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Chapter 1: Introduction to Hematology and Basic Laboratory Practice
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. Tube length when referring to the microscope is the:
| a. | Resolution power of the objective |
| b. | Distance from the eyepiece to the objective |
| c. | Numerical aperture |
| d. | Magnitude of the image on the stage |
____ 2. What is the most useful corrective action for the microscope when fine details cannot be visualized in immature cells?
| a. | Open up diaphragm for maximum light. |
| b. | Wipe off lenses with lens cleaner. |
| c. | Get a new slide. |
| d. | Move to a lower power. |
____ 3. Which of the following behaviors is a violation of standard precautions?
| a. | Handwashing after glove removal |
| b. | Use of impermeable laboratory gowns |
| c. | Use of goggles and face shields |
| d. | Placing laboratory notebooks on laboratory work area |
____ 4. Standards and calibrators differ from control materials because:
| a. | An exact amount of analyte is present in a standard or calibrator |
| b. | A variable amount of analyte is present depending on patient samples |
| c. | Standards only need to be within a target range |
| d. | Standards are run to the best estimate of the known value |
____ 5. If the confidence interval for most laboratories is 95.5%, what is the acceptable range for hemoglobin if a hemoglobin control was run with a mean of 12.5 and a standard deviation of 1.0?
| a. | 9.5 to 12.5 |
| b. | 10.5 to 14.5 |
| c. | 11.5 to 15.5 |
| d. | 10.0 to 13.5 |
____ 6. Proper mixing of samples and timely delivery of samples to the laboratory are both examples of:
| a. | Delta checks |
| b. | Postanalytic variables |
| c. | Preanalytic variables |
| d. | Reflex testing |
____ 7. A delta check is a historical reference on samples run in the laboratories. Once a sample fails a delta check, the most obvious corrective action is to:
| a. | Verify the identification of the patient sample |
| b. | Reestablish the parameters of the delta check |
| c. | Perform reflex testing |
| d. | Perform a manual method |
____ 8. Which of the following is the definition of a reference interval?
| a. | A solution of a known amount of analyte |
| b. | Materials analyzed concurrently with unknown samples |
| c. | Values established for a particular analyte, given a method, instrument, or patient population |
| d. | Validation techniques on flagged samples |
____ 9. Which of the following is not considered a postanalytic variable?
| a. | Delta checks |
| b. | Proper anticoagulant used |
| c. | Specimen checked for clots |
| d. | Critical results called |
____ 10. Error analysis, standard protocols, and turnaround time are all part of the:
| a. | Quality assurance system |
| b. | Quality control program |
| c. | Reference standards |
| d. | Delta check protocol |
____ 11. The average of a group of data points is defined as the:
| a. | Mean |
| b. | Mode |
| c. | Median |
| d. | Modicum |
____ 12. Safety training is part of new employee training in health care and includes:
| a. | Biological hazards |
| b. | Chemical hazards |
| c. | Environmental hazards |
| d. | All of the above |
____ 13. Control materials are:
| a. | Analyzed concurrently with the unknown samples |
| b. | Substances with a known amount of analyte |
| c. | Used to calibrate the method |
| d. | All of the above |
____ 14. Delta checks are used in the hematology laboratory to:
| a. | Compare past patient results to the current result |
| b. | Verify control accuracy |
| c. | Establish a target range |
| d. | Establish reference ranges for a particular analyte |
____ 15. When handwashing after a patient contact, the soap application process should last at least:
| a. | 5 seconds |
| b. | 15 seconds |
| c. | 20 seconds |
| d. | 30 seconds |
____ 16. Which of the following represents an example of a safety violation in the laboratory?
| a. | Application of cosmetics |
| b. | Mouth pipetting |
| c. | Consuming bottled water |
| d. | All the above |
True/False
Indicate whether the statement is true or false.
____ 17. Standard deviation is a measurement of precision.
____ 18. Accuracy is a measurement of the true value of an analyte.
____ 19. A normal distribution curve will have 99.7% of the measured values fall within 2 SDs.
Short Answer
- Label the parts of the microscope.
