal distribution?
A. Cold agglutinin disease
5. A 60-year old patient presents increased number of B. High concentration of globulin
burr cells and schistocytes in his peripheral blood C. Autoimmune hemolytic anemia
smear. You review the patient’s medical history, which D. Iron deficiency
includes a diagnosis of uremia. Given these findings, E. None of the choices
which treatment option would be most likely
appropriate in the patient’s condition? 11. Which of the following inclusions is found in
A. Iron supplementation patients with sideroblastic anemia?
B. Dialysis A. Heinz bodies
C. Transfusion of packed RBC B. Pappenheimer bodies
D. Increase exercise C. Cabot rings
D. Hemoglobin H bodies 17. Which red cell inclusion is typically associated with
E. None of the choices protozoan infections, particularly in malaria?
A. Schuffner’s dots
12. Which of the following inclusions would stain B. Spherocytes
positively with Perl’s Prussian Blue and indicate iron C. Hemoglobin C crystals
overload in red cells? D. Howell-Jolly bodies
A. Heinz bodies E. None of the choices
B. Hemoglobin H
C. Hemoglobin SC 18. Which red cell inclusion, identified by a supravital
D. Pappenheimer bodies stain, suggests a diagnosis of G6PD deficiency?
E. None of the choices A. Howell-Jolly bodies
B. Heinz bodies
13. Which red cell inclusion is associated with C. Pappenheimer bodies
aggregates of ribosomes and associated clinically with D. Cabot rings
distributed defective erythropoiesis? E. None of the choices
A. Heinz bodies
B. Fine basophilic stippling 19. A young patient with liver disease presents with
C. Coarse basophilic stippling both codocytes and high RDW. What
D. Pappenheimer bodies pathophysiological process could explain this RBC
E. None of the choices distribution abnormality?
A. Impaired hemoglobin synthesis due to iron
14. You are evaluating two patients: one has a high deficiency
RDW with anisocytosis, and the other has a high B. Lipid abnormalities affecting the RBC membrane
RDW with normocytic RBCs. What additional test C. Ineffective erythropoiesis
result would be most helpful in distinguishing the D. Abnormal globulin production leading to
underlying cause? autoagglutination
A. Mean Corpuscular He moglobin Concentration E. None of the choices
(MCHC)
B. Serum ferritin levels 20. If a blood smear shows red cells with a pitted golf
C. Reticulocyte count ball appearance, what type of inclusion is present?
D. Peripheral blood smear A. Multiple Heinz bodies
E. None of the choices B. Hemoglobin H
C. Howell-Jolly bodies
15. A peripheral blood smear shows dacryocytes and D. A and B only
elliptocytes. Which of the following is the most likely E. None of the choices
condition?
A. Hereditary elliptocytosis Quiz #6 Finals - RBC Disorders
B. Hemoglobin C Disease
C. Myelophthisic anemia 1. What disease is characterized by
D. A and B only leukoerythroblastic features and is associated with
E. None of the choices cancer and bone metastasis?

