A leukemoid reaction is: The nitroblue tetrazolium test (NBT) can be

used to detect deficiency in:

A. pre-leukemia
A. NADPH oxidase
B. A decrease in cells, indicating an infectious
response B. Myeloperoxidase

C. An increase cells, indication of infectious C. G6PD

response
D. Superoxide dismutase
D. An increase in peripheral blood cells,
E. Alkaline phosphatase
indicating in the presence of leukemia
This is considered to be the major neoplastic
E. A decrease in peripheral blood cells,
disorder of childhood
indicating in the presence of leukemia
A. CML
A “shift to the left” when used in describing
a cells population indicates B. ALL

A. An increase erythrocytes C. CLL

B. An increase reactive lymphocytes D. AML

C. An increase immature cells The following are features of CML except:

D. A cell production “hiatus” or gap A. Increased LAP

E. A higher percentage of lymphocytes than B. Tear drop cells present

granulocytes
C. Splenomegaly observed
Eosinopenia can be produce by giving
D. Leukocytosis
A. ACTH
What is the immediate precursor of mature
B. Androgens neutrophils?

C. Antipyrine A. Promyelocyte
D. Chloramphenicol B. Band neutrophils

E. Pituitrin C. Myelocytes
Vasodilation and bronchoconstriction would D. Metamyelocyte
be associated with which blood cells?
E. Myeloblast
A. Eosinophils
What is the anticoagulant of choice if there
B. Monocytes is pseudoleukocytosis?

C. Neutrophils A. EDTA
D. Basophils B. Sodium citrate
E. Lymphocytes C. Double oxalate
D. Heparin
E. Acid citrate dextrose Hgb F determination
In the myeloid series, the first appearance of Diagnose H spherocytosis
cytoplasmic granules is seen in what cell?
E Test for PNH
A. Myelocyte
A. Dithionite solubility
B. Metamyelocyte
B. Singer test
C. Promyelocyte
C. EOFT
D. Myeloblast
D. Schilling’s test
E. Band cell
E. Sucrose hemolysis test
Which of the following diluting fluids contain
Which of the following is true regarding
substances that will NOT lyse RBCs?
erythrocyte maturation?
A. Turk’s fluid
A. These are four cell division takes places
B. 2% acetic acid place from blast to mature RBC
C. Hayem’s B. RBC maturation takes place approximately
72 hours
D. 3% HCl
C. Multiple nucleoli are present in rubriblast
E. C and D
D. A and B
Basophils contain large amounts of which of
the following secretory products? E. A,B,C
A. Histamine Which of the following maturing red cell is
capable of hemoglobin synthesis?
B. Acid phosphatase
A. Basophilic normoblast
C. Immunoglobulins
B. Diffusely basophilic erythrocyte
D. Myeloperoxidase
C. Metarubricyte
E. A and B
D. A and B
This abnormal RBC shape develops from
excess cell membrane or a decrease in Hgb E. A,B,C
that results in a relative membrane increase
Extrusion of nuclear material occurs in what
A. Acanthocyte stage of maturing RBC?

B. Codocyte A. Rubriblast

C. Spherocyte B. Metarubricyte
D. Schistocytes C. Basophilic rubricyte

E. Sickle cell D. Reticulocyte

D Test to assess pernicious anemia Which of these anemias is the result of
abnormal DNA synthesis because of a single
A Sickle cell test
or combined deficiency of folate or Vitamin In the absence of EPO, what marrow cells
B12? cease production?

A. Hemolytic anemia A. Megakaryocyte

B. Sideroblastic anemia B. RBC

C. Myelodysplastic anemia C. Platelets

D. Megaloblastic anemia D. WBC

Which of the following RBC abnormalities What is the actiom oh phloxine in the diluting
are seen in the blood smear of a patient with fluid for direct eosinophil count?
megaloblastic anemia?
A. Acts as accentuator
A. Schistocyte
B. Stains eosinophils red
B. Macroovalocyte
C. Lyses RBC
C. Microcyte
D. Prevents clumping of cells
D. Spherocyte
In the HiCN method, these forms of
What is the anticoagulant of choice for hemoglobin are converted to
platelet counting? hemoglobincyanide?

A. EDTA A. Hgb

B. Sodium Citrate B. HgbO2

C. Double Oxalate C. Hi

D. Heparin D. HbCO
Which of the following conditions is E. ALL
associated with the presence of
Which of the following is NOT a diluent in
hypersegmented neutrophils in the
manual WBC count?
peripheral blood smear?
A. Glacial acetic acid
A. Severe infection
B. Drabkin’s reagent
B. Allergy
C. Turk’s fluid
C. Infectious mononucleosis
D. 1% HCl
D. Vitamin B12 and Folic Acid Deficiency
Total WBC count times % of each type of
Red blood cells in hereditary spherocytosis
leukocyte in the differential count is for the
are
A. Corrected cell count
A. Normocytic
B. Direct relative cell count
B. Microcytic
C. Absolute count
C. Hyperchromic
D. Indirect relative count
D. Normochromic
Which of these will shift the oxygen curve to B. Protein Band 4.1
the right?
C. Glycophorin A
A. Acidosis
D. Glycophorin B
B. Alkalosis
E. Protein Band 3
C. Hypothermia
Which of the following integral proteins
D. Decrease 23DPG Level transports the negatively charged
neuraminic acid within the red cell
C Pelger huet
membrane?
B Alder relly
A. Alpha and Beta spectrin
A Chediak Higashi
B. Protein band 3
E Dohle bodies
C. Glycophorins
D May Heglin Anomaly
D. RH antigens
A. With giant lysosomal inclusion
E. ICAM-4
B. Associated with mucopolysaccharidoses
Which of the following membrane protein if
C. Neutrophilic inclusion caused by injury defective is associated with paroxysman
nocturnal hemoglobinuria?
D. Blue spindle inclusion with >5um in diameter
A. Spectrin
E. Halted nuclear lobulation
B. Protein band 4.1
Which of the following statement/s is/are
TRUE regarding RBC metabolic system? C. Protein band 3

A. The cytochrome B5 reductase is responsib;e D. GPI anchor proteins

for maintenance of the enough level of reduced
E. ICAM-4
gluthathione
The CD marker 55 or also known as the
B. The NADH+ that was formed from G3P and
decaying accelerating proteins (DAF) are
1,3BPG interaction served as a co-factor of
linked to what RBC membrane protein?
methemoglobin reductase in reducing back
hemoglobin on its functional oxygen carrier A. Spectrin
C. The HMP is responsible for converting the B. Protein band 4.1
NADP to its reduced form
C. Protein band 3
D. A and B
D. GPI anchor proteins
C. B and C
E. ICAM-4
Which of the following transmembrane
Which of the following RBC membrane
proteins of red cell acts as anion transporter
protein interaction defect may lead to the
and supports the ABH Antigen?
deformation-induced membrane
A. Aquaporins fragmentation leading to ellipsoidal RBC
shape?
A. Spectrin-actin-PB4.1 C. Prevention of peroxidase formation
B. Spectrin-ankyrin-PB3 D. Diversion by biphosphoglycerate mutase