Chapter 1: Introduction to Hematology and Basic Laboratory Practice
Answer Section
MULTIPLE CHOICE
- ANS: B PTS: 1
- ANS: A PTS: 1
- ANS: D PTS: 1
- ANS: A PTS: 1
- ANS: B PTS: 1
- ANS: C PTS: 1
- ANS: A PTS: 1
- ANS: C PTS: 1
- ANS: B PTS: 1
- ANS: A PTS: 1
- ANS: A PTS: 1
- ANS: D PTS: 1
- ANS: A PTS: 1
- ANS: A PTS: 1
- ANS: B PTS: 1
- ANS: D PTS: 1
TRUE/FALSE
- ANS: T PTS: 1
- ANS: T PTS: 1
- ANS: F PTS: 1
SHORT ANSWER
- ANS:
- Objectives
- Stage
- Eye piece
- Base
- Light source
- Iris diaphragm
- Course adjustment knob
- Fine adjustment knob
- Stage adjustment knobs
- Clips
- Substage condenser
PTS: 1
Chapter 5: The Microcytic Anemias
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. Transferrin receptors for iron uptake are located on the:
| a. | Basophilic normoblast |
| b. | Pronormoblast |
| c. | Reticulocyte |
| d. | Orthochromic normoblast |
____ 2. Storage iron is usually determined by the:
| a. | Serum transferrin level |
| b. | Hemoglobin value |
| c. | Myoglobin value |
| d. | Serum ferritin level |
____ 3. In addition to iron ingestion, over 90% of iron in adults that is used for erythropoiesis is obtained through:
| a. | Transfusion |
| b. | Recycling of iron |
| c. | Storage forms from spleen and the liver |
| d. | Hemosiderin |
____ 4. The first stage of iron deficiency anemia is termed:
| a. | Microcytic hypochromic anemia |
| b. | Iron depletion |
| c. | Iron deficiency |
| d. | Iron overload |
____ 5. All of the following are symptoms of iron deficiency anemia except:
| a. | Pallor |
| b. | Pica |
| c. | Vertigo |
| d. | Numbness |
____ 6. In adults, which of the following is the most common cause of iron deficiency anemia?
| a. | Intestinal parasites |
| b. | Malabsorptive disorders |
| c. | Dietary content |
| d. | Chronic blood loss |
____ 7. Ringed sideroblasts in the bone marrow are characteristics of which of the following disorders?
| a. | Chronic disease |
| b. | Infection |
| c. | Sideroblastic anemia |
| d. | Inflammation |
____ 8. Given the laboratory results of serum iron = 300 mg/dL, transferrin = 312 mg/dL, transferrin saturation = 122%, and ferritin = 1,000 ng/mL, which of the following should be considered?
| a. | Hereditary hemochromatosis |
| b. | Anemia of inflammation |
| c. | Iron deficiency anemia |
| d. | Lead poisoning |
____ 9. Which type of inclusion is likely to be seen in the above patient?
| a. | Howell-Jolly bodies |
| b. | Pappenheimer bodies |
| c. | Hemoglobin H inclusion bodies |
| d. | Cabot rings |
____ 10. A 15-year-old Lebanese boy was sent to the laboratory for an evaluation of anemia and had the following lab results:
| a. | WBC = 7.5 ´ 109/L |
| b. | RBC = 5.9 ´ 1012/L |
| c. | Hgb = 11.6 g/dL |
| d. | Hct = 36% |
____ 11. What is the presumptive clinical condition?
| a. | Pernicious anemia |
| b. | Autoimmune hemolytic anemia |
| c. | Iron deficiency trait |
| d. | Thalassemia trait |
____ 12. The alpha thalassemic condition that is incompatible with life is:
| a. | Hemoglobin H disease |
| b. | Bart’s hydrops fetalis |
| c. | Alpha thalassemia trait |
| d. | Silent carrier condition |
____ 13. Which inclusion is associated with a “pitted,” golf ball appearance?
| a. | Hgb H inclusion |
| b. | Howell-Jolly body |
| c. | Cabot rings |
| d. | Pappenheimer bodies |
____ 14. Failure to thrive, facial structure abnormalities, severe anemia, and splenomegaly are signs of which of the following disorders?