16. A blood smear of a pregnant woman shows A. Secondary hemochromatosis

rouleaux formation. Which laboratory parameter B. Porphyria cutanea tarda
change would mostly likely correlate with this finding? C. Cooley's Anemia
A. Increased RDW D. Myelophthisic Anemia
B. Increased fibrinogen levels E. Aplastic Anemia
C. Decreased MCHC
D. Increased reticulocyte count 2. Which antibody is associated with Cold
E. None of the choices Autoimmune Hemolytic Anemia?
 A. Anti-Kidd A. There is decreased RBC Adenine deaminase
B. Anti-Kell result
C. Anti-P B. There is increased reticulocytes
D. Anti-I C. WBC and platelets are not affected in this
disease
3. What is the most common porphyria associated D. Acquired Pure Red Cell Aplasia cannot be
with neurological abnormalities affecting brain overcome immediately
function?
8. What is TRUE regarding Hemoglobin D?
A. ALAD deificiency porphyria
B. Acute intermittent porphyria I. Peripheral blood smear shows normal
C. Congenital erythropoietic porphyria II. Hgb S migrates the same with Hgb D on cellulose
D. Variegate porphyria acetate at pH 8.6
III. The disease is symptomatic with anemia
4. What gene is associated with hereditary IV. This hemoglobin do not sickle
hemochromatosis and known to cause a decrease in
hepcidin levels when mutated? A. I, II and III only
B. II and III only
A. Sickle gene C. I, III and IV only
B. SPTB gene D. I, II, and IV only
C. ANK1 gene E. I, II, III and IV
D. HFE gene
E. SLC4A1 gene 9. The antiobdy involved is IgG in nature with a
characteristic of biphasic in nature. What disease is
5. What is the most likely cause of anemia in a patient associated with this kind of offending antibody?
with a history of liver disease, with an MCV of 110 fL
and a reticulocyte count of 4.5%? A. Paroxysmal Cold Hemoglobinuria
B. Paroxysmal Nocturnal Hemoglobinuria
A. Megaloblastic anemia C. Cold Agglutinin Disease
B. Non-megaloblastic anemia D. Mixed Type Autoimmune Hemolytic Anemia
C. Thalassemia
D. Pure Red Cell Aplasia 10. What is NOT TRUE regarding Anemia of Chronic
Inflammation?
6. What is TRUE regarding Congenital
Dyserythropoietic Anemia? A. There is a problem on the mobilization of iron
B. Acute phase reactant increases due to
I. There is hypercellularity malignant diseases
II. There are lots of erythroid cells but morphologically C. Iron cannot be released due to increase
abnormal amount of apoferritin
III. There is no response to treatment D. Iron is deficient
IV. This disease is formed during gestation E. All of the choices

A. I, II and III only 11. What form or classification of sideroblastic anemia

B. I and II only is a risk of developing acute leukemia? (10% of the
C. II, III and IV only patients with this form of sideroblastic anemia develop
D. III and IV only acute leukemia)
E. I, II, III and IV
A. Hereditary Sideroblastic Anemia
7. What is TRUE regarding Pure Red Cell Aplasia? B. Porphyrias
C. Secondary Acquired Sideroblastic Anemia
D. Idiopathic Acquired Sideroblastic Anemia
 III. There is cracks in the corners of the mouth
12. How many alpha gene remains in Hemoglobin H IV. There is craving to eat things that are unusual
Disease to produce alpha chain?
A. 1 A. I and II only
B. 2 B. I, II and III only
C. 3 C. I only
D. 4 D. I, III and IV only
E. No alpha gene is produced E. I, II, IV only

13. This disease becomes more severe with 18. Variegate porphyria and Porphyria cutanea tarda
Beta-Thalassemia, the disease becomes more severe are all inherited as autosomal dominant traits. True or
and closely resembles B-Thalassemia major, requiring False?
regular transfusion.
A. True
A. Hgb C-Harlem Disease B. False
B. Hgb D Disease
C. Hgb E Disease 19. A patient from Middle East was reffered to a
D. Hgb G Disease Hematologist. His hemoglobin electrophoresis result
E. None of the choices are as follow:

14. This is also known as Hereditary Erythroblastic 51% Hgb C ; 49% Hgb S only
Multinuclearity with Positive Acidified Serum Test
What could be the possible diagnosis?
A. Congenital Dyserythropoietic Anemia I
B. Congenital Dyserythropoietic Anemia II A. Hemoglobin SC Disease
C. Congenital Dyserythropoietic Anemia III B. Hemoglobin C Trait
D. None of the choices C. Hemoglobin AS
D. Hemoglobin S
15. This can cause direct damage to the RBC E. None of the choices
membrane, producing acute hemolysis, which
characterized by severe anemia with many 20. What is the most likely finding in a bone marrow
schistocytes and microspherocytes. aspirate from a patient with aplastic anemia?

