Hema tology id c ” po segs only are marked wit an NLS ONLY. io Bg 290 = Answers with Explanations ve been identified generally as appropriate for both entry level medical ns questions pr ysiology 291 Erythrocytes: Physiology Bg Eee isoase States 291 Erythrocytes: Disea Ft Ett aboralory Determinations 294 Erythrocytes: Laboratory Fee eee physiology 296 Leukocytes: me oS Disease States 297 Leukooytes: 46 Levies: Laboratory Determinations 300 Levkot jay Laboratory Operations 301 Hematology Laborat Hemat 301 Platelets: Physiology zl s Physiology z Pets OF satin Soe Potts: obrtoy etembaions 14 protelets: 306 Hemostasis art Hemostasis Eythrocytes: Physiology The following are compounds formed in the synthesis of heme: t 4 coproporphyrinogen 2 porphobilinogen 3 uroporphyrinogen 4 protoporphyrinogen Which of the following responses lists these compounds in the order in which they are formed? 2 The majority of the iron in an adult is found as a constituent of: &@ hemoglobin i hemosiderin myoglobin 4 transferrin The main function of the hexose monophosphate shunt in the erythrocyte is to: f (29ulate the level of 2,3-0PG ot e Provide reduced glutathione to prevent hemoglobin oxidation ceent the reduction of heme iron wide energy for membrane maintenance a Si CP ISBN o78-o9910-nano, cunical Laboratory Certification Examinations 2194: Hematology Erythrocytes: Phy sigy, logy, 4. Refer to the following illustration: 2 £ i's 50°) S | 40: 3 § 30. gE 20 oc 10: oS 0 a & 6 -3 birth 3 6 3 (Months) Which curve represents the 2 “s 50+ S_ 404 35 30 BB 204 ao 104 3s o4 == = -6 -3 birth 3 6 & (Months) production of alpha polypeptide chains of hemoglobin? Which curve represents the production of beta polypeptide chains of hemoglobin? ¥ “6-3 birth 3 (Months) $ Which curve represents the production of gamma polypeptide chains of hemoglobin? aore gQm> 220 The Board of Ce ISBN 978-0891 89-6609 enptBase?pematology & lobin to combi Erythrocytes: Physiology order for hemoglol bine reversibly wilt exygon in complexed with haptoglobin y circulating in the cytoplasm f tresened to transferrin din the ferrous state ich of the following disease states are t nm vit cal iy seen? ardrop cells and abnormal platelets most a hemolytic anemia b multiple myeloma ¢ GEPD deficiency § primary myelofibrosis The characteristic erythrocyte found in pernicious anemia is: a icrocytic Sa micro “Sf spherocytic | ¢ hypachromic | d macrocytic | 40, Inthe normal adult, the spleen acts as a site for: | | } | a storage of red blood cells b production of red blood cells ¢ synthesis of erythropoietin d removal of imperfect and aging celis 41. After the removal of red blood cells from the circulation hemoglobin is broken down into: a iron, porphyrin, and amino acids b iron, protoporphyrin, and globin ¢ heme, protoporphyrin, and amino acids d heme, hemosiderin, and globin 12. Heinz bodies are: @ readily identified with polychrome stains b remnants of RNA ¢ closely associated with spherocytes d denatured hemoglobin inclusions that are readily removed by the spleen 4% Hemolysis in paroxysmal nocturnal hemoglobinuria (PNH) is: % * a tamperature-dependent b complement-independent © antibody-mediated _ @ caused by a red cell membrane defect Calls for the transport of O2 and COz are: a erythrocytes granulocytes © lymphocytes d thrombocytes oy 7" Erythropoietin acts to: @ shorten the replication time of the granulocytes @ stimulate RNA synthesis of erythroid cells iNcrease colony-stimulating factors produced by the B lymphocytes decrease the release of marrow reticulocytes tificatic raminations 221 ieAS> Iggy com naos ‘ptininat Laboratory Certification Examination:4: Hematology EVENS: Physic, ‘ay 16, What cell shape is most commonly associated with an increased MCHC @ teardrop cells b target cells, © spherocytes d sickle cells — 17. Which of the following is most closely associated with idiopathic hemochromatosis» ® a iron overload in tissue b target cells © basophilic stippling d ringed sideroblasts 18. Which description best fits the Donath-Landsteiner antibody? a IgM cold agglutinin b biphasic IgM hemolysin ¢ |gG biphasic hemolysin d_ IgG warm agglutinin 19. Which of the following represent residual nuclear fragments? a Pappenheimer bodies b Cabot rings © Heinz bodies d target cells 20. Which of the following RBC inclusions are seen i n sideroblastic anemia and contain high amounts of iron? a Cabot rings b Howell-Jally bodies ¢ Heinz bodies d_ Pappenheimer bodies 21. "The nucleated cell in this image may be seen in the peripheral blood of a normal newborn and is Classified as a(an): basophilic normoblast polychromatophilic normoblast orthochromatic normoblast megaloblastic normoblast aoce 222 The Board of Certification Study Guide Ge sen oredspoaane @x015 ec? _ atPi os 4; Hematol oy un Erythrocytes: Physiology ormal e| te in the cant i a R ae processes? © Of this image (aifew) may result oni which of the b absence of plasma lipoproteins ¢ defects in the cellular lipid bilayer d deficiencies of cellular enzymes | a deficiencies of cellular membrane proteins | | 24, Whats the composition of the inclusion seen in this RBC? | a DNA b RNA ¢ iron d denatured hemoglobin 14 Which of the following ions is bound to hemoglobin in methemoglobin’? a Cat b Fe cre © d Mg?4: Hematology Erythrocytes: Diseasg 8 S te Erythrocytes: Disease States 25. mas ctr 26. mas 27. ot 28. Bhi 29. tas ontr 30. Mtr 8s A patient with polycythemia vera who is treated by phlebotomy is most likeh y to dey deficiency of: Velo a a iron b vitamin By2 ¢ folic acid d erythropoietin The direct antiglobulin test can help distinguish: a inherited from acquired spherocytosis b intravascular from extravascular hemolysis © heterozygous from homozygous thalassemia d sickle cell trait from sickle cell disease The anemia of chronic infection is characterized by: a decreased iron stores in the reticuloendothelial system b decreased serum iron levels G macrocytic erythrocytes d increased serum iron binding capacity Factors commonly involved in producing anemia in patients with chronic renal disease include: a marrow hypoplasia b inadequate erythropoiesis ¢ vitamin Bz deficiency d increased erythropoietin production 20-year-old woman with sickle cell anemia whose usual hemoglobin concentratian is 8 g/dL (80 g/L) develops fever, increased weakness and malaise. The hemoglobin concentration is 4 g/dL (40 g/L) and the reticulocyte count is 0.1%. The most likely explanation for her