| a. | Thalassemia minor |
| b. | Alpha thalassemia trait |
| c. | Thalassemia major |
| d. | Thalassemia intermedia |
____ 15. One of the gravest clinical problems for individuals with thalassemia major is:
| a. | Chronic anemia |
| b. | Iron overload |
| c. | Therapeutic phlebotomy |
| d. | Collapsed veins |
____ 16. The majority of the hemoglobin made in individuals with thalassemia major is:
| a. | Hemoglobin H |
| b. | Hemoglobin A |
| c. | Hemoglobin F |
| d. | Hemoglobin Barts |
____ 17. Which if the following is also known as Cooley’s anemia?
| a. | Alpha thalassemia |
| b. | Beta thalassemia major |
| c. | Hereditary hemochromatosis |
| d. | IDA |
____ 18. The alpha thalassemias result from:
| a. | Gene deletion |
| b. | Defective alpha genes |
| c. | Iron overload |
| d. | Excessive production of alpha chains |
____ 19. The globin chains found in hemoglobin A2 are:
| a. | Alpha 2, Delta 2 |
| b. | Alpha 2, Gamma 2 |
| c. | Alpha 2, Beta 2 |
| d. | Alpha 2, Epsilon 2 |
____ 20. The presence of which hemoglobin will result in an inherited methemoglobinemia?
| a. | Hemoglobin D |
| b. | Hemoglobin M |
| c. | Hemoglobin H |
| d. | Bart’s hemoglobin |
____ 21. Hemoglobin H disease is associated with:
| a. | Bart’s hydrops fetalis |
| b. | Alpha thalassemia disease |
| c. | Thalassemia major |
| d. | Hereditary hemochromatosis |
____ 22. The primary storage forms of iron are:
| a. | Ferritin and hemosiderin |
| b. | Ferritin and transferrin |
| c. | Hemosiderin and ferrous iron |
| d. | Heme and ferritin |
____ 23. In the United States, approximately ____ of the anemias seen are due to IDA.
| a. | 25% |
| b. | 40% |
| c. | 50% |
| d. | 75% |
____ 24. In iron deficiency anemia, the reticulocyte count will be:
| a. | Normal |
| b. | Low |
| c. | High |
| d. | Extremely high |
____ 25. In patients with iron overload, Desferal may be administered to chelate the excess iron. The chelated iron is shed in:
| a. | The feces |
| b. | The urine |
| c. | Gastric secretions |
| d. | None of the above |
True/False
Indicate whether the statement is true or false.
____ 26. In regards to the thalassemias, the deficit has nothing to do with iron.
Chapter 5: The Microcytic Anemias
Answer Section
MULTIPLE CHOICE
- ANS: B PTS: 1
- ANS: D PTS: 1
- ANS: B PTS: 1
- ANS: B PTS: 1
- ANS: D PTS: 1
- ANS: D PTS: 1
- ANS: C PTS: 1
- ANS: A PTS: 1
- ANS: B PTS: 1
- ANS: D PTS: 1
- ANS: D PTS: 1
- ANS: B PTS: 1
- ANS: A PTS: 1
- ANS: C PTS: 1
- ANS: B PTS: 1
- ANS: C PTS: 1
- ANS: B PTS: 1
- ANS: A PTS: 1
- ANS: A PTS: 1
- ANS: B PTS: 1
- ANS: B PTS: 1
- ANS: A PTS: 1
- ANS: C PTS: 1
- ANS: B PTS: 1
- ANS: B PTS: 1
TRUE/FALSE
- ANS: T PTS: 1