A. Malaria A. Marked hyperplasia

B. Thermal Injury B. Increased plasma cells
C. Cold Agglutinin Disease C. Hypocellularity accompanied by pancytopenia
D. Aplastic anemia D. Hypercellularity with increased RBC
E. Iron Deficiency Anemia E. None of the choices

16. What is the result of serum iron in stage 1 iron Quiz 7: WBC and Leukocyte Disorders
deficiency?
1. Case: A peripheral smear shows 75% blasts.
A. Normal These stain positive for both Sudan Black B
B. Increased (SBB) and peroxidase. Given these values, which
C. Decreased of the following disorders is most likely?
D. Normal or increased Acure Myeloid Leukemia (AML)

17. Which describes stage 3 iron deficiency? 2. What would be the most likely designation by the
WHO for the FAB AML M2 by the
I. RBCs are microcytic and hypochromic French-American-British classification?
II. Normal RBC production A. AML with t(15;17)
 B. AML with mixed lineage B. At least 20%
C. AML with t(8;21) C. At least 10%
D. AML with inv(16) D. Any percentage

3. The genetic mutation associated with CML: 9. Which of the following reaction are often positive in
ALL but are negative in AML?
A. t(15;17)
B. t(11;14) A. Chloroacetate esterase and nonspecific
C. t(9;22) esterase
D. t(8;21) B. Terminal deoxynucleotidyl transferase and
PAS
4. What cells should be counted in testing for C. Sudan Black B and peroxidase
leukocyte alkaline phosphatase activity? D. New methylene blue and acid phosphatase

A. Atypical lymphocytes 10. What would be the most likely designation by the
B. Monocytes WHO for the FAB AML M3 by the
C. Macrophages French-American-British classification?
D. Segmented neutrophils
A. AML with t(15;17)
5. What is the type of cell that is mostly associated B. AML with mixed lineage
with immediate hypersensitivity? C. AML with t(8;21)
D. AML with inv(16)
A. Neutrophil
B. Basophil 11. What white blood cell abnormality is associated
C. Monocyte with increased immunoglobulin levels and multiple
D. Lymphocyte myeloma?
E. Eosinophil
A. Sezary cells
6. What is the youngest white blood cell to normally B. Auer rods
appear in peripheral blood? C. Flame cells
D. Chediak-Higashi grnaules
A. Retics E. None of the choices
B. Band
C. Segemented neutrophil 12. Disseminated Intravascular Coagulation or DIC is
D. Mature basophil most common often associated with which of the
E. All of the choices following acute leukemia?

7. What morphological grnaulocyte abnormality is A. Acute myeloid leukemia without maturation

associated with severe infections and septicemia? B. Acute promyelocytic leukemia
C. Acute myelonomocytic leukemia
A. Hypersegemented neutrophil D. Acute monocytic leukemia
B. Toxic vacuoles
C. Alder-reilly granules 13. In which age group does acute lymphoblastic
D. Pelger-Huet leukemia occur with high frequency?
E. None of the choices
A. 1-15 years
8. The WHO classification requires what percentage B. 20-35 years
for the blast count in the blood or bone marroe for the C. 45-60 years
diagnosis of AML? D. 60-75 years

A. At least 30%
14. What is a type of white blood cell that is HEMATOLOGY LABORATORY
approximately the size of a normal red blood cell? Quiz #1- Hematocrit & ESR

A. Lymphoblast 1. Normal red cells settle faster at the bottom of the

B. Myeloblast tube because of their negatively charged cell surface.
C. Plasma cells
D. Small lymphocyte A. True
E. NK cells B. False

15. The JAK2 mutation may be positive in all of the 2. The coulter counter series of analyzers provide a
following chronic myeloproliferative disorders, direct measurement of hematocrit.
EXCEPT?
A. True
A. Essential thrombocythemia B. False
B. Myelofibrosis
C. Polycythemia vera 3. Which side of the Wintrobe tube is used in
D. CML measuring packed cell volume?