clinical picture is: a increased hemolysis due to hypersplenism b aplastic crisis, © thrombatic crisis d occult blood loss The hypopr by: a infiltration of bone marrow by toxic waste products b decreased levels of circulating erythropoietin © defective globin synthesis overcrowding of bone marrow space by increased myeloid precursors Which of the following characteristics are common to hereditary spherocytosis, hereditary elliptocytosis, hereditary stomatocytosis, and paroxysmal noctural hemoglobinuria? a autosomal dominant inheritance b red cell membrane defects € positive direct antiglobulin test. d measured platelet count rative red cell population in the bone marrow of uremic patients is caused ° 224 Tho Board of Certification Study Guide 6e ISBN s7e-oe999-6608 o2018 ASC"ees 1 towing laboratory data: wae 10.0 * 10%L. (40.0 1991) ABC: 341 * 105pL (31 x 401%) Hob’ 7.2 gidL (72 g/L) Het: 24% MCV: 78 pm? (76 fL) MGH: 23g MCHC 31% serum Iron’ 29 ugidL (8.2 umollL) T16c: 160 g/dL (28.6 umol/L) serum ferritin 100 ngimt. (400 j1g/t) These data are most consistent with which of the following conditions? a iron deficiency anemia b anemia of chronic inflammation cc hemochromatosis d acute blood loss 3. Apatient is admitted with a history of chronic bleeding secondary to peptic ulcer. Hematology workup reveals a severe microcytic, hypochromic anemia. Iron studies were requested. Which of the following would be expected in this case? Serum iron Tec Storage iron result A ‘decreased increased increased result B increased decreased increased resultC decreased increased decreased result D increased normal decreased a resultA b result B ¢ result C d result D ‘Which of the following is most closely associated with iron deficiency anemia? @ iron overload in tissue b macracytes ¢ basophilic stippling d chronic blood loss Which one of the following hypochromic anemias is usually associated with a normal free erythrocyte protoporphyrin level? @ anemia of chronic disease b iron deficiency ¢ lead poisoning thalassemia minor _** Evidence indicates that the genetic defect in thalassemia usually results in: a the production of abnormal globin chains al ; b a quantitative deficiency in RNA resulting in decreased globin chain production © asstructural change in the heme portion of the hemoglobin @ an abnormality inthe alpha- or beta-chain binding or affinity 4%, a Gertification Examinations 225 ASC sen orcseas sco Cine Laboratory ON4: Hematology Erythrocytes: Disease ‘ 37. oy 38. ns 33. tas uy 40. 4m. 42. 43. nas cht State A 20-year-old African-American man has peripheral blood changes suggesting x thalassemia minor. The quantitative hemoglobin A, level is normal, but the hemogiopj level is 5% (normal <2%). This is most consistent with: mn a alpha thalassemia minor b beta thalassemia minor ¢ delta-beta thalassemia minor d_ hereditary persistence of fetal hemaglobin Anemia secondary to uremia characteristically is. a microcytic, hypochromic b hemolytic © normocytic, normochromic d_ macrocytic Which of the following sets of laboratory findings is consistent with hemolytic anemia? a normal or slightly increased erythrocyte survival; normal reticulacyte count b decreased erythrocyte survival; increased catabolism of heme ¢ decreased serum lactate dehydrogenase activity; normal catabolism of heme @ normal concentration of haptoglobin; marked hemoglobinuria An enzyme deficiency associated with a moderate to severe hemolytic anemia after the patient is exposed to certain drugs and characterized by red cell inclusions formed by denatured hemoglobin is: a lactate dehydrogenase deficiency b G6PD deficiency © pyruvate kinase deficiency d_ hexokinase deficiency Patients with G6PD deficiency are least likely to have hemolytic episodes in which of the following situations? a following the administration of oxidizing drugs b following the ingestion of fava beans © during infections d spontaneously patient has a congenital nonspherocytic hemolytic anemia. After exposure to anti-malarial drugs the patient experiences a severe hemolytic episode, This episode is characterized by red cell inclusions caused by hemoglobin denaturation. Which of the following conditions is most consistent with these findings? b thalassemia major © pyruvate kinase deficiency paroxysmal nocturnal hemoglobinuria Alll of the findings listed below may be seen in autoimmune hemolytic anemias. The one considered to be the most characteristic is: No a increased reticulocyte count b leukopenia and thrombocytopenia ¢ ‘peripheral spherocytosis 4 positive direct antigiobulin test Peripheral blood smears from patients with untreated pernicious anemia are characterized by: a panoytopenia and macrocytosis. b leukocytosis and elliptocytosis ¢ leukocytosis and ovalocytosis d_ pancytopenia and microcytosis ° 226 The Board of Certification Study Guide 66 IsBn978-ca9169-6609 2018 ASCP ‘a anemia of chronic disease b vitamin By2 deficiency ¢ iron deficiency q acute hemorrhage ag. Apatient has the following laboratory data ws RBC: 2.35% 10% (2.35 x 10194 oe wee: 3.0% 10% 0» 108%) Pit 95.0 = 10%) (95.0. 10511) Habs 95 gid. (95 gi Hot 27% MCW: 148 um? (115 FL MCHC: 35% MCH 40g which of the following tests would contribut a reticulocyte count b platelet factor 3 ¢ serum By» and folate d leukocyte alkaline phosphatase te toward the diagnosis? 41, The characteristic morphologic feature in folic acid deticiency is a macrocytosis b target cells ¢ basophilic stippling d rouleaux formation 4, A50-year-old pa nt was found to have the following lab results: ns fir Hgb: 7.0 gldl (70 g/t) Het 20% REC: 2.0 10%%piL (2.0 * 10°2/L) [twas determined that the patient was suffering from pernicious anemia. Which of the following sets of results most likely was obtained from the same. patient? WBCs Platelets Reticulocytes: result A 17,500 350,000 5.2% resultB 7,500 80,000 41% result §,000 425,000 2.9% result D 3,500 80,000 0.8% a resultA b resuttB © result C d result D ‘The most likely cause of the macrocytosis that often accompanies primary myelofibrosis is: a folic acid deficiency b increased reticulocyte count © inadequate Byz absorption 4 pyridoxine deficieney Certification Examinations 227 “ZOERSCH Ise ora oteo soe Glinical LaboratoryEE : Hematology 50. _Megaloblastic asynch vss, following? a. proliferation of erythrocyte precursors b impaired synthesis of DNA fa ¢ inadequate production of erythropoietin deficiency of G6PD 51. Which of the following are