C. Spectrin-PB3-PB4.2 E. Reduction of oxidized gluthathione

D. Spectrin-glycophorin A-PB3 How many ATP is produced during the entire
process of EMP pathway?
E. Either A or B
A. 2
The ATP dependent cation balancing within
RBC membrane maintains the normal B. 3
intracellular-to-extracellular ratio of Na+ and
C. 4
K+ which are __ and __, respectively.
D. 5
A. 25:1, 1:12
E. 6
B. 1:25, 1:12
Which of the following is an example of RBC
C. 1:12, 25:1
peripheral protein?
D. 1:21, 1:52
A. Adducin
E. 1:12, 1:25
B. ICAM-4
Which RBC process does not require energy?
C. Duffy
A. Oxygen transport
D. RH antigen
B. Prevention of peroxidation of proteins and
E. Kell
lipids
What is the function of the ankyrin protein in
C. Cytoskeleton protein deformability
the RBC membrane?
D. Maintaining cytoplasm cationic
A. Caps actin filament
electrochemical gradients
B. Binds beta spectrin
Which of the following processes under the
EMP pathway consumes ATP? C. Anchors band 3 and protein band 4.2

A. Glucose conversion to G6PD hexokinase D. Regulates actin polymerization

B. Pyruvate kinase converting PEP to pyruvate E. Actin binding protein

C. Conversion of 1,3BPG to 3- What pathway anaerobically generates

phosphoglycerate energy in the form of ATP?
D. Methemoglobin reduction A. HMP pathway

E. None of the above B. Rapoport-Luebering pathway

Which is NOT the function of the RBC’s C. Embden-Meyerhof pathway
pentose phosphate pathway?
D. 2,38PG pathway
A. H2O2 detoxification
E. A and B
B. Reduction of the oxidized sulfhydryl groups
Which of the following coagulation test A. PT is used to monitor the dosage
results is normal in a patient with classic von
B. Not recommended for pregnant and lactating
Willebrand’s disease?
women
A. Bleeding time
C. Vitamin K antagonist
B. APTT
D. Needs antithrombin III as a cofactor
C. Platelet count
Liver disease is characterized by all of the
D. Factor VIII:C and vWF levels following EXCEPT:

How is the endpoint in platelet aggregation A. Prolonged PT

test using aggregometer detected?
B. Acanthocytosis
A. Change in optical density
C. Decreased factor VIII
B. Turbidity
D. Decreased fibrinogen
C. Clot formation via clotting time
Hemorrhagic disease of newborns is often
D. Clot formation via specific gravity due to hypoprothrombinemia. This condition
may be prevented by giving expectant
Which among these factors is present in
mothers adequate doses
adsorbed plasma but not in aged serum?
A. Vitamin A
A. XI
B. Vitamin C
B. II
C. Vitamin D
C. VII
D. Vitamin K
D. VIII
All of the following will occur if povidone-
Epsilon aminocaproic acid is an inhibitor of:
idonie is used as an antiseptic agent for
A. Platelet activation venepuncture EXCEPT:
B. Fibrinolysis A. Falsely elevated potassium level

C. Fibrin clot stabilization B. Falsely elevated phosphorus level

D. Collagent attachment C. Falsely elevated uric acid level

A positive protamine sulfate test is D. Falsely increased cholesterol level
suggestive of:
Ratio of blood to anticoagulant for light blue
A. DIC tube:

B. vWD A. 1:9
C. Glanzmann’s thrombasthenia B. 4:1

D. Primary fibrinolysis C. 1:4

Incorrect statement regarding oral D. 9:1

anticoagulants:
Increased concentration of larger molecules Cells are pagocytised with subsequent
and analytes in the blood as a result of a shift degradation of cell organelles:
water balance:
A. Pitting
A. Hematoma
B. Kinetics
B. Hemoconcentration
C. Culling
C. Ecchymosis
D. Transit
D. Syncope
Macrophages remove inclusions and
Prevents the conversion of prothrombin to damaged surface membranes from the red
thrombin blood cells:

A. Tripotassium EDTA A. Pitting

B. Disodium EDTA B. Kinetics

C. Heparin C. Culling
D. Potassium Lithium Oxalate D. Transit

Which of the following is the effect in a Process of replacing the active marrow by
patient who some 5 cigarette sticks before adipose tissue during development:
blood collection:
A. Kinetics
A. Increase WBC and cortisol level
B. Progression
B. Increase potassium and sodium level
C. Retrogression
C. Increase RBC and cortisol level
D. Culling
D. Decrease hemoglobin and RBC level
All of the following are compositions of
Muscle activity such as exercise elevates yellow marrow EXCEPT:
which of the following values:
A. Fat cells
A. Hemoglobin and RBC count
B. Differentiated mesenchymal cells
B. Creatinine and protein
C. Macrophages
C. Protein and glucose level
D. Undifferentiated mesenchymal cells
D. Platelet and sodium level
Macrophages that remove cellular and
Change from supine position to sitting foreign debris from the blood that circulates
position results in; through the liver:

A. Shift of water balance from the bone marrow A. Microglia

B. Decrease protein value B. Kupffer cells

C. Decrease lipid value C. Intestinal macrophages

D. Increase enzyme values D. All of the above

High nuclear to cytoplasm ratio with round B. Promyelocyte and myelocyte
to slightly indented nucleus with immature
C. Myelocyte and metamyelocyte
chromatin:
D. Metamyelocyte and band
A. Monoblast
Contains secretory granules:
B. Eosinophil promyelocyte
A. Promyelocyte
C. Neutrophilic myeloblast
B. Myelocyte
D. Basophilic myeloblast
C. Metamyelocyte
All cells are found in mitotic pool EXCEPT:
D. Band
A. Myelocyte
High N:C ratio, less prominent nucleoli,
B. Metamyelocyte
indented nucleus with immature chromatin,
C. Myeloblast vacuoles sometimes seen:

D. Promyelocyte A. Promyelocyt
This stimulates the granulocyte release from B. Promonocyte
the bone marrow
C. Myelocyte
A. GM-CSF
D. Myeloblast
B. IL-3
High nuclear to cytoplasm ratio, with
C. G-CSF prominent nucleoli and presence of 20
visible azurophilic granules:
D. HSC
A. Promyelocyte
This is used to differentiate HSC from CMP:
B. Neutrophil
A. Wright’s stain
C. Type I myeloblast
B. Giemsa stain
D. Type II myeloblast
C. Romanowsky stain
Measures 14-16um, 20-30% in the bone
D. Flow cytometry
marrow, with indented kidney-bean shaped
All of the following are present in the primary nucleus, and more clumpled chromatin:
azurophilic granules EXCEPT:
A. Promyelocyte
A. Myeloperoxidase
B. Myelocyte
B. Cathepsins
C. Metamyelocyte
C. Elastase
D. Band
D. Beta-2-microglobulin
32% in the bone marrow, no cytoplasmic
Contains secondary specific granules: basophilia, highly clumped nucleus with
indentation greater than ½ of its diameter
A. Myeloblast and promyelocyte
A. Promyelocyte
B. Myelocyte D. 18 hours
C. Metamyelocyte Monocytic series from the earliest
progenitor:
D. Band
A. Monoblast-monocyte
Round nucleus with immature chromatin
containing charcot-leyden crystals: B. Promyelocyte-metamyelocyte-myelocyte-
band-monocyte
A. Neutrophilic promyelocyte
C. Monoblast-promyelocyte-metamyelocyte-
B. Eosinophilic promyelocyte
monocyte
C. Basophilic myelocyte
D. Monoblast-promonocyte-monocyte
D. Neutrophilic myeloblast
Macrophage found in the skin:
Absolute normal value of neutrophils found
A. Type A cell
in the peripheral blood:
B. Dendritic cells
A. 50-75%
C. Langerhan cells
B. 45-60%
D. Microglia
C. 2.3-8.7 x 109/L
Spleen filters how many mL of blood:
D. 1.3-5.7 x 109/L
A. 100 mL blood/minute
The transit time for myeloblast to become
myelocyte: B. 350 mL blood/hour
A. 1 day C. 100 mL blood/hour

