HEMATOLOGY

1. Handwashing is one of the most important safety practices. Hands must be

washed with soap and water. If water is not already available, alcohol hand gels
with a minimum of which of the following concentration may be used?
Answer: 62%
2. Household bleach is an effective disinfectant which is prepared by adding 10 mL
of bleach to 90 mL of water or 2 and ½ cups of bleach to 1 gallon of water. This
measurement is followed to achieve which of the following recommended
concentration of chlorine?
Answer: 5500ppm
3. Which of the following is the most important practice in preventing the spread of
disease?
Answer: Proper handwashing
4. Which of the following is describe as the process that eliminates many or all
pathogenic microorganisms, except bacterial spores, on inanimate objects?
Answer: Sterilization
5. All of the following statements are TRUE of the proper technique for
handwashing, EXCEPT?
Answer: Rinse hands thoroughly under running water in an upward flow
from fingertips to wrist
6. For a proper manual leukocyte counting, leukocyte counts should be performed
within how many hours of dilution?
Answer: 3 hours
7. Mr. Pogi C. Nuarin, a medical technologist, conducted a manual WBC count on a
patient’s sample. Using the thoma pipet, he aspirated blood up to its .5 mark and
diluted up to 11 mark. Using the 4 large corner squares, he counted the WBC. In
the first chamber of the hemocytometer he counted 24, 26, 25, 24 while on the
other side of the chamber, he counted 28, 24, 23, 26. What is the WBC count of
the patient?
Solution: 99/100= 100x20x25
Answer: 5.0 x 10^9 / uL or 5000/mm^3
8. A medical technologist conducted a manual WBC count and counted 48 cells in
all nine square millimeters on a Neubauer ruled hemocytometer with 1:10
dilution. What is the patient’s total WBC?
Answer: 5.33 x 10^9
9. All of the following are true of the procedure in performing a WBC estimate,
EXCEPT?
Choices:
 Scan a thin area, using the 50x OIO lens
 Observe 10 fields, counting all WBCs in each field
 Average the WBCs seen per OIO field
 Multiply the number of WBCs per OIO field by 2000
 None of the choices
Answer: None of the choices
10. A medical technologist conducted conducted a manual platelet count using a
hemocytometer. Upon viewing it under the microscope, he noticed that there are
too many platelets and as he counts it there where more than 500 platelets
counted on each side. Which of the following should the medical technologist do
next?
Answer: The medical technologist should repeat the procedure by
diluting the blood to 1: 100 uisng calibrated pipettes
11. Platelet sattelitosis is phenomenon that refers to the adherence of platelets
around neutrophils, producing a ring or satellite effect. Having this phenomenon,
the medical technologist is expected to do which of the following procedure?
Answer: Recollection of a sample using Sodium Citrate anticoagulant
and multiply the platelet count by 11
12. Which of the following is TRUE of the Westergren tube?
Answer: The Westergren tube is a straight pipet 30 cm long, 2.55 mm in
internal diameter, and calibrated in millimeters from 0-200
13. I.There is adequate platelet in peripheral blood smear if there is 7 to 25 platelets
per OIO.
II.There is adequate platelet in peripheral blood smear if there is one platelet
in every 10-30 RBCs.
Answer: First statement is TRUE. Second statement is FALSE
14. I.In Clay-Adams Microhematocrit determinations, the capillary tube should be
filled with 2/3 of blood.
II. In Clay-Adams Microhematocrit determinations, the clay pluh should be
approximately 2-4 mm.
Answer: First statement Is FALSE; second statement is TRUE
15. Most routine cell-counting procedures in the hematology laboratory are
automated. It maybe necessary to use manual methods when which of the
following?
 Answer: All of these
16. In charging the hemocytometer, at what angle should the medical laboratory
scientist hold the microhematocrit tube to the coverslip edge where it meets the
chamber floor?
Answer: 45 degree
17. All of the following are TRUE of the Copper Sulfate Method, EXCEPT?
Answer: The specific gravity of the copper sulfate solution is 1.053
(CORRECT: 1.052)
18. Alkali hematin method is a colorimetric method used to measure hemoglobin.
Which of the following statements are TRUE of this method?
Answer: It can be used for Hb determinations of newborns
19. Which of the following is true of a Romanowsky stain?
Answer: A Romanowsky type of stain contains methylene blue as the
basic dye and eosin as the acidic dye
20. If and adult male has as hematocrit of 30% (0.30L/L) and a reticulocyte count of
3%, the corrected reticulocyte count would be:
Answer: 2.0 (Yan answer natin kanina walang nakalagay na sagot dito)
21. Which of the following statement is TRUE of the aperture diameter in
impedance?
Answer: The RBC/ platelet aperture is smaller than the WBC aperture to
increase platelet counting sensitivity
22. Which of the following statements/s is/are TRUE of the distrubution graph of
electronic impedance coulters?
Choices:
 a. Data are plotted with the relative number on the y-axis and size on
the x-axis
 c. The number of pulses is proportional to the numebr of cells counted
Answer: Both A and C
23. Which of the following instrument uses VCS technology for WBC differentials?
Answer: Coulter LH 750
24. Hematology analyzers have some common basic components such as the
hydraulics system. The hydraulics system includes the following, EXCEPT?
Answer: Vacuum
25. Which of the following instruments reads hemoglobin concentration at 555 nm
Answer: Sysmex XE-2100
26. Which of the following systems is/are used by the Coulter LH 750 in WBC
counting?
Answer: Optical scatter
27. The following results were obtained in an electronic impedance particle counter;
WBC: 6.5 x 10^9/L
RBC: 4.55 x 10^9/L
Hgb: 180 g/L
Hct: 41.5%
MCV: 90.1 fL; MCH; 39.6 pg; MCHC 43.4%
Which of the following is the first step to do in obtaining valid results?
Answer: Correct the hemoglobin for lipemia
28. Which of the following should a technician do if a specimen run on an automatic
cell counter has a platelet count of 19 x 10^9/L?
Answer: Review the stained blood smear
29. Which of the following is the most common cause of error when using automated
cell counters?
Answer: Inadequate mixing of sample prior to testing
30. Using automated coagulation instruments, duplication of normal tests is no longer
appropriate because
Answer: All technologists on all shifts can be taught with QC (NOT
SURE)
31. Which of the the following uses dye-tagged monoclonal antibodies specific for
tumor surface markers for malignant cell identification?
Answer: Immunohistochemical dyes
32. Which of the following dye is used to evaluate iron stores for deficiency or excess
iron?
Answer: Prussian Blue
33. Which of the following dye is used to examine marrow fibrosis?
Answer: Reticulin and Trichome stain
34. Which of the following is the most preferable site for bone marrow aspiration and
biopsy in an adult?
Answer: Posterior Superior Iliac Crest
35. Which of the site is used in bone marrow aspiration in children younger than age
of 2?
 Answer: Anterior medial surface of the tibia
36. All of the following statements are TRUE of blood islandsof the yolk sac,
EXCEPT.
Answer: The blood islands remains active only through the 7 t0 8 weeks
(CORRECT: 8 to 12 weeks) of gestation and are primarily responsible for
red cell production
37. The hepatic phase of the hematopoiesis begins at which of the following?
Answer: 6-7 gestational weeks
38. Which of the following phases of hematopoiesis is characterized by recognizable
clusters of developing erythroblasts, granulocytes, and monocytes?
Answer: Hepatic phase
39. Which of the following is/are TRUE of multipotential stem cells?
Answer: All of the above (NOT SURE)
40. Which of the following is/are TRUE of hematopoietic stem cells (HSCs)?
Answer: All of the above
41. All of the following are the primitive hemoglobins formed by immature
erythrocytes in the yolk sac, EXCEPT:
Answer: Gower III
42. A physician wants to obtain a measure of a patient’s iron stores. Which of the
following tests would be the most suitable?
Answer: Serum transferrin (TIBC)
43. A 65-year-old woman visited her physician with reports of fatigue and weakness.
A CBC was ordered, and the patient’s results were as follows:
RBC: 2.50 x 10^12/L
Hct: 18.8%
MCH: 24.8 pg
Hgb: 6.2 g/dL
MCV: 75.2 fL
MCHC: 33%
Which of the following would be a plausible diagnosis for this patient?
Answer: Iron Deficeincy Anemia
44. A peripheral smear shows a decreased RBC count with microcytic, hypochromic
cells with small grapelike inclusions in the RBCs on both Wright stain and
Prussian blue stain. This is consistent with which of the following?
 Answer: Iron Deficiency Anemia
45. Which disorder will the most likely give the following results of iron studies?
Decreased Serum Iron
Increased TIBC
Decreased Ferritin
Decreased % Saturation
Answer: Iron Deficiency Anemia
46. Acquired sideroplastic anemia may be present in all of the following, EXCEPT:
Answer: Malabsorption
47. A patient has macrocytic anemia, and the physician suspects pernicious anemia.
Which test would best rule in a definitive diagnosis of pernicious anemia?
Answer: Intrinsic factor antibodies
48. Megaloblastic anemias result from which of the following?
Answer: Deficiencies in vitamin B12 and folic acid
49. The CBC for 57-year-old man had the following results. Which tests would be
best to order next?
RBC: 2.5 x 10^12/L
Hct: 26.0%
MCH: 34 pg
Hgb: 8.5 g/dL
MCV: 104 fL
Answer: Vit B12 and folic acid levels
50. Fanconi’s anemia is an inherited aplastic anemia with mutations that leads to:
Answer: Increased chromosome fragility
51. Which of the following values is the most likely to be normal in patient with
aplastic anemia?
Answer: Absolute Lymphocyte count

52. Which of the following is decreased in cases of intravascular hemolytic anemia?

Answer: Haptoglobin

53. Which of the following is a typical CBC findings in patients with hemolytic
anemia?
Answer: Macrocytic, normochromic cells with increased polychromasia
54. A 36-year-old male patient has a cbc performed as part of a routine physical test.
The wbc count was 6.5x10^9/L with a differential count of 48% neutrophils, 8%
monocytes, 3% eosinophils, and 1% basophils. The majority of thee neutrophils were
mature but hyposegmented, showing band-like or single nuclei. What disorder would
be suspected?
Answer: Pelger-Huet anomaly

55. A 38-year-old male patient has the following CBC results:

WBC 32.5.10^9/L
RBC 5.50X10^12/L
Hgb 16 g/dL
Hct 48 %
Platelet 225x10^9/L
Differential:
49% segmented neutrophils
9% bands
25% lymphocytes
9% monocytes
1% eosinophils
4% metamyelocytes
3% myelocytes
RBC and platelet morphology appear normal

Which of the following conditions is the most likely the cause of these results?
Answer: Bacterial Infection

56. Which of the following cytochemical stains is best used to distinguish cells of
monocytic origin?
Answer: A-Naphthyl acetate esterase

57. A positive tartrate-resistant acid phosphatase (TRAP) stain is indicative of which

of the following?
Answer: Hairy cell leukemia

58. A patient has a CBC and peripheral smear with an elevated WBC count and left
shift, suggestive of a diagnosis of CML. Which of the following tests would be the
most helpful in confirming the suspected diagnosis?
Answer: Cytochemical staining for myeloperoxidase and LAP

59. A patient has a splenomegaly, and his CBC shows a left shift; bizarre RBCs,
including dacrocytes; and notable platelet abnormalities. Which of the following
would be the most helpful in determining the patient’s diagnosis?
Answer: Karyotyping for the Philadelphia Chromosome

60. Which of the following peripheral blood findings would not be expected in a
patient with a myelodysplastic
syndrome?
Answer: Decreased vit. B12 and folic Acid
61. Which of the following does the WHO system classifies as a disorder under
myeloproliferative/myelodysplastic
syndrome?
Answer: Refractory anemia with Ringed Sideroblasts

62. A 4-year-old male patient presents with a slightly elevated WBC count, and
occasional blasts are present on the differential. Flow cytometry is performed with
the following results: CD10 (+), CD19 (+), CD22 (+), CD79a (+), TdT (+). Which of
the following diagnoses is the most likely?
Answer: Pre-B cell ALL

63. Which of the following may predict a better prognosis in patients with ALL?
Answer: The Philadelphia Chromosome is present

64. A patient presents with an elevated WBC count, increased monocytes, and
blasts present on the differential. Flow cytometry is performed with the following
result: CD4+, CD11b+, CD11c+, CD13+, CD14+, CD33+, CD36+, CD64+. Which of
the following diagnoses is the most likely?
Answer: Acute myelomonocytic leukemia

65. A 75-year-old male patient visits his physician for an annual checkup. His CBC
showed an elevated WBC count with numerous small lymphocytes and smudge
cells, and a subsequent bone marrow biopsy and aspirate showed hypercellularity
with increased lymphoid cells. What is a presumptive diagnosis based on this
information?
Answer: Chronic Lymphocytic leukemia/ small cell lymphocytic
lymphoma

66. Which of the following is not true regarding platelets?

Answer: Platelet are not affected by aspirin

67. Which enzyme is blocked by the presence of aspirin?

Answer: Cyclooxygenase

68. Normally, which of the following is the average number of platelets produced by
an average megakaryocyte?
Answer: 2,000-4,000

69. Which of the following is the marrow transit time of megakaryocyte?

Answer: 5 days

70. Which of the following indicates that a patient has a condition that causes
increased platelet destruction?

71. Which of the following is characteristic of cellular changes as megakaryoblasts

mature into megakaryocytes within the bone marrow?
Answer: Nuclear division without cytoplasmic division

72. Aspirin affects platelet function by interfering with platelets’ metabolism of which
of the following substances?
73. Alpha, dense, and lysosomal granules are found on which platelet zone?
Answer: Organelle zone

74. Which of the following platelet zones are associated with platelet adhesion and
aggregation?
Answer: Peripheral zone

75. A platelet count of approximately 100,000 to 149,000 per microliter is described

as which of the following?
Answer: Slightly decreased

76. Which of the following lists the steps of the hemostatic response in the correct
order?
Answer: Injury>Primary hemostasis>Secondary
hemostasis>Fibrinolysis

77. Which of the following properties renders the vessel wall prothrombic?
Answer: Release of tissue factor

78. Which of the following tests would help to differentiate between Bernard-Soulier
syndrome and Glanzmann’s thrombasthenia?
Answer: Response to ADP, collagen, epinephrine in an aggregation
assay

79. A young boy is taken to his pediatrician because his parents noticed that he
seems to bleed easily and has swollen knees. The following results were obtained:
PT= Normal
Aptt= Prolonged
Fibrinogen= Normal
Platelet count= Normal
aPTT with normal pooled plasma= Corrected the aPTT

Which of the following statements best describes the next steps?

Answer: The pediatrician should order factor assays for factors 8 and 9

80. Which of the following results would be expected in a patient with

dysfibrinogenemia?
Answer: Normal PT, Normal Aptt, prolonged thrombin time

81. The following results were obtained from a patient who recently underwent major
surgery.
PT= prolonged
Aptt= Prolonged
Fibrinogen= Decreased
D-dimer= Positive
Platelet count= Decreased

Which of the following conditions is likely to be present in patient?

Answer: Disseminated intravascular coagulation
82. Which of the following tests is helpful in differentiating fibrinogenolysis from DIC?
Answer: D-dimer

83. A patient has been receiving a broad-spectrum antibiotic is found to have a

prolonged PT. After running a couple of factor assays, you conclude that both the
factor X and factor VII levels are decreased. The PT corrected when mixed with
normal pooled plasma. What is a possible cause?
Answer: Inherited factor deficiency

84. When performing platelet aggregation assays, which of the following is an

important preanalytic factor?
Answer: The patient must refrain from aspirin-containing products for 7
days before testing

85. Which of the following describes the principle of the thrombin time test?
Answer: An excess of thrombin is added to patient plasma, and the time
to
clot is measured

86. Which of the following factors binds to platelets via the glycoprotein IIb/IIa
receptor?
Answer: vWF

87. Which of the following factors is called prothrombin?

Answer: Factor II

88. Which of the following factors usually results in no clinical bleeding when
deficient?
Answer: Factor XII

89. Which of the following cleaves the fibronopeptides from fibrinogen?

Answer: Thrombin

90. Activation of factor VII after the release of tissue factor initiates which of the
following pathways?
Answer: Extrinsic pathway

91. Which of the following is not true?

Answer: Protein K is a cofactor for protein C

92. If a deficiency of this factor is present, the cross-linking of fibrin will not occur.
Answer: Factor XIII

93. Which of the following is associated with hemophilia B?

Answer: Platelet cofactor2 and Plasma thromboplastin component
94. Glanzmann’s thrombasthenia is best described as a:
Answer: Deficiency of Glycoprotein IIb/IIIa

95. Which of the following conditions will cause an increase in fibrinogen levels?
Answer: Afribrinogenemia

96. What is the ultimate goal of Quality control systems?

Answer: Correction of identified patient care problems
Enhancement of patient care services
Reduction of both systematic and random errors to zero

97. Which of the following is/are TRUE of random errors?

98. Which of the following is/are TRUE of systematic errors?

99. Which of the following refers to the reproducibility of test results of a given
analyte?
Answer: Precision

100. Which of the following refers to the closeness with which measured values
agree with the true values?
Answer: Accuracy