found in asso kya neutropenia and thrombocytopenia b decreased LD activity ¢ increased erythrocyte folate levels d_ decreased plasma bilirubin levels 52. Which of the following represents characteristic fe with anemia of chronic disease? Erythrocytes: Disease gy, . les nous development in the bone marrow indicates which one of the ro ciation with megaloblastic anemia? atures of iron metabolism in patients Serum iron Transferrin saturation TIBC. result A normal normal normal result B increased increased normal or slightly increased result C normal markedly increased normal result D decreased decreased normal or decreased a resultA b resultB ¢ resultC d resultD 53. A characteristic morphologic feature in hemoglobin C disease is: a macrocytosis b spherocytosis ¢ rouleaux formation d target cells 54, Thalassemias are characterized by: a structural abnormalities in the hemoglobin molecule b absence of iron in hemoglobin c decreased rate of heme synthesis d decreased rate of globin synthesis 58. Apatient has the following blood values: s ty RBC: 6.5 x 10%pL (6.5 = 1072/1) Hab: 13.0 g/dL (130 g/L) Het: 39.0% Mev: 65 um? (65 11) MCH: 21.59 MCHc: 33% These results are compatible with: a iron deficiency b pregnancy ¢ thalassemia minor d beta thalassemia major 58. Laboratory findings in hereditary spherocytosis include: . decreased WBCs decreased RBC bend 3 prot © reticulocytopenia poen 4 positive direct antiglobulin test 228 The Board of Certification Study Guide 6e ISBN 978. 2018 ASCP 3-089189-6609- matology Erythrocytes: Disease States Which of the following types of polycythemia is a Severely burned patient most likely to 5 rave? olycythemia vera a eeveythemia, secondary to hypoxia P felative polycylhemia associated with dehydration polycythemia associated with renal disease Giant, vacuolated, multinucleated erythroid precursors are present in which of the following? 4 chronic myelocytic leukemia b primary myelofibrosis ¢ erythroleukemia @ acute myelocytic leukemia Which of the following is a significant feature of dyserythropoiesis? Ai a persistently increased M “BIEASCE 65H s7acestesc600 Clinical Laboratory Certification Examinations 229 - _—4: Hematology Erythrocytes: Disea, 66, 67. 68. 63. 70. ey 11. or 72. 73. 74, 230 The Board of Gertification Study Guide 6e sen 976-089189-8009 ©" St What protein is commonly defective in hereditary elliptocytosis? tes a ankyrin b spectrin © band 4.1 d elliptocin What is the most common mechanism resulting in hereditary stomatocytosis? a abnormal Na/K permeability b deficient cytoskeletal structural proteins inability to repair oxidative stress damage d_ ATP depletion due to glycolytic enzyme deficiency What accounts for the majority of cases of sideroblastic anemia? a clonal stem cell defect b medications ¢ alcohol d irradiation To what class of disorders does Fanconi anemia belong? a hypoproliferative b myeloproliferative ¢ myelodysplastic d_ mitochendrial Two common causes of acquired pure red cell aplasia are: a cytomegalovirus and parvovirus infection b thymoma and parvovirus infection © parvovirus infection and squamous cell carcinoma d squamous cell carcinoma and thymoma Which of the following tumors are associated with erythrocytosis due to excessive erythropoietin production? a renal cell carcinoma b sarcoma ¢ basal cell carcinoma d_ squamous cell carcinoma of the lung Which of the following features of G6PD deficiency are typically present on a Wright Giemsa stained peripheral blood smear? a Cabot rings b microcytosis ¢ bite cells, d Heinz bodies Which abnormal RBC morphology is associated with pyruvate kinase deficiency? a acanthooytes b dacryocytes © echinocytes d drepanocytes Which of the following hemoglobinopathies is associated with rod shaped crystals? a HgbS b HgbC © HabSC d HgbD east? atl4 Hematol’ Erythrocytes: Disease States: same ofthe folowing slatoments about hemoglobins D and G fs hue? fe clinically abnormal aa Both migrate with HabS on alkaline gel w ey are bolt caused by mutations in the beta-glabin gene 4 wey cannot be separated on citrate gels 5 This nemoglobinopathy results from a fusion product of the delta and bela gene! 1 sg HgbD a ey HgbG E HgbLepore @ HgbGonstent Spring 11 which ofthe following is consistent with the diagnosis of heterozygous beta-thalassemia? y 4 increased red blood cell count high MCV » creased HabA2 d decreased iron stores 74. Hereditary persistence of fetal hemoglobin (HPFH) is due to a loss of expression of this us globin chain: " g alpha b beta ¢ gamma d delta 18, What is the specificity of cold autoagglutinin disease? a anti-i b anti-H ¢ anti-Pr d antil J. What is the most common presentation of paroxysmal cold hemoglobinuria? a older people with Raynaud syndrome b children following a viral iliness ¢ neonates with congenital syphilis d alcoholics with advanced cirrhosis 81. Which of the following is the most common cause of anemia in hospitalized patients? a inadequate iron intake » inadequate folate intake © hemolytic anemia 4 anemia of chronic disease ®. Ina patient with an increased red cell mass into the 99th percentile and serum erythropoietin level below reference range for normal, which of the following criteria confirms a diagnosis of polycythemia vera? @ bone marrow panmyelosis b inv(16) mutation a © JAK2V617F mutation 9 BCR-ABL4 translocation Ca, *S0P ISBN s7e.90ta9.c609 Clinical Laboratory Certification Examinations 234 a4: Hematology Erythrocytes: Disea: 3 83, 84. 85. ® States ‘A medical technologist is examining a peripheral smear and notices 7 large segment neutrophils with between 5.and 7 lobes. Everything else about the CBC is otherwise Normal. This observed morphologic change might develop months ahead of which of nq following changes: s aan increase in MCV, MCH and RDW b a decrease in MCV, MCH, RDW, ¢ an increase in metamyelocytes. and bands d_a bone marrow showing aplasia Autoimmune hemolytic anemia is often a complication of: a PV b CML © CLL d HCL Which red cell morphology may be expected in a treated polycythemia vera patien: a microcytic cells b teardrop cells ¢ helmet cells d oval macrocytes The red blood cells in this image are representative of an anemia that is: a microcytic, hypochromic b nonmegaloblastic macrocytic © normocytic, normochromic d_ myelodysplastic ISBN 978-089189.6609 ©2018 ASCPny AS 4; Hematology Erythrocytes: Laboratory Determinations a Tris image ofthe blood smear trom’& newbom most ikaly represonts a severe GEPD deficiency