B. 3 days D. 350 mL blood/minute

C. 6 days Macrophage found in the lymph nodes:

D. 120 days A. Alveolar macrophage

Presence of large, pale, reddish orange B. Dendritic cells

secondary granules along with azure
C. Type A cells
granules in blue cytoplasm:
D. Microglia
A. Promyelocyte
Responsible for production of T cells:
B. Myelocyte
A. Red marrow
C. Metamyelocyte
B. Yellow marrow
D. Band
C. Thymus
Half-life of eosinophil:
D. HSC
A. 4 hours
Largest lymphoid in the body:
B. 15 hours
A. Bone marrow
C. 21 hours
B. Spleen A. Reticular cells
C. Thymus B. Endothelial cells

D. Lymph nodes C. Macrophages

Highest hemoglobin found in an adult: D. Osteoblast

A. Alpha2beta2 Associated with the formation of reticular

fibers that form a lattice that supports the
B. Alpha2gamma2
vascular sinuses and HSCs
C. Alpha2delta2
A. Reticular cells
D. Alpha2epsilon2
B. Osteoclasts
Highest hemoglobin found in adult:
C. Stroma cells
A. Gower-1
D. Macrophages
B. Portland
This mediate progenitor binding to the
C. Hb F stroma:

D. Hb A1 A. Fibronectin

Highest hemoglobin found at birth: B. Proteoglycans

A. Alpha2beta2 C. Laminin

B. Alpha2gamma2 D. Collagen

C. Alpha2delta2 Erythropoiesis is governed by what specific

hormone:
D. Alpha2epsilon2
A. APO
Amount of hemoglobin in adult:
B. GPO
A. A2>A1>F
C. EPO
B. F>A2>A1
D. RPO
C. A1>A2>F
Which of the following is INCORRECT:
D. A1>F>A2
A. Polychrom Normoblast 4:1
Amount of hemoglobin at birth:
B. Retic 1:2
A. F>A1>A2
C. Pronormoblast 8:1
B. F>Gower1>Gower2>Portland
D. Polychrom erythrocyte: None
C. F>A1
Erythroid specific lineage marker:
D, F>A1>Portland>Z
A. CD71
Broad flat cells that form a single continuous
layer along the surface of the BM sinus: B. CD33
C. CD10 D. Attach the cytoskeleton to the lipid layer
D. CD5 E. All of these

B-lymphoid lineage specific marker: Which of the following is a FALSE statement?

A. CD71 A. The heme is attached in the E and F helices
of the globin chain
B. CD33
B. The conversion of phorphobilinogen to
C. CD10
coproporphyrinogen III happens outside the
D. CD5 mitochondria

A Which of the following is part of the first C. Ferrochelatase reduce and inserts iron in the
phase of glucose metabolism under EMP PIX ring
pathway?
D. ALA synthetase is located in the cytosol of a
E Which of the following statement is FALSE developing RBC
regarding EMP pathway?
E. Protophorhyrinogen oxidase is responsible
D Which of the following is part of the for forming the heme ring
second phase of glucose metabolism in the
C Which of the following curves represents
EMP pathway?
the gamma globin chain production
C Which among reactions below where
D Which curve is for beta globin chain?
lactate dehydrogenase will react to
eventually form lactic acid B Which of the curves represents the alpha
polypeptide chain?
B Which of the following is part of the third
phase of glucose metabolism in the EMP E Which of these curves represents the delta
pathway? polypeptide chain?
A. Hexokinase catabolizes glucose forming G6P Timeline of globin chain production from
and ADP intrauterine to adulthood (graph)

B. Phosphoglycerate kinase converts 1,3DPG Which of the following statement is FALSE

and ADP to 3PG and ATP regarding the hemoglobin function?

C. Phosphoenol pyruvate is acted upon by A. An increase of H+ ion in the plasma may lead
pyruvate kinase forming pyruvate and ADP to increase binding of 2,3DPG to the globin
chain to favour T-formation
D. Biphosphoglycerate phosphatase is the
enzyme responsible for forming 3PG and G3P B. A decrease in the plasma pH may
consequently increase the release of oxygen to
E. Enolase converts 2-PG to PEP
the tissue
The glycolipids of the RBC membrane:
C. Shifting of the curve to the left may happen if
A. Provides flexibility the blood pH reaches 7.6

B. Carry RBC antigens D. Hypercapnia may trigger the twisting of Hgb

chain around 15o angle
C. Constitute ion channels
E. Both C and D
Which of the following statement/s is/are C Nitrate toxicity may cause the shift of the
TRUE? curve to

A. P50 oxygen saturation normally happens at

blood pH 7.2

B. P50 oxygen saturation normally happens if

there is 27 mmHg O2 pressure A B C
C. The Hgb curve may shift to the right if there
is methemoglobinemia

D. High affinity of oxygen to the Hgb molecule

may happen in alkalosis

E. Only B, C, D are correct

Anticoagulant of choice for platelet studies:
Anomaly in heme kinetics may happen in
A. Citrate
cases of:
B. EDTA
A. Lead poisoning
C. Heparin
B. Congenital erythrocyte protoporphyria
D. Oxalate
C. Methemoglobinemia
Most preferable site for bone marrow
D. A, B, C
aspiration and biopsy in an adult?
E. Only A and B
A. Iliac Crest
C Which curve is expected in case of severe
B. Sternum
hypoventilation?
C. Tibia
C If there is an increase demand for
bicarbonate release to the plasma from the D. Spinous processes of a vertebra
Hgb; the curve may shift to
Most predominant cell in an adult bone
C Which curve is exhibited if the Hgb resist marrow:
binding to an oxygen molecule?
A. Prolymphocyte
A Deficiency of cytochrome b5 reductase
B. Metamyelocyte
may shift the curve to
C. Promonocyte
C If the p50 has increased to about 35mmHg,
the curve will shift into D. Metarubricyte
A In hyperthyroidism, low body metabolism Defibrinated blood can be used on all of the
may happen which leads to low oxygen following tests EXCEPT:
demand and this may possible shift the
A. EOFT
curve to
B. Autohemolysis test
C If one goes to a high altitude place, the
curve may shift to C. Ham’s acidified serum test
D. Donath-Landsteiner test A defective centrifuge was used to
determine a hematocrit value. Which of the
Which of the following forms of hemoglobin
following parameters will not be affected?
cannot be measured by the
hemoglobincyanide method? A. MCH

A. Carboxyhemoglobin B. MCHC

B. Carbaminohemoglobin C. MCV
C. Sulfhemoglobin D. RDW

D. Methemoglobin What effect would using a buffer at pH 6.0

have on a Wright-stained smear?
What is the effect of pancytosis on ESR
result? A. Red cells would be stained too blue
A. Increased B. Red cells would be stained too pink