16. What is the earliest recognition stage in the A. 0 at the top, 100 at the bottom
granulocytic maturation series? B. 100 at the top, 0 at the bottom
C.
A. Myelocyte 4. Trapped plasma would result in _____.
B. Myeloblast
C. Metamyelocyte A. Increased hematocrit
D. Mature granulocyte B. Decreased hematocrit
E. Band
5. What is the unit of reporting in Hematocrit?
17. case: A 30-year old female patient presented to
the emegency department with symptoms suggestive A. %
of DIC. A CBC and coagulation studies were ordered. B. mm/hr
The peripheral smear showed blasts and immature C. /L
cells with heavy granulation and Auer rods. Which of D. cm/60 mins
the following disorders would be most likely?
6. It is the single most important factor determining
A. Acute Nonlymphocytic Leukemia with t(9;11) ESR.
B. Acute Nonlymphocytic Leukemia with t(12;21)
C. Acute Nonlymphocytic Leukemia with t(9;22) A. RBC
D. Acute Nonlymphocytic Leukemia with t(15;17) B. Plasma composition
C. Mechanical factor
18. A patient with normal chromosomes has a WBC D. Technical factor
count of 3.0 x10^9/L and dysplasia in all cell lines.
There are 60% blasts of varying sizes. The blasts 7. Why ESR values tend to rise with age?
stain positive for CD61. The most likely type of
leukemia is: A. Old people have anemia
B. Old people have increased body temperature
A. Acute lymphoblastic
C. Old people have decreased albumin
B. Acute megakaryoblastic
D. Old people have positively charged red cells
C. Acute monoblastic
D. AML with t(15:17)
8. It is performed in the laboratory by placing
anticoagulated blood in an upright tube and measures
the rate of sedimentation.
 A. ESR A. Anemia
B. CRP B. Increased albumin
C. Both C. Tilting of the tube
D. Neither D. Sickle cells

9. What is the standard method for ESR? 17. A phase of ESR where red cells have rapid, and
A. Westergren constant rate of sedimentation?
B. Wintrobe
A. Lag phase
10. Patient name: Juan Dela Cruz, Sex: Male, B. Decantation phase
Hematocrit= 30%. What is the interpretation? C. Packing phase

A. Increased hematocrit 18. Why increased rouleaux formation contributes to

B. Decreased hematocrit high ESR?
C. Within the normal range
A. Stack of red cells become heavier, thus, it
11. Steroid drugs can cause a/ an _____ ESR. sediment faster
B. Plasma proteins intensify the negative charge
A. Increased of red cells promoting cell adherence and
B. Decreased rouleaux formation.
C. Both
12. A marker for inflammation. D. Neither

A. ESR 19. Buffy coat is included in the measurement of

B. CRP packed cell volume.
C. Both
D. Neither A. True
B. False
13. A high sedimentation rate signals high levels of C.
inflammation in the body. 20. Which method of ESR is also used for measuring
packed cell volume?
A. True
B. False A. Westergren
C. B. Wintrobe
14. Inflammation causes a/ an _____ fibrinogen in the
plasma.
Quiz #2- WBC & RBC Counting
A. Decreased
B. Increased 1.Source of error: Improper mixing

15. Which of the following conditions has a decreased A. WBC Counting

hematocrit? Select all that apply. B. RBC Counting
C. Both
A. Dehydration D. Neither
B. Anemia
C. Pregnancy 2. Inverted "L" rule is applied in counting
D. Newborns
A. WBC Counting
16. Which of the following conditions has increased B. RBC Counting
ESR? Select all that apply. C. Both
 D. Neither C. Both
D. Neither
3.
Increased following strenuous physical activity. 10. Area counted factor= 25/5

A. WBC Counting A. WBC Counting

B. RBC Counting B. RBC Counting
C. Both C. Both
D. Neither D. Neither

4. 4 drops of mixture is discarded after mixing. 11. Dahil honest at mabait kang student, choose
"Papasa ako ng Hema 1" for a 3-point-bonus
A. WBC Counting
B. RBC Counting A. Papasa ako ng Hema 1
C. Both
D. Neither 12. Cell count is corrected in the presence of NRBC