b hereditary spherocytosis ¢ untreated megaloblastic anemia d_ HON due to ABO incompatibility } 88, Hemoglobin H disease results from. | thi avabsence of 3 of 4 alpha genes b absence of 2 of 4 alpha genes ¢ absence of 1 of 1 alpha genes d absence of all 4 alpha genes Erythrocytes: Laboratory Determinations 88. Which of the following technical factors will cause a normal (low) erythrocyte us. sedimentation rate? a gross hemolysis b small fibrin clots in the sample ¢ increased room temperature d tilting of the tube 0. Which of the RBC indices is a measure of the amount of hemoglobin in individual red blood cells? a MCHC b Mcy © Het d MCH ‘The ROW-CV and RDW-SD performed by automated hematology analyzers are calculations that provide’ 4 an index of the distribution of RBC volumes b acalculated mean RBC: hemoglobin concentration £ acalculated mean cell hemoglobin d the mean RBC volume a “EHBASCe isan arn cepien ete Clinical Laboratory Certification Examinations 2334: Hematology Erythrocytes: Laboratory Determinations 92. 93. 95. 96. 97. The erythrocyte sedimentation rate (ESR) can be falsely elevated by: a tilting the tube b refrigerated blood © air bubbles in the column d specimen being too old A Wright-stained peripheral smear reveals the following: erythrocytes enlarged 11% to 2 normal size Schiifiner dots Parasites with inegular “spread-out" trophozoites, golden-brown pigment 12-24 merozoltes wide range of stages This is consistent with Plasmodium @ falciparum b malariae © ovale d vivax Which of the following is the formula to calculate an absolute cell count? a number of cells counted/total count b total count/number of cells counted ¢ 10x total count d % of cells counted * total count Using a supra vital stain, the polychromatic red blood Gelis below would probably be @ rubricytes (polychromatophilic normoblast) b reticulocytes © sickle cells d target cells. The mean value of a reticulocyte count on specimens of cord blood from healthy, full-term newborns is approximately: a 05% b 2.0% © 5.0% d 8.0% Ared blood cell about 5 \1m in diameter that stains bright red and shows ho central pallor isa. a spherocyte b leptocyte © microcyte d-macrocyte 234 ‘The Board of Certification Study Guide 6e ISBN 978-080160.6609 e018 ASCPHematology Erythrocytes; L aboratary Determinations The following results were obtainéd bn a patient 9 8 blood Hab: 11.5 gidt (MEL) Hct 34% MCv: 89 um? (89 AL) cH 28 pg MCHC: 29% Examination of a Wright-st a macrocytic, normochromic b microcytic, hypochromic erythrocytes ¢ normocytic, hypochromic erythrocytes d normocytic, normochromic erythrocytes g9. Evidence of active red cell regeneration may be indi a basophilic stippling, nucleated re. b hypochromia, macrocytes and ni ¢ hypochromia, basophilic stipplin 4 Howell-Jolly bodies, Cabot ring d smear of the same sample would most ikely show erythrocytes d blood. cells an: lucleated red bio 9 and nucleated 3S and basophilic 400, The smear represented below displays id polychromasia 10d cells, red blood cells stippling a congenital ovalocytosis b hemoglobin C disease © poor RBC fixation d delay in smear preparation 1M. The presence of excessive rouleaux formation ona blood smear is often accompanied by an increased: @ reticulocyte count » sedimentation rate © hematocrit d erythrocyte count ‘M2. The characteristic peripheral blood morphologic feature in multiple myeloma is. 2 cytotoxic T cells rouleaux formation © spherocytosis @ macrocytosis The M:E ratio in polycythemia vera is usually: @ normal b high © low 4 variable 103. (235 Clinical Laboratory Certitcation Exeminations “OMASCP oan sre. ooo1s.t004; Hematology 104. Many microspherocytes, schistocytes and spherocytes with budding eytoplasm can seen.on peripheral blood smears of patients with: De Erythrocytes: Laboratory Determyp, ation, a hereditary spherocytosis b disseminated intravascular coagulation (DIC) © acquired autoimmune hemolytic anemia d extensive bums 405. The values below were obtained using an automated hematology analyzer and wo performed on a blood sample from a 25-year-old man: Patient Normat WBC 5.1% 10%L 5.0-10.0% 10% (6.1* 10%) (8.0-10.0% 10%) REC 2.94% 10%) 4(6-6.2« 10% (2.94107) (46-62 10°/L) Hgb 13.8 g/dL (138 g/L) 14-18 g/dL (140-180 g/L) Het 35.4% 40-54% MCV 128 pm? (128 fL) 82-90 ym? (82-90 fL) MCH 46.7 pa 27-31 pg, MCHG 40% 32-36% These results are most consistent with which of the following? a megaloblastic anemia b hereditary spherocytosis ¢ a high titer of cold agglutinins d_an elevated reticulocyte count 406. A 56-year-old man was admitted to the hospital for treatment of a bleeding ulcer. The §s, following laboratory data were obtained: REC 4.2 10% (4.2% 1072/L) wee: 5.0 x 10% (5.0 = 10°/L) Het 30% Hab: 85 g/dL (85 g/L) serum iron: 40 pgidt. (7.2 mol/L) TIBC: 460 ugidl (82.3 umol/L) serum ferritin 12 ngimL (12 po/L) Examination of the bone marrow revealed the absence of iron stores. This data is most consistent with which of the following conditions? a iron deficiency anemia ‘b anemia of chronic disease ‘© hemochromatosis d_ acute blood loss ISBN 978-0a9189-6609 ©2018 ASCP 236 The Board of Certification Study Guide 6e - i allHematology 77, A40-year-old Caucasian male us lassitude, weight loss, and tos: Erythrocytes: Laboratory Determinations was Geimitted to the hospital for treatment of Bhemia 8. of lib laboratory data: ido. The patient presented with the following MBC: 5.8 * 103/uL (6,8 x 1091) ie 3.7% 105huL (8.7 « s0124 Hab: 10.0 afd (100 git) 32% 86 um? (86 fL), 28 pg 220 gid (39.4 pmol.) 300 pa/at (53.7 moti) 2,800 ng/mL (2,800 git) conditions? a iron deficiency anemia b anemia of chronic disease © hemochromatosis d. acute blood loss 198. A common source af interference in the cyanmethemoglobin method is: a hemolysis b very high WBC count ¢ cold agglutinins | d clumped platelets A. A patient with beta-thalassemia characteristically has a(n): ~ Se @ elevated Ay hemoglobin b low fetal hemoglobin ¢ high serum iron d normal red cell volume 110. With this blood picture, an additional test indicated is: a alkali denaturation b alkaline phosphatase stain © peroxidase stain ; @ hemoglobin electrophoresis: Clinical Laboratory Certification Examinations 2374: Hematology Erythrocytes: Laboratory Deter 111, 112. 113, wer 114, 115. mas eae 116, Ascreening procedure for detecting hemoglobin F is the: @ fluorescent spot test b dithionite solubility test ¢ Kleihauer- d heat instability test The most appropriate screening test for hemoglobin S is: a Kleihauer-Betke b dithionite solubility ¢ heat instability d fluorescent spot Which of the following is characteristic of hemoglobin H? a itis a tetramer of gamma chains b itis relatively stable © electrophoretically, it represents a “fast” hemoglobin d ithas a lower oxygen affinity than hemoglobin A In most cases of hereditary persistence of fetal hemoglobin (HPFH): a hemoglobin F is unevenly distributed throughout the erythrocytes by the black heterozygote has 75% hemoglobin F ¢ beta and gamma chain synthesis is decreased d_ gamma chain production equals alpha chain production When using the turbidity (solubility) method for detecting the presence of hemoglobin 3, an incorrect interpretation may be made when there is a(n): a increased reticulocyte count b glucose concentration >150 mg/dL (8.3 mmol/L) ¢ blood specimen >2 hours old d decreased hematocrit Refer to the following pattern: + pattern A pattern 8 pattern C pattern D control ong A, SF OA Hemoglobin electrophoresis patterns at pH 8.4 (cellulose acetate strip) Which pattern is consistent with homozygous beta-thalassemia? a pattern A b pattern B ¢ pattern C d pattern D p igen 97e-0a9189-6609 «201880 238 The Board of Certification Study Guide 6e J118. oer MB. ofa. ‘S2NBASCP ISBN 972-089180-6600 Erythrocytes: Laboratory Determinations + Pattern A pattern B pattern G pattern D control mmogiobin electrophoresis patterns at pH 8.4 Hernogionin Calulose acelatestip) Which electrophoresis pattern is consistent with sickle cell trait? a pattern A b patter B cc pattern C pattern D Anative of Thailand has a normal hemoglobin level. Hemoglobin electrophoresis on callulose acetate shows 70% hemoglobin A and approximately 30% of a hemoglobin with the mobility of hemoglobin Ag. This is most consistent with hemoglobin: a C trait b E trait c Otrait d D trait The laboratory findings on a patient are as follows MCV: 55 ym? (55 IL) MCHC; 25% ct AT pg Astained blood film of this patient would most likely reveal a red cell picture that is: ‘a. microcytic, hypochromic b macrocytic, hypochromic ¢ normocytic, normachromic d_microcytic, normochromic patient has the following laboratory results: RBC: 2.00 10°%pL (2.00 = 10°21) Het: 24% Hgb 6.8 g/dL (68 g/L) reticulocytes: 0.8% ‘The mean corpuscular volume (MCV) of the patient is: a 35 um? (35 fL) b 83 ym (83 fL) ¢ 120 ym? (120 fL) d 150 pm? (150 fL) Clinical Laboratory Certification Examinations 239' 4: Hematology Erythrocytes: Laboratory Detorm), ati ns 121. A patient has a high cold agglutinin titer. Aulomated hematology analyzer results raven, an elevated MCV, MCH and MCHC as well as a decreased RBC. Individual erythrocy, appear normal on a stained smear, but agglulinales are noted. The appropriate courses action would be to: ~ @ perform the RBC, Hgb, and Het determinations using manual methods b perform the RBC determination by a manual method; use the automated results for ty, Hgb and Het le © repeat the determinations using a microsample of diluted blood d repeat the determinations using a prewarmed microsample of diluted blood 122. hile the following is the formula for calculating the mean corpuscular hemoglobin 2 a Hct/(RBC = 1000) b HgbiHet © RBC/Hct d (Hgb x 10)/RBC 123. What is the MCH if the Hct is 20%, the RBC is 2.4 « 10®/pL (2.4 « 10!2/L) and the Hgb is S gid (50 g/L)? . a 21pg b 23pg © 25pg d 84pg _ 124, Which of the following is the formula for calculating the MCHC? a (Hgb x 100)/Het b Hab/RBC © RBC/Het d (Het x 1000)/RBC (125. What is the MCHC if the Hct is 20%, the RBC is 2.4 « 108/uL (2.4 = 10'2/L) and the Hab is 5 gidL (50 giL)? a 21% b 25% © 30% d 34% 126. Which of the following is the formula for calculating the mean corpuscular volume (MCV)? a (Hab 10)/RBC b Hgbi/Hct © (Hct x 10)/RBC d RBC/Het 127. Given the following data: = Hgb: B g/dL (80 g/L) Het 28% Ree: 3.6 * 10%%uL (3.6 « 107%) The MGV is: a 28 um (28 fL) b 35 um? (35 fL) 40 ums (40 fL) 77 pm (77 fL) ISBN 978-089189-6609 €2018AS0P —~ 240 The Baard of Certification Study Guide 6e,Py . yematology aH nat is the MCV if the hematocrit is 20% 128. varnoglobin is 6 g/dL (60 g/L}? a 68h b 75m ¢ 115 fL @ 133 fl x29, Aconfirmatory test for paroxysmal noctumal hemoglobinuria is: ‘a heat instability test b sucrose hemolysis ¢ flow cytometric immunophenotyping dithionite solubility Erythrocytes: Laboratory Determinations ‘N the RBC is 1.5 x 10% L (1.5 « 1072/L) and the 150, The Prussian blue staining of peripheral blood a Howell-Jolly bodies b siderotic granules ¢ reticulocytes d basophilic stippling 41. Supravital staining is important for reticulocytes since th: / stain the: a remaining RNA in the cell b iron before it precipitates ¢ cell membrane before it dries out d denatured hemoglobin in the cell 432, Which of the following is used for staining reticulocytes? identifies: 1@ cells must be living in order to a Giemsa stain b Wright stain ¢ new methylene blue d. Prussian blue 133. Which of the following stains is used to demonstrate iron, ferritin and hemosiderin? a myeloperoxidase b methylene blue © specific esterase Prussian blue Which of the following stains can be used to differentiate siderotic granules (Pappenheimer bodies) fram basophilic stippling? a Wright b Prussian blue © crystal violet d myeloperoxidase S2MeASCP isan 7e-000189.6609 Clinical Laboratory Certification Examinations 2444: Hematology Erythrocytes; Laboratory Determination, s 135. In an uncomplicated case of severe iron deficiency anemia, which of the following sary represents the typical pattern of results? Marrow Marrow Serum Serum % sidero- iron iron TIBC % Saturation blasts stores A L ~ t L t B 4 1 t t A c 4 tT L L 4 D + 4 t - 7 increased = + dex aa bB ee dD 136. Which of the following test results are consistent with a diagnosis of paroxysmal nocturnal §s, hemoglobinuria (PNH)? out a decreased conversion of NADH to NAD b increased production of globulin c decreased hemolysis in acidified serum d diminished CD55 on hematopoietic cells 137. Which of the following conditions is most often associated with the V617F mutation of JAK2? a chronic myelogenous leukemia b essential thrombocytosis © chronic idiopathic myelofibrosis d_ polycythemia vera 138. Which of the following values is calculated from the red blood cell indices in an automated hematology analzyer? a red blood cell count (RBC) b hematocrit ¢ mean corpuscular volume (MCV) d red cell distribution width (RDW) 139. The cyanmethemoglobin method of measuring hemoglobin cannot detect this form of hemoglobin: a methemoglobin b carboxyhemoglobin ¢ deoxyhemoglabin d_sulthemoglobin 140. In the hemoglobin solubility (dithionate) test, which type of hemaglobin causes turbidity (positive reaction)? a HgbD b HgbE c HgbS d HgbA 242 The Board of Certification Study Guide 6e ISBN 978-0891 69-6609 62018 ASCP= A Hematology 144. 142. as hy 143. 144, 145, Leukocytes: Physiology ‘The presence of hemoglobin H may be demonstrated a Prussian blue stain ated by: b Wright stain ¢ Giemsa stain d brilliant cresyl blue The hemoglobin variant whic ‘ Senontates amoroyictioes sae gua te Sou Eas Asin copation anne: JIgbC at pH 8.6 is: b HobF ¢. HgbE @ HabH hematology analyzer counts red blood cells by which method? a impedance b chromogenic ¢ photometric d turbidimetric Adelta check is a method that: a determines the mean and variance of b monitors the testing system for precision ¢ monitors patient samples day to day d is determined by each laboratory facility The RDW is elevated on a CBC report. The smear would show: a hypochromia b anisocytosis ¢ poikilocytosis d_macrocytosis Leukocytes: Physiology : 48. The light-colored zone adjacent to the nucleus in a plasma cell is the: S@O1BASCP ISBN 978-069180-6609 a ribosome b chromatin mitochondria d Golgi area Glinical Laboratory Certification Examinations 2434: Hematology 147, 148. 149. 150, 151. 152, 153, Inclusions in the cytoplasm of neutrophils as shown in the figure below are known a Auer bodies b Howell-Jolly bodies © Heinz bodies d_Déhle bodies An increased amount of cytoplasmic basophilia in a blood cell indicates: @ increased cytoplasmic maturation b decreased cytoplasmic maturation © reduction in size of the cell d decreased nuclear maturation The term “shift to the left” refers to: a a microscope adjustment b immature cell forms in the peripheral blood € atrend on a Levy-Jennings chart a calibration adjustment on an instrument Leukocytes: Phy sig, lo oy Aterm that means varying degrees of leukocytosis with a shift to the left and occasional nucleated red cells in the peripheral blood is: @ polycythemia vera b erythroleukemia © leukoerythroblastosis d_megaloblastoid Cells that produce antibodies and lymphokines are: a erythrocytes b granulocytes © lymphocytes d_thrombocytes Specific (secondary) granules of the neutrophilic granulocyte: @ appear first at the myelocyte stage b contain esterases © are formed on the mitochondria dare derived from azurophil (primary) granules In normal adult bone marrow, the most common granulocyte is the: a basophil b myeloblast © eosinophit d_metamyelocyte ‘The Board of Certification Study Guide 6e ISBN 976-063169-6609 ante ascP5: eee ju Elevation of the total granulocyte cou a relative lymphocytosis b leukocytosis ¢ relative neutraphilic leukocytosis d absolute neutrophilic leukocytosis 455. Elevation of the total white cell count above 11.9 x 103; 9 relative lymphocytosis HL (12 * 10°) is termed: b absolute lymphocytosis ¢ leukocytosis d relative neutrophilic leukocytosis 456, Elevation of the lymphocyte percentage ab. ’ ag relative lymphocytosis b absolute lymphocytosis ¢ leukocytosis d absolute neutrophilic leukocytosis 487. Terminal deoxynucleotidyl transferase (Tat) a hairy cells b myeloblasts monobiasts d lymphoblasts J iS a marker found on: 158. Pluripotent hematopoietic stem cells are capable of producing: a daughter cells of only one cell line b only T lymphocytes and B lymphocytes ¢ erythropoietin, thrombopoietin, and leukopoietin d lymphoid and myeloid stem cells 452, The Philadelphia chromosome is formed by a translocation between: a chromosome 22 and chromosome 9 b chromosome 21 and chromosome 9 ¢ chromosome 21 and chromosome 6 d@ chromosome 22 and chromosome 6 460. Phagocytosis is a function of: a erythrocytes b granulocytes lymphocytes d thrombocytes ‘61. The mechansim causing catecholamine-induced ‘neutrophilia includes: ws “Ya a shift in granulocytes from the marginating pool to the circulating pool 'b an increased exit of granulocytes from the circulation © a decrease exit of granulocytes from the bone marrow 4 granulocyte return from the tissues to the circulating pool Which cells are involved in immediate hypersensitivity reactions? @ eosinophils b basophils © plasma cells d reactive lymphocytes 162, us ot | en NBASCP ISBN 978-089189-6609 Clinical Laboratory Certification Examinations 245‘4: Hematoloy> Leukocytes: Disease sin, lates 163. Which of the following cytokines is most responsible for eosinophil differentiation ang release from the bone marrow? a l-1 b IL-2 ¢ IL-4 d IL-5 164. What accounts for the frequent smudge cells in CLL? a increased in vivo cell lysis b apoptosis related changes © artifact due to fragile cells, d artifact due to heparin 165. In which of the following types of cells is CDS usually expressed? mus Sty a mature T cells pro B cells. macrophages endothelial cells aooo Leukocytes: Disease States 166. A 14-year-old boy is seen in the ER complaining of a sore throat, swollen glands and fatigue. The CBC results are: wec: 16.0 « 10%/pL (16.0 x 10%/L) Rec: 4.37 * 10%pL (4.37 * 1012/L) Hab: 12.8 g/dL. (128 g/L) Het: 38.4% Pit 180 « 10%/aL (180 x 109/L) Differential absolute neutrophils: 3.9 « 10% absolute lymphs: 6.0 10% absolute monos: 0.5» 10% absolute atypical lymphs: 3.2 « 10%L What is the most likely diagnosis’? a acute lymphocytic leukemia b chronic lymphocytic leukemia ¢ viral hepatitis, d infectious mononucleosis 167. The M:E ratio in chronic myelocytic leukemia is usuall a normal b high s low d variable 168. In the World Health Organization (WHO) classification, myelomonocytic leukemia would Ms, be acute myeloid leukemia (AML): a with myelodysplastic-related changes b with recurrent cytogenetic changes ¢ not otherwise specified d therapy-related cP 246 The Board of Certification Study Guide 6e isan o78.0g91e9.609 @z0184SP nematology Fonormailies found in erythvoleukomia natnder ie 's rapid ONA synthesis, yarrow fibrosis, inegaloblastoid development q increased erythrocyte survival Neutropenia is usually associated with: ‘a bacterial infections b viral infections ¢ inflammatory processes 4 myeloproliferative neoplasms Leukocytes; Disease States 70. srt, Averrods are most likely present in which ofthe following? a chronic myelocytic leukemia b primary myelofibrosis ¢ erythroleukem: d acute myelocytic leukemia 472, The following results were obtained on a 48-year-old man complaining of chills and fever: wee: 23.0» 10% (23.0 x 10°/L) Philadelphia chromosome: negative BCRIABL fusion gene: negative Differential segs: 60% Bands: 21% Lymphs: ae Monos: 3% Metamyelos: ae yelos Sy Toxic granulation, Dahle bodies and vacuoles ‘These results are consistent with: a neutrophilic: leukemoid reaction b polycythemia vera ¢ chronic myelocytic leukemia 4 leukoerythroblastosis in myelofibrosis 113. In an uncomplicated case of infectious mononucleosis, which of the following cells are affected? a erythrocytes » lymphocytes © monocytes d thrombocytes 14. The reactive lymphocyte seen in the peripheral blood smear of patients with infectious mononucleosis is probably derived from which of the following? @ Tlymphocytes b Blymphocytes © monocytes @ mast cells _]35. The disease most frequently present in patients with reactive lymphocytosis and iy Persistently negative heterophile antibody tests is: a toxoplasmosis cytomegalovirus (CMY) infection © herpes virus infection 4 viral hepatitis ‘SPIeASCe Ison srecestea.ce08 Clinical Laboratory Certification Examinations 2474: Hematology Leukocytes: Disease gy 5 fate, 176. Dwarf or micro megakaryocytes may be found in the peripheral blood of patients with: = a pernicious anemia b polycythemia © primary myelofibrosis chronic lymphocytic leukemia 177. Which of the following is associated with pseudo-Pelger-Huét anomaly? a aplastic anemia b iron deficiency anemia © myelogenous leukemia d Chédiak-Higashi syndrome 178. Auer rods are characterized as: ms oy a fused primary granules b DNA precipitates ¢ denatured hemoglobin d large cytoplasmic granules 179. Increased numbers of basophils are often seen in: a acute infections b chronic myelocytic leukemia & chronic lymphocytic leukemia d erythroblastosis fetalis (hemolytic disease of the newborn) 180. A hypercellular marrow with an M:E ratio of 6:1 is most commonly due to: ms ou a lymphoid hyperplasia b granulocytic hyperplasia © normoblastic hyperplasia d myeloid hypoplasia 181. The following results were obtained: ‘ont WBC; 5.0 * 10°yplL (5.0 « 10°/L) RBC: 1.7 * 108/pL (1.7 * 1072/L) McVv: 84.0 um? (84 fL) Pit: 89,0 x 103/pL (89 « 109/L) Philadelphia chromosome: negative BCR/ABL fusion gene: negative Differential Segs: 16% Bands: 22% Lymphs: 28% Monos: 16% Eos: 1% Basos: 1% Metamyetos: a Myelos: 3% Promyelos: 4% Blasts: 5% 1 megakaryobiast; 30 nucleated erythrocytes; teardrops; schistocytes; polychromasia; giant, bizarre platelets noted These results are consistent with: a essential thrombocythemia b polycythemia vera © chronic myelecytic leukernia d primary myelofibrosis 248. The Board of Certification Study Guide Ge teen ove-cesredceoa 00018 ASCP aLeukocytes: Disease States 8 admitted into the hospital with cut le leukemia, Laboratory findings sine 1089 Blast cells ne Oe egative rarnucleotwytransterase (TAT): las! cots postive Blast cells negative Blast cells negative Positive Positive S are most consistent with: sults nes? rer yelogenous leukemia hacytic leukemia in lymphoblastic transformation mphocytic leukemia jogenous leukemia in lymphoblastic transformation go syd man who had been diagnosed as havin ; ig leukemia 2 k 09% ited because of cervical lymphadenopath awe need 3s ream Wy. Laboratory findings included the 39.6 « 10°/pL. (39.6 x 109/L) 3.25 10%)L (3.25 * 10°2/L) 9.4 gidl (84 g/L) 28.2% 86.7 ym? (86.7 TL) 29.0 pg 33.4% 53 10%L (53 * 10%/L) BeRIABL fusion gene: positive tal pifferer ™% Lye - onos Eos: 3% Fes 48% Myels: 13% Promyelos: 2% etamyelos 8% Blass 13% NRBCS: 11% Bone marrow: 95% cellularity, 50% blast cells (some with myeloperoxidase positivity) These results are most consistent with: a acute myeloid leukemia b erythroleukemia ¢ chronic myelogenous leukemia (CML) d CML in blast transformation Biochemical abnormalities characteristic of polycythemia vera include: a increased serum B42 binding capacity b hypouricemia © hypohistaminemia d increased erythropoietin Ses gay '978-089189-6609 Clinical Laboratory Gertification Examinations 2494: Hematology 185, 186. 187. nas outy. 188. 189. 190. 191. ms 192. 193. 250 The Board of Cer Leukocytes: Disea: Se States A differential cell count of 50-90% myeloblasts in a peripheral blood smear is typicar which of the following? *t a chronic myelocytic leukemia b primary myelofibrosis © erythroleukemia @ acute myelocytic leukemia The M:E ratio in acute myelocytic leukemia is usually: a normal b high © low d variable Which of the following is most closely associated with acute promyelocytic leukemia? a ringed sideroblasts b disseminated intravascular coagulation ¢ micromegakaryocytes d Philadelphia chromosome Which of the following is most closely associated with chronic myelomonocytic leukemia? a Philadelphia chromosome b disseminated intravascular coagulation ‘© micromegakaryacytes d lysozymuria The absence of intermediate maturing cells between the blast and mature neutrophil commonly seen in acute myelocytic leukemia and myelodysplastic syndromes is called: a subleukemia b aleukemic leukemia © leukemic hiatus d_leukemoid reaction Which of the following is most closely associated with chronic myelogenous leukemia? a ringed sideroblasts b disseminated intravascular coagulation © micromegakaryocytes d BCR/ABL fusion gene The bone marrow in the terminal stage of erythroleukemia is often indistinguishable from that seen in: a myeloid metaplasia b polycythemia vera ¢ acute myelocytic leukemia d aplastic anemia A block in the differentiation or maturation of, and an accumulation of immature hematopoietic progenitors is a hallmark of: a. chronic lymphacytic leukemia b myelodysplastic syndromes c polycythemia vera d acute myelocytic leukemia All stages of neutrophils are most likely to be seen in the peripheral blood of a patient with: chronic myelocytic leukemia myelofibrosis with myeloid metaplasia erythroleukemia acute myelocytic leukemia aoce . ication Study Guide 6e igen o7e-caoree.4609 ©2018 ASC jLeukocytes: Disease States 'S myeloproliferative neoplasm? th of the following con a refractory anemia b secondary erythrocytosis, ¢ myelomonocytic leukemia d_ essential thrombocythemia following results were obtain i id Tre ein ed On a 55-year-old man complaining of headaches and ‘we: 19.0 105% (9.0% 1074) RBC. T2% WML (2x rie) Plt 1,058 * 10°44 (1056 x 10%) uri acia 13.0 mg/dL (0.78 mmouty 02 saturation: 93% Red cell volume: 3,917 mL (normal = 1,800) Differential segs: 84% Bands: 10% Lymphs: 3% Monos: 2% Eos: 1% These results are consistent with: neutrophilic leukemoid reaction b polycythemia vera ¢ chronic myelocytic leukemia d primary myelofibrosis 196. A patient has.a tumor that concentrates erythropoietin. He is most likely to have which of the following types of polycythemia? a polycythemia vera b polycythemia, secondary to hypoxia ¢ benign familial polycythemia d polycythemia associated with renal disease 187, Wrich of the following types of polycythemia is most often associated with lung disease? a polycythemia vera b polycythemia, secondary to hypoxia ¢ relative polycythemia assaciated with dehydration d polycythemia associated with renal disease 198. A patient diagnosed with polycythemia vera 5 years previou: sly now has a decreased hemoglobin and micracytic, hypochromic red cells, What is the most probable cause for the current peripheral blood findings? a phlebotomy b myelofibrosis ¢ preleukemia d aplastic anemia ASCP isan sra.oeo160.6600 Clinical Laboratory Certification Examinations 2544: Hematology 199, 200. 201., us 202. our 203. 204. 205. 206. utr 252 PEUIOCYIRE; Disease sia, les A patient has been treated for polycythemia vera for several years. His blood smear no, shows: 0 Oval macrecytes Howell-Jolly bodies Hypersegmented neutrophils Large, egranular platelets The most probable cause of this blood picture Is: a iron deficiency b alcoholism € dietary B,2 deficiency d_ chemotherapy In comparison to malignant lymphocytes, reactive lymphocytes: a have a denser nuclear chromatin b are known to be T cells ¢ have more cytoplasm and more mitochondria d_ are morphologically more variable throughout the smear Which of the following 2 malignancies represent different clinical manifestations of the same disease? a chronic lymphocytic leukemia and adult T cell leukemia b_ hairy cell leukemia and Hodgkin lymphoma chronic lymphocytic leukemia and small lymphocytic lymphoma d_ Sézary syndrome and prolymphocytic leukemia Increased levels of TdT activity are indicative of: a Burkitt lymphoma b acute promyelocytic leukemia ¢ acute lymphocytic leukemia d_ eosinophilia Which of the following is true of acute lymphoblastic leukemia (ALL)? a occurs most commonly in children 1-2 years of age b patient is asymptomatic ¢ primitive lymphoid-appearing cells accumulate in bone marrow d children under 1 year of age have a good prognosis The most common form of childhood leukemia a acute lymphocytic b acute granulocytic © acute monocytic d_ chronic granulocytic Chronic lymphocytic leukemia is defined as a(n): a malignancy of the thymus b accumulation of prolymphocytes © accumulation of hairy cells in the spleen d accurnulation of monoclonal B cells Hairy cell leukemia is a(an): a acute myelocytic leukemia b chronic leukemia of myelocytic origin ¢ chronic leukemia of lymphocytic origin d acute leukemia of monocytic origin ISBN 970-089180-4609 €2018 ASCP The Board of Certification Study Guide 6elogy Leukocytes: Disease States hil neutmractear cells with ruffled edges b Mite for CDS § froreased resistance to infection Morphologic variants of plasma cells include: ame cel 2 apat cells © bite cells 5 Gaucher cells tanh of the following bone marrow findings favor the diagnosis of multiple myeloma? 1 presence of Reed Stemberg cells Baths of immature plasma cells rsence of occasional flame cell resence of plasmacytic satellitosis 108: dp an, Which of the following have a B cel origin? U8, a Sézary syndrome - b large granular lymphocytosis 7 ¢ Sternberg sarcoma - @ Waldenstrém macroglobulinemia pti Which ofthe following cells is most likely identified in lesions of mycosis fungoides? fa T lymphocytes b B lymphocytes ¢ monocytes d mast cells Of the following, the disease most closely associated with cytoplasmic granule fusion is: ut. a Chédiak-Higashi syndrome b Pelger-Huét anomaly ¢ May-Hegglin anomaly d AlderReilly anomaly Wihich of the following anomalies is an autosomal dominant disorder characterized by itregularly-sized inclusions in polymorphonuclear neutrophils, abnormal giant platelets and often thrombocytopenia? a Pelger-Huét b Chédiak-Higashi ¢ Alder-Reilly d May-Hegglin 14, of the following, the disease most closely associated with granulocyte hyposegmentation @ May-Hegglin anomaly b Pelger-Huét anomaly © Chédiak-Higashi syndrome 4 Gaucher disease Which of the following is associated with Chédiak-Higashi syndrome? OB, 2 membrane defect ofl ie 3 lysosomes : Dahle bodies and giant platelets § 2 lobed neutrophils ™ucopolysaccharidosis SCP ISBN a72 paging eann Clinical Laboratory Certification Examinations 2534: Hematol 216. 217. 218, 249. 220. ~ her 221. 222, hy 223. oaty _d@ TAT JU. 254 Leukocytes: Disease Sint, lates 3? Which of the following is associated with Alder-Rellly inclusion: a membrane defect of lysosomes b Ddhle bodies and giant platelets ¢ 2-lobed neutrophils d_ mucopolysaccharidasis ? P i 2 Which of the following is associated with May-Hegalin anomaly’ a membrane defect of lysosomes b Dohle bodies and giant platelets chronic myelogenous leukemia d_ mucopolysaccharidosis ‘differential was performed on an asymptomatic patient. The differential included 60% neutrophils, 55 of which had 2 lobes and 5 had 3 lobes. There were no other com ortnulities. This is consistent with which of the following anomalies? a Pelger-Huat b May-Hegglin c Alder-Reilly d Chédiak-Higashi The cytoplasmic abnormality of the while blood cell of Alder-Reilly anomaly is found in the a endoplasmic reticulum b lysosomes ¢ mitochondi d ribosomes Patients with chronic granulomatous disease suffer from frequent pyogenic infections due to the inability of: a lymphocytes to produce bacterial antibodies b eosinophils to degranulate in the presence of bacteria © neutrophils to kill phagocytized bacteria d_ basophils to release histamine in the presence of bacteria Which of the following can cause neutropenia? a medications b lymphcid neoplasms ¢ chronic myelogenous leukemia d_ polycythemia vera Which of the following immunohistochemical patterns is most consistent with CLU/SLL? a CD5-/CD23— b CDS-/CD23+ ¢ CD5+/CD23— d CD5+/CD23+ Which CLL/SLL marker is associated with poor prognosis? a CD138 b ZAP-70 © FMC7 Which of the following morphologic characteristics i i i 7 call nich of fi teristics is consistently associated with hairy a small cells b clumped nuclear chromatin € flocculent dark blue cytoplasm d_uneven cytoplasmic margins ‘The Board of Certification Study Guide 6e ISBN 978-089169-6609 €2018 ASCP —