B. Decreased C. White cell cytoplasm would be stained too

blue
C. Variable
D. Red cells could lyse on the slide
D. Not affected
The naphthol AS-D chloroacetate esterase
Using a Coulter counter analyser, an
stain is positive on which type of cell?
increased RDW should correlate with:
A. Megakaryoblast
A. Spherocytosis
B. Prolymphocyte
B. Anisocytosis
C. Promonocyte
C. Poikilocytosis
D. Myeloblast
D. Leukoerythroblastosis
What is the principle of automated
A miller disc is an ocular device used to
impedance cell counters?
facilitate counting of:
A. Angle of laser beam scatter by cells
1. Polychromatophilic erythrocytes
B. Amplification of an electrical current by cells
2. Reticulocytes
C. Interruption of an electrical current by cells
3. Nucleated RBCs
D. Change in optical density of the solution
4. Platelets
containing cells
A. 1 and 2
Side angle scatter in a laser-based cell
B. 2 only counting system is used to measure:
C. 1, 2, and 3 A. Cell size

D. 4 only B. Cytoplasmic granularity

C. Cell number

D. Antigenic identification
A WBC count is done on an automated The demarcating membrane system (DMS)
impedance cell counter from a patient with begins to form in what stage of platelet
leukoerythroblastosis. The WBC count is maturation?
most likely:
A. Megakaryoblast
A. Falsely increased due to nRBCs
B. Promegakaryocyte
B. Falsely increased due to RBC fragments
C. Megakaryocyte
C. Falsely decreased due to nRBCs
D. Metamegakaryocyte
D. Accurate; no error with this methodology
Stem cell marker:
Automated cell counters should be
A. CD16
calibrated:
B. CD56
A. At least every 6 months
C. CD34
B. After replacement of any major part
D. CD10
C. Using commercially available controls
A well-defined hof and a cart-wheel like
D. All of the above
pattern of chromatin are characteristics of:
On automated hematology analyzers,
A. Macrophages
marked red blood cell fragments will cause
an abnormal histogram and/or scatterplots B. Plasma cells
for:
C. Megakaryocytes
A. WBCs and RBCs
D. Mast cells
B. RBCs and Platelets
A single megakaryocyte can produce how
C. WBCs and Platelets many platelets?

D. WBCs, RBCs and Platelets A. 1,000-3,000

G6PD deficiency is an abnormality in: B. 5,000-7,000

A. Rapoport-Luerbering pathway C. 4,000-6,000

B. Embden-Meyerhoff pathway D. 2,000-4,000
C. Methemoglobin reductase pathway Drabkin’s solution contains:

D. Hexose monophosphate shunt A. Calcium chloride

Non-specific granules appear at what stage B. Cyanide
of the myelocytic series?
C. Magnesium sulfate
A. Myeloblast
D. Sulfosalicylic acid
B. Myelocyte
The color of the wright-stained RBCs may be
C. Promyelocyte adjusted by:

D. Juvenile granulocyte A. Dipping the slide in methanol before staining

B. Rapid drying of slides A. Platelet count
C. Adjusting the buffer pH B. ESR

D. Decreasing the concentration of glycerol in C. Hematocrit

the stain
D. Solubility test for HbS
The addition of 0.5mL of blood to 4.5mL of
In the platelet count procedure using phase
diluent results in a dilution of:
microscopy:
A. 1:5
A. Platelets appear dark against a light
B. 1:50 background
C. 1:20 B. The entire ruled counting surface of the
hemocytometer is used
D. 1:10
C. Ammonium oxalate will lyse the WBCs
Which determination is considered a reliable
assessment of effective erythropoiesis in D. Platelets should be counted immediately
the bone marrow? after plating the hemocytometer

A. Reticulocyte count The blood smear made on a patient with

polycythemia vera is too short. What should
B. Hemoglobin
be done to correct this problem?
C. RBC count
A. Decrease the angle of the spreader slide
D. M:E ratio
B. Increase the angle of the spreader slide
The specific diagnosis of sickle cell anemia
C. Adjust the angle of the spreader slide to 45o
can be made from which of the following
laboratory tests? D. Use a smaller drop of blood

A. Solubility test If a patient with and RBC count of 2.90

x1012/L has a reticulocyte count of 9.08, what
B. Sodium metabisulfite
is the absolute reticulocyte count in SI units?
C. Hemoglobin electrophoresis
A. 2.61 x 109/L
D. Presence of sickle cells
B. 26.1 x 109/L
Which among the following instruments
C. 261 x 109/L
applies the principle of optical light
scattering? D. 261 x 103/L
A. Fibrometer Which of the following would not be the
cause of a falsely high MCHC of 40.5g/dL on
B. Technicon autoanalyzer
an automated instrument?
C. Coulter counter
A. Hereditary spherocytosis
D. Sysmex counter
B. Lipemia
A clotted EDTA tube can be used to perform
C. Presence of cold agglutinins
a(n):
D. Instrument sampling or mixing error A. Wright’s stain
A wintrobe tube is graduated between: B. Brilliant cresyl blue

A. 0-18mm C. May-Grunwald
B. 0-50mm D. Giemsa

C. 0-100mm A blood pressure cuff is needed to carry out

the following test(s):
D. 0-200mm
1. Ivy’s bleeding test
A platelet count of 100,000-150,000/uL is
reported as: 2. Duke’s bleeding test

A. Normal (200,000-400,000) C. Coomb’s test

B. Low normal (150,000-199,000) 4. Lee and White clotting time

C. Slightly decreased A. 1 only

D. Moderately decreased (50,000-100,000) B. 1 and 2

A stomatocyte grading of 3+ indicates how C. 1, 2, and 4

many stomatocytes per oil-immersion field?
D. 1, 2, 3, and 4
A. 0-2/OIO
Which ratio of anticoagulant to blood is
B. 2-10/OIO correct for coagulation procedures?

C. 10-20/OIO A. 4:1

D. 20-50/OIO B. 1:5

Which of the following types of hemoglobin C. 9:1

is the fastest to migrate on cellulose acetate
D. 1:9
hemoglobin electrophoresis?
Which anemia has red cell morphology
A. A1
similar to that seen in iron deficiency anemia?
B. Bart
A. Sickle cell anemia
C. I
B. Thalassemia
D. H
C. Pernicious anemia
Fetal hemoglobin can be detected by:
D. Hereditary spherocytosis
A. Sickle preparation
Which type of anemia is usually present in a
B. Osmotic fragility test patient with acute leukemia?

C. Measuring alkali-resistant hemoglobin A. Microcytic, hyperchromic

D. Looking for basophilic stippling B. Microcytic, hypochromic

Which of the following blood stains is used C. Normocytic, normochromic
to demonstrate reticulocyte?
D. Macrocytic, normochromic C. 1, 3, and 4
Iron deficiency anemia may be distinguished D. 1, 2, 3, and 4
from anemia of chronic infection by:
In myelofibrosis, the characteristic
A. Serum iron level poikilocyte is:

B. Red cell morphology A. Codocyte

C. Red cell indices B. Schistocyte

D. TIBC C. Drepanocyte
In which of the following conditions does D. Dacryocyte
LAP show the least activity?
According to FAB, to establish the diagnosis
1. Leukemoid reaction for leukemia, the percentage of blasts found
in the bone marrow should be:
2. Idiopathic myelofibrosis
A. ≥ 20%
3. Chronic myelogenous leukemia
B. ≥ 30%
4. Polycythemia vera
C. ≥ 15%
A. 1, 2, and 4
D. ≥ 40%
B. 2, 3, and 4
Stage in the myelocytic series wherein a
C. 3 only
given granulocyte can be identified:
D. 1 only
A. Promyelocyte
Cells exhibiting a positive stain with tartrate-
B. Myeloblast
resistant acid phosphatase are
characteristically seen in: C. Metamyelocyte
A. Infectious mononucleosis D. Myelocyte
B. Hairy cell leukemia A term that describes a plasma cell with red
to pink cytoplasm is known as:
C. Sezary syndrome
A. Grape cell
D. Gaucher’s disease
B. Morula cell
Auer rods may be seen in which of the
following: C. Flame cell
1. Acute myeloblastic leukemia D. Plasmacytoid lymphocyte
2. Acute lymphoblastic leukemia Faggot cells are predominantly seen in
which type of leukemia?
3. Acute promyelocytic leukemia
A. M1
4. Acute myelomonocytic leukemia
B. M2
A. 1, 2, and 3
C. M3
B. 2, 3, and 4
D. M4 Hemoglobin configuration characteristic of
Hemoglobin H:
Which of these tests will determine the
inability of phagocyte to kill ingested A. Gamma4
microorganisms?
B. Alpha2-Gamma2
A. LAP score
C. Beta4
B. NBT dye test
D. Alpha2-Delta2
C. Boyden chamber assay
Which of the following match(es) is/are
D. All of these incorrect?
Oval macrocytes, Howell-Jolly bodies and 1. Stomatocyte- Mouth cell
hypersegmented neutrophils are associated
2. Spherocyte- Bronze cell
with what condition?
3. Schistocyte- Fragmented cell
A. Broadfish tapeworm infection
4. Elliptocyte- Pear shaped cell
B. Cyanocobalamin deficiency
5. Acanthocyte- Burr cell
C. Pteroylglutamic acid deficiency
6. Ovalocyte- Mexican hat cell
D. All of these
A. 1, 2, and, 3
Which of the following stains are most often
positive in ALL but are negative in AML? B. 4, 5, and 6

1. Terminal deoxyribonucleotidase C. 2, 4, and 5

2. Periodic acid schiff D. 3, 5, and 6

3. Esterases Which of the following pathways generates

2, 3- Biphosphoglycerate that regulates
4. Sudan black B
hemoglobin affinity for oxygen?
A. 1 and 3
A. Rapoport-Luebering
B. 1, 2, and 4
B. Glycolytic
C. 1 and 2
C. Pentose phosphate
D. 1, 2, 3, and 4
D. Methemoglobin reductase
Which organ removes erythrocyte
Mauve lavender color of blood is associated
inclusions without destroying the cell?
with increased concentration of what
A. Liver hemoglobin?
B. Spleen A. Carboxyhemoglobin
C. Kidney B. Methemoglobin

D. Lymph nodes C. Oxyhemoglobin

D. Sulfhemoglobin
Which of the following is incorrect regarding Ehler- Danlos, von Willebrand and Bernard
aplastic anemia? Soulier are all qualitative platelet disorders
that have abnormalities of:
A. May be due to drugs such as
chloramphenicol, or chemicals such as benzene A. Adhesion

B. Congenital type is known as Diamond- B. Aggregation

Blackfan anemia
C. Granule release
C. Pancytopenia
D. None of the above
D. RBCs are normocytic and normochromic
A bleeding tendency is likely to be present
If the area of RBC palor is three-fourths of when the platelet count is below:
the cell diameter, the degree of hypochromia
A. 50,000/uL
is graded as:
B. 150,000/uL
A. 1+
C. 200,000/uL
B. 2+
D. 400,000/uL
C. 3+
The phase contrast microscope is employed
D. 4+
in which platelet count method?
Factors that cause shift to the right in the
A. Rees-Ecker
oxyhemoglobin dissociation curve:
B. Brecker-Cronkite
1. Increased pH
C. Indirect
2. Decreased 2,3-BPG
D. Coulter
3. Increased temperature
A disorder characterized by a very high
4. Increased pCO 2
platelet count yet functionally abnormal
A. 1 and 2 platelets:
B. 3 and 4 A. Glanzmann’s thrombasthenia

C. 1, 3, and 4 B. Essential thrombocythemia

D. 2, 3, and 4 C. Acute megakaryocytic leukemia

In the Pelger-Huet anomaly, neutrophils D. Thrombotic thrombocytopenic purpura

show:
Aspirin prevents platelet aggregation by
A. A shift to the left inhibiting the action of which enzyme?

B. Dohle bodies A. Phospholipase

C. 2 lobes and hyperclumped chromatin B. Thromboxane A2 synthetase

D. Toxic granulation C. Prostacyclin synthetase

D. Cyclooxygenase
Contents of platelet dense granules: A. Prolonged PT
1. Serotonin B. Prolonged APTT

2. Fibrinogen C. Prolonged PT and APTT

3. ADP D. Normal PT and APTT

4. Platelet factor 0.01mL of blood is diluted in 1.99mL of

diluent. This dilution is plated on both sides
5. ATP
of a Neubauer counting chamber. A total of
6. Calcium 453 cells is seen when both large center
squares are counted. The platelet count
A. 1, 2, 3, and 5
expressed in SI units is:
B. 1, 4, 5, and 6
A. 453 x 109/L
C. 1, 3, 5, and 6
B. 453 x 109/uL
D. 1, 3, 4, and 6
C. 227 x 109/L
Which part of the platelet structure serves as
D. 906 x 109/L
the site of arachidonic acid metabolism?
The platelet parameter PDW refers to the:
A. Microfilaments
A. Average platelet volume
B. Dense tubular system
B. Cell weight versus density
C. Microtubules
C. Variation in platelet cell size
D. Glycocalyx
D. Capacity to adhere to foreign substances
This factor is essential for normal platelet
aggregation: Causes of positive errors in particle-
counting instruments EXCEPT:
A. Calcium
A. Aperture plugs
B. Glycoprotein Ib
B. Bubbles in the sample
C. von Willebrand factor
C. Extraneous electrical pulses
D. Glycoprotein IIb-IIIa complex
D. Excessive lysing of RBCs
If a physician suspects a qualitative platelet
defect, the most useful test to order is: On a well stained blood smear of a normal
patient, there should be how many platelets
A. Platelet count
in each oil immersion field?
B. Prothrombin time
A. 8-20
C. Duckert’s test
B. 6-9
D. Bleeding time
C. 4-8
The expected screening test results for a
D. 5-10
patient with a fibrin stabilizing factor
deficiency are:
Part of the platelet structure major A. 1, 2, and 3
responsible for clot retraction:
B. 1, 3, and 4
A. B-Thromboglobulin
C. 2, 3, and 4
B. Thrombospondin
D. 1, 2, 3, and 4
C. Thrombosthenin
Prolonged PT and APTT are corrected with
D Canalicular system aged serum, but not with adsorbed plasma.
What factor is deficient?
Which of the following does not contribute
to hemostasis? A. I
A. Liver B. II

B. Endothelial cells C. V

C. Thrombocytes D. X

D. None of these Activators used in the activated partial

thromboplastin time:
The activity of the lupus anticoagulant and
anticardiolipin antibodies appears to be 1. Ellagic acid
directed against:
2. Celite
A. Factor V
3. Micronized silica
B. Factor VIII
4. Kaolin
C. Factor IX
A. 1, and 2
D. Phospholipid
B. 1, 2, and 3
5M urea or 1% monochloroacetic acid are
C. 2, 3, and 4
reagents used in tests for which plasma
factor deficiency? D. 1, 2, 3, and 4
A. VIII Variables to consider in the visual detection
of fibrin clot formation (tilt tube method):
B. IX
A. Temperature
C. XII
B. Pipetor calibration
D. XIII
C. Accuracy of timing devices
Laboratory results from a patient with DIC
are: D. All of the above