5. Sample can be both capillary blood and venous A. WBC Counting

blood B. RBC Counting
C. Both
A. WBC Counting D. Neither
B. RBC Counting
C. Both 13. Diluting fluid: Formol citrate
D. Neither A. WBC Counting
B. RBC Counting
6. HPO is used in counting C. Both
D. Neither
A. WBC Counting
B. RBC Counting 14. Cells are counted in each 5 small square in the
C. Both upper-left large corner square.
D. Neither
A. WBC Counting
7. Whole blood is aspirated up to 0.5 mark B. RBC Counting
C. Both
A. WBC Counting D. Neither
B. RBC Counting
C. Both 15. Depth factor= 10
D. Neither
A. WBC Counting
8. There are 2 basic methods in counting: the manual B. RBC Counting
method and using Coulter counter analyzers. C. Both
D. Neither
A. WBC Counting
B. RBC Counting 16. Cells are counted in 4 large corner squares
C. Both
D. Neither A. WBC Counting
B. RBC Counting
9. Diluting fluid is a weak acid solution. C. Both
D. Neither
A. WBC Counting
B. RBC Counting
17. Cell count is higher in adults compared to
newborns. A. True
B. False
A. WBC Counting
B. RBC Counting 6. What is the distribution of WBC during infection?
C. Both
D. Neither A. Shift to the left
B. Shift to the right
18. Diluting fluid is aspirated up to 101 mark C. Shift to the top
D. Shift to the bottom
A. WBC Counting
B. RBC Counting 7. In healthy adults, the predominant white cell is the
C. Both Neutrophil.
D. Neither
A. Yes
B. No

Quiz #3- Retics & Diff count 8. The most absolute and most preferred method of
reporting differential count.
1.Corrected reticulocyte count is used if the patient
has _____. A. %
B. cells/ L
A. polycythemia
B. abnormally low hematocrit 9. Incubation requirement for reticulocyte counting.
C. leukocytosis
D. presence of NRBC A. -4 C, 15 minutes
B. 22 C, 15 minutes
2. What is the troubleshooting done in Reticulocyte C. 37 C, 20 minutes
counting if the patient has an unusual high D. 60 C, 20 minutes
hematocrit?
10. Are you an honest person?
A. smaller amount of blood is added
B. larger amount of blood is added A. Yes
B. No
3. What is the purpose of reticulocyte count? Select all
that apply 11. Coulter counters report the differential cell count in
percent and also as an absolute count.
A. To help in monitoring anemic patients
B. To determine the state of erythropoietic activity A. True
C. To diagnose infection or inflammation B. False
D. To assess bone marrow activity
12. In infectious mononucleosis, what cell type may
4.What objective is used in differential counting? show an absolute increase in the blood?

A. 10x A. Neutrophil
B. 40x B. Lymphocyte
C. 100x C. Monocyte
D. Eosinophil
5. Manual differential count is performed to determine
the absolute number of each type of white cell present
in blood.
13. An important diagnostic tool which reflects the B. Mature RBC
effectiveness of the bone marrow in producing red C. Both
cells. D. Neither

A. Differential cell count

B. RBC count
C. WBC count
D. Reticulocyte count

14. Reticulocyte contains remnant of _____ which are

present in large amount in the cytoplasm in the
precursors which they were derived.

A. RNA & DNA

B. DNA & Protein
C. RNA & Ribosome
D. DNA & Ribosome

15. White cells are counted in consecutive fields from

tail toward the head of the smear.

A. Battlement method
B. Cross-sectional method
C. Longitudinal method

16. All are supravital stains, except: Select all that

apply

A. New methylene blue

B. Brilliant cresyl blue
C. Crystal violet
D. Wright's

17. All conditions have high reticulocyte count, except:

A. IDA
B. blood loss
C. Aplastic anemia
D. Hemolytic anemia

18. If there are 20 retics in 1000 red cells, what is the

% retics?
A. 0.5
B. 1.5
C. 1.0
D. 2.0

19. In Miller disk, the small area is used for counting

_____.

A. Reticulocytes