1. Decreased platelets What solution is used to decontaminate the

probes in an electromechanical instrument
2. Increased factors I, V, VIII
such as the fibrometer?
3. Positive D-dimer
A. 0.85% NaCl
4. Prolonged APTT
B. 2% Acetic acid
C. Tap water A. ALL
D. 0.1N HCl B. AML

Which of the following aggregating agent is C. CML

very difficult to store because of its
D. CLL
susceptibility to oxidation?
It is the rarest of all ALL with large
A. ADP
homogenous cells:
B. Epinephrine
A. L1
C. Arachidonic acid
B. L2
D. Collagen
C. Burkitt Type (L3)
In the Coulter Counter electrical impedance
D. L4
instrument, the R1 flag in flagging indicates:
Epstein Barr virus is associated with this
A. Increased granulocyte count
leukemia:
B. Overlap of cell populations at the lymphocyte-
A. CML
mononuclear boundary
B. AGL
C. Presence of nucleated RBCs, giant platelets
or sickle cells C. CLL

D. Overlap of cells at the mononuclear- D. ALL

granulocyte boundary
It is a special form of CLL. This condition is
In the Sysmex cell counting instruments, an a monoclonial proliferation of B
“asterisk with a number” flag indicates: lymphocytes:
A. A value exceeds the linearity of the system A. Plasma cell leukemia

B. Values are outside the numerical limits preset B. Hairy cell leukemia
by the user
C. Burkitt type
C. Analysis error
D. Infectious mononucleosis
D. Distribution error
Anemia is a feature in this/these leukemia(s)
The size threshold range used by electrical in its early stage(s):
impedance methods to count particles as
A. CML
platelets is:
B. AML
A. 0-10 fL
C. CLL
B. 2-20 fL
D. A and B only
C. 15-40 fL
Auer bodies are seen in the following:
D. 35-90 fL
A. M1
High levels of basophils is seen in this type
of leukemia: B. M2
C. M3 Blast cell with irregular cytoplasm and slight
indentation of nucleus:
D. All
A. Rubriblast
This WBC has the capacity of destroying
helminthic larvas: B. Myeloblast

A. Neutron C. Lymphoblast

B. Eo D. Monoblast

C. Baso Which stain should be used to differentiate a

neutrophilic leukemoid reaction from
D. Mono
chronic myelogenous leukemia?
Increased in leukemoid reaction but absent
A. Sudan Black B
in CML:
B. PAS
A. LE cell
C. NBT
B. Downey cell
D. LAP
C. Toxic granules
The familial disorder featuring pseudo Dohle
D. Russel bodies
bodies, thrombocytopenia, and large
Cell in the granulocytic series where platelets is called as:
indented nucleus is seen:
A. May-Hegglin anomaly
A. Myeloblast
B. Chedialk-Higashi
B. Promyelocyte
C. Pelger-Huet
C. Myelocyte
D. Alder-Reilly
D. Metamyelocyte
A hypercellular bone marrow and myeloid-
Disease where large azurophilic granules erythroid (M:E) ratio of 8:1 is most
are seen in matured cells: characteristic of:

A. May-Hegglin A. CML

B. Alder- Reilly B. Primary polycythemia

C. Dohle Amato C. Beta thalassemia major

D. All D. Aplastic anemia

Azurophilic granules are replaced by Often confused with variants of lymphocytes

specific granules in this cell: like atypical lymphocytes:
A. Myeloblast A. Basophil

B. Promyelocyte B. Eo

C. Myelocyte C. Monocyte

D. Metamyelocyte D. Mast cell

This WBC was classified first as A. Hereditary Spherocytic Anemia
agranulocyte, but later on found to have
B. PK Deficiency and G6PD Deficiency
granules to:
C. AIHA and HDN
A. Segmenters
Microcytic, hypochromic is the blood picture
B. Lymphocytes
in this anemia:
C. Eosinophils
A. Vitamin B12 Deficiency
D. Monocytes
B. PNH
Feature of a drepanocyte:
C. AIHA
A. Decreased EOFT
D. Sideroblastic anemia
B. Low Hct
A 1:200 dilution of a patient’s sample was
C. Crescent shaped made and 336 red cells were counted in an
area of 0.2mm2. What is the RBC count?
D. Seen HAS
A. 1.68 x1012/L
These cells increased Hb content and
decreased surface area: B. 4.47 x1012/L

A. Spherocyte C. 3.36 x1012/L

B. Spheroldocyte D. 6.16 x1012/L

C. Elliptocyte What is the M:E ratio found in a normal bone

marrow?
D. Acanthocytes
A. Approx. 3:1
These are inclusion bodies which are
stained positively with Perl’s Prussian Blue B. Approx. 1:3
stain:
C. 1:1
A. Basophilic stippling
D. 2:3
B. Heinz bodies
Which of the following red cell indices
C. Pappenheimer bodies reflects the amount of hemoglobin per
individual red cell?
D. Cabot ring
A. Hgb
Stains for Inclusions:

Prussian Blue  Pappenheimer bodies

B. MCV

Acetyl phenyl hydrazine  Heinz bodies C. MCHC

Fuelgen  Howell-Jolly bodies D. MCH

Modified brialliant cresyl blue  Hgb H Which of the following morphological

classifications best describes the hemolytic
Types of hemolytic anemias due to defects
anemia:
in the red blood cell membrane:
A. Microcytic, hypochromic
B. Normocytic, hypochromic B. Hemoglobin A2
C. Normocytic, normochromic C. Hemoglobin F

D. Macrocytic, normochromic D. Hemoglobin H

E. Macrocytic, hypochromic Which ONE of the following is the most
common inherited bleeding disorder?
An osmotic fragility test shows initial
hemolysis of the red cells at 0.70% NaCl. A. Hemophilia C
This is the most consistent with:
B. Von Willebrand Disease
A. Hereditary spherocytosis
C. Bernard Soulier Disease
B. Hereditary ovalocytosis
D. Hemophilia A
C. G6PD deficiency
E. Wiskott-Aldrich Syndrome
D. Paroxysmal Cold Hemoglobinuria
What is the normal value range for an
One of the following best indicates aPTT/PTT?
intravascular hemolysis:
A. 15-20 seconds
A. Increased serum bilirubin
B. 25-39 seconds
B. Increased urine bilirubin
C. 27-42 seconds
C. Increased reticulocytes
D. 10-18 seconds
D. Hemoglobinuria
Which tube is used in coagulation testing?
One of the following may lead to pernicious
A. Heparin
anemia:
B. EDTA
A. Gastric resection
C. Sodium Citrate
B. Strict vegan diet
D. Sodium Fluoride
C. Hookworm infection
“Christmas disease” – functional deficiency
D. Pregnancy
of coagulation factor IX
The aplastic anemias may be classified by
A. Hemophilia A
which morphological group?
B. Hemophilia B
A. Normocytic/Normochromic
C. Acquired immunodeficiency
B. Macrocytic/Normochromic
D. Color blindness
C. Megaloblastic/Normochromic
This process by which platelets and plasma
D. Microcytic/Hypochromic
proteins react to convert fibrinogen into
What is the majority hemoglobin in fibrin
thalassemia major?
A. Coagulation
A. Hemoglobin A
B. Hemostasis
C. Vasoconstriction B. Iodine
D. Hemophilia C. Calcium

Control and cessation of bleeding: Both intrinsic and extrinsic pathways

activate this:
A. Coagulation
A. Common pathway
B. Hemostasis
B. Coagulation cascade
C. Vasoconstriction
C. Vasoconstriction
D. Aggregation
D. Hemostasis
The process by which platelets and plasma
proteins react to convert fibrinogen into A thrombus that is carried in the
fibrin bloodstream

A. Coagulation A. Embolus

B. Hemostasis B. Thrombus
C. Vasoconstriction C. Platelet

D. Hemophilia A screening test used to evaluate the

function of platelets and small blood vessels:
What is the fourth system in hemostasis:
A. Bleeding time
A. Vascular factors
B. APTT
B. Platelet factors
C. Thrombin time
C. Coagulation factors
D. Hemoglobin
D. Fibrinolysis
What is the normal bleeding time value range
Union of platelets to the endothelial lining:
in minute?
A. Adhesion
A. 1-2
B. Aggregation
B. 2-9
C. Vasoconstriction
C. 3-7
D. Vasodilator
D. 8-9
Factor 3 is also known as?
Which pathway does prothrombin time test?
A. Prothrombin
A. Intrinsic
B. Thromboplastin
B. Extrinsic
C. Fibrinogen
C. Common
D. Fibrin
What is Protime recorded in?
Which mineral is essential for coagulation?
A. Seconds or INR
A. Sodium
B. INR or minutes D. AHG
C. Seconds or minutes The common pathway begins with factor __
activation:
D. Seconds or hours
A. X
What is the normal range for a protime in
seconds? B. II
C. I
A. 10-20
D. XIII
B. 25-35
The final stage of a coagulation pathway
C. 12-14
involves the conversion of factor:
D. 20-45
A. I to Ia
What test is used to monitor patients on IV
B. II to IIa
heparin therapy?
C. V to Va
A. Protime
D. I to fibrin clot
B. APTT
Aspirin ingestion has the following
C. Bleeding time
hemostatic effect in a normal person:
D. Hemoglobin
A. Prolongs the BT
Serum differs from plasma by the loss of:
B. Prolongs the clotting time
A. Factor II
C. Inhibits factor VIII
B. Factor VII
D. Creates a circulating anticoagulant effect
C. Thromboplastin
The proper proportion (in parts) of blood to
D. Fibrinogen anticoagulant in the PTT and Protime:

The substance necessary to convert A. 2:1

fibrinogen to fibrin is:
B. 3:1
A. Platelets
C. 5:1
B. Thromboplastin
D. 9:1
C. Thrombin
Of the following tests, which one should be
D. Prothrombin drawn last:

The clotting factor dependent on Vitamin K A. EDTA- CBC

is (II, VI, IX, X):
B. Heparin- pH
A. Fibrinogen
C. Citrate- PTT
B. Prothrombin
D. Clot tube- CPK
C. Thrombin
A protime vacutainer was not filled with A. Extrinsic clotting system
blood, the results would be
B. Intrinsic clotting system
A. Unaffected
C. Factor VII and platelets
B. Normal
D. Fibrinogen
C. Shortened
When performing a bleeding time, the usual
D. Prolonged puncture site in Ivy method is the:

The reagent used for PTT: A. Finger

A. Phospholipid B. Forearm

B. Tissue thromboplastin C. Hell

C. Heparin D. Earlobe

D. Thrombin E. Big toe

The bleeding time test measures: The PTT test is a good measure of quantity
and function of which of the following
A. The ability of platelets to stick together
factors except:
B. Platelet adhesion and aggregation on locally
A. VIII and IX
injured vascular subendothelium
B. VII and XIII
C. The quantity and quality of platelets
C. I and II
D. Antibodies against platelets
D. V and X
If a protime or PTT cannot be run
immediately, it is best to:
A. Wait to centrifuge the whole blood Thrombine test measures:

B. Refrigerate the whole blood A. Thrombin

C. Centrifuge the whole blood, decant, and B. Prothrombin

freeze plasma
C. Fibrinogen
D. Centrifuge the whole blood, then refrigerate
D. Factor XIII
This is the time required for a small cut to
Thrombocytopenia may be associated with
stop bleeding:
the prolongation of all of the following
A. Bleeding time except:

B. Clotting time A. BT
C. Clot Retraction time B. Ristocetin assay

D. Prothrombin time C. Platelet aggregometry

The PTT is different from the prothrombin D. PTT
time in that it measures the:
Hemoglobin values are commonly B. Hemophilia B
expressed in:
C. Afibrinogenemia
A. mg/dL
D. Hypothrombinemia
B. g/dL
Which leukemia does not have
C. g/L thrombocytopenia?

D. None of these A. ALL

The periodic acid Schiff stain (PAS) is B. AML

positive due to the presence of:
C. CML
A. Lipids
D. CLL
B. Mucoproteins and polysaccharide
Increased reticulocyte counts are noted in:
C. Bile pigments
A. Aplastic anemia
D. None
B. Hemolytic anemia
In charging the counting chamber, allow the
C. Pernicious anemia
1st few drops from the pipette to:
Hemophilia A is a condition which results in
A. Flow into the counter
a deficiency of factor
B. Be used for Hgb result
A. I
C. Be expelled
B. II
The angle used for preparing blood smear on
C. VIII
normal patient blood is:
D. IX
A. 10
A “labile” factor is factor __:
B. 15
A. I
C. 45
B. II
Identify the characteristic/s of a good
peripheral blood smear: C. V
A. Progress from thick at the point of origin to D. VII
thin
Which of the following is a cofactor?
B. Has a blunt feathered termination
A. XII
C. It is smooth without waves or streaks
B. X
D. All of these
C. VIII
A defect in factor IX causes which of the
D. VII
following diseases
E. II
A. Hemophilia A
What are the components in a PTT?
A. Plasma + phospholipid + calcium C. Non-vital
B. Plasma + thromboplastin + calcium D. Counterstaing

C. Plasma + phospholipid + thromboplastin The precursor of the platelet is:

D. Plasma + thrombin + calcium A. Myeloblast

E. Plasma + plasmin + calcium B. Megablast

What is the most common inherited bleeding C. Megakaryocyte

disorder?
D. Plasmablast
A. Von Willebrand’s disease
The normal number of thrombocytes per uL
B. Hemophilia A is:

C. Hemophilia B A. 5,000-10, 000

D. Factor V Deficiency B. 125,000- 150,000

In high altitudes, the hemoglobin value is: C. 150,000- 450,000

A. Lower D. 500,000- 1,000,000

B. Higher Polychromatophilic erythrocytes are also

called:
C. Same
A. Ovalocytes
The hemoglobin types found in a normal
adult are: B. Left shift

A. S, A, F C. nRBC

B. A, A2, C D. Reticulocytes
C. A2, F The cyanmethemoglobin procedure
measures all hemoglobins except:
D. A, A2
A. Methemoglobin
In the improved Neubauer ruling, the 400 sm
sqs are composed of: B. Sulfhemoglobin
A. 25 grps of 16 sqs C. Deoxyhemoglobin

B. 20 grps of 20 sqs D. Carboxyhemoglobin

C. 40 grps of 10 sqs The hematocrit is the:

D. 9 sq mm A. Volume of packed red cells

The type of staining we use to stain B. Volume of total red cells
reticulocytes is called:
C. Volume of average red cells
A. Supravital
D. Weight of average red cells
B. Ultra-vital
Which of the following conditions would
introduce a source of error (?) into a
hemocytometer cell count?

A. Uneven distribution of cells in the counting

chamber

B. Immediate counting of cells

C. A sample with an extremely low cell count

D. Using normal saline as the diluting fluid

HEMATOLOGY 1 Midterm Exam
Di sure answer
Walang answer
Walang question
7. Average number of RBC counted is 500.
1. The following choices will NOT falsely Blood sample suck up to 0.4 mark,
elevate the Hct counting area is 6 small squares in the
a. Presence of sickle cell center large square. Give the RBC count in
b. Inadequate centrifugation SI unit.
c. Interstitial fluid contamination a. 7.2x10¹²/L
d. Prolonged tourniquet application b. 6.8x10¹²/L
c. 5,2x10¹²/L
2. The following may interfere with d. 4.8x10¹²/L
cyanmethemoglobin due to increase
absorbance: 8. The following inclusions may not be stained
a. Lipemic blood samples by Romanowsky stain?
b. Blood with WBC ct. of 15x10⁹/L a. Heinz bodies
c. Presence of sulfhemoglobin b. Neutrophil granules
d. Presence of adult hemoglobin c. Eosinophil granules
e. A and B only d. Platelets

3. False regarding microhematocrit method 9. False regarding ESR

a. RCF 10,000g to 15,000g I. Measure the degree of RBC settling in
b. Reading should be below the buffy the plasma
coat II. Enhance by fibrinogen or alpha and
c. RPM is 200 to 500 beta globulin
d. Centrifugation is 5mins a. I, II
e. None b. II, III, IV
c. III, IV
4. Give the MCH: (Hgb: 15.0g/dl; RBC: d. III only
4.0x10¹²/L; Hct: 0.38) e. All of the above
a. 45.5 pg
b. 35.5 pg 10. The following may falsely increase ESR
c. 37.5 pg values
d. 40.5 pg a. Tilting of tube
b. Macrocytes
5. Give the MCV: (Hgb: 12.0g/dl; RBC c. Spherocytes
4.0x10¹²/L; Hct 0.40) d. B and C
a. 75 fl e. A and B
b. 80 fl
c. 90 fl 11. Give the absolute retic count (25 retics
d. 100 fl seen mong 1000 RBC; RBC ct: 4.0x10¹²/L)
a. 20x10⁹/L
6. What will be the WBC ct if the blood b. 30x10⁹/L
aspirated at 0.5 mark of the WBC pipet, and c. 10x10⁹/L
the number of WBC counted is 600, in all 4 d. 15x10⁹/L
WBC squares and the nRBC observed is 10
per 100 WBC during the differential count? 12. What will be the RPI if the relative retic
a. 30, 000/uL count is 3.5%and the Hct: 0.32/L
b. 29, 850/uL a. 2.0
c. 27, 272/uL b. 1.65
d. 25, 789/uL c. 3.45
d. 2.65
13. Can be stained by prussian blue c. Read after 60 mins
a. Siderocytes d. Unit of reporting is mm/hr
b. Pappenheimer bodies
c. Howell-jolly 20. Which of the following values show a
d. A and B normal Hgb for female patient?
a. 160g/dL
b. 110g/dL
14. False regarding the Drabkin’s reagent c. 90g/dL
a. Photosensitive reagent d. None
b. The active component of KFe(CN)₆
c. KCN gives CN to HiCN 21. This is a stage of granulocyte production
d. Should be fresh every month where the nucleus begins to flatten on one
e. A and B only side and begins to constrict or indent,
becoming kidney or peanut shape, what is this
15. All of the following are associated with stage?
increase ESR reading EXCEPT a. Juvenile cell
a. Tuberculosis b. Myelocyte
b. Polycythemia c. Promyelocyte
c. Myocardial infarction d. Band or stab cell
d. Rheumatoid arthritis e. A and B
e. A and B only
22. Which of the following has increased
16. Which of the following conditions will have sensitivity to EOFT study?
an elevated Hct reading? a. Sickle cell
I. Burnt patient b. Extremely hypochromic cells
II. Hemodilution c. Target cells
III. Excessive exercise d. A and B
IV. Severe diarrhea e. A, B, C
a. I, II
b. II, III 23. The following conditions may present red
c. I, III, IV cell aggregation EXCEPT
d. II, III, IV a. Hemolytic anemia
e. All of the above b. Blood incompatibility
c. Cold agglutinin syndrome
17. True regarding cyanmethemoglobin d. Hyperproteinemia
a. Qunatitates all forms of Hgb e. B and D
b. Potassium ferricyanide oxidizes Hgb to
Hl 24. Which of the following statements is false?
c. Read at 640mm a. Autohemolysis is used to confirm
d. A and B enzyme defect in RBC metabolism
e. None b. Sugar water test is the screening test
for PNH
18. An RPI of <2.0 usually indicates c. Schilling test is used to diagnose
a. Effective erythropoiesis pernicious anemia
b. The bone marrow response effectively d. Dithionate solubility test detects
c. Probable BM inefficiency spherocytosis
d. A and B e. All of the above
e. A, B, C
25. What is the test for the diagnosis of
19. False regarding modified Westergren hereditary spherocytosis?
method for ESR a. EOFT
a. Blood kept for RT must be set up b. HAM’s test
within 3hrs c. Autohemolysis
b. EDTA is anticoagulant used d. A and C
 e. A, B, C a. The bone marrow is efficiently
responding
26. Which of the following will give an b. The bone marrrow is not responding
increased reading of ESR value? efficiently
a. Hyperproteinemia c. It cannot be predicted due to lack of
b. Polycythemia information
c. Presence of spherocytes
d. A and C 31. X
32. X
27. Poikilocyte caused by prolonged standing 33. What is the normal ESR (wintrobe
of the blood specimen in EDTA anticoagulant method) value for a 35 year old male patient?
a. Microcytes a. 0-15mm/hr
b. Spherocytes b. 0-20mm/hr
c. Target cell c. 0-30mm/hr
d. A and B d. 0-10mm/hr
e. None
34. What is the overall length of the
28. A 45 year old male patient who was in the westergren tube used for ESR determination?
ER is complaining of nausea and easy a. 115 mm
fatigability. The attending physician requested b. 100 mm
some blood work, one of which is CBC. The c. 200 mm
result of the CBC are as follows: d. 300 mm
● RBC ct: 4.5x10¹²/L
● WBC ct: 20x10⁹/L 35. Which of the following special strains is
● Platelet estimate: platelet normal used to differentiate basophilic type of
● Hgb: 9g/dl leukemia from other types of myeloid
● Hct: 30% leukemia?
● Diff. count: a. LAP
❖ PMN - 0.79 b. Toludine blue
❖ Lympho - 0.21 c. Peroxidase
❖ Mono - 0.05 d. None
❖ Eo - 0.05
❖ nRBC: 6/100WBC 36. When the Hgb is said to be on a “T” form it
What classification of anemia possibly the means that _______
patient has? a. The Hgb is fully oxygenated
a. Normocytic, normocytic b. There is a strong binding of 1,2 DPG
b. Macrocytic, macrocytic in the B-globin chain
c. Macrocytic, monochromic c. Oxidation of iron takes place
d. Microcytic, hypochromic d. The oxygen is bound strongly to Hgb
e. Normocytic, hypochromic
37. Which of the following will contribute to the
29. Using the situation and the data on the early release of reticulocyte from the bone
question above, if ESR was requested, what marrow to the circulation?
will be the expected result of it? I. Hypoxia
a. Will have a decrease ESR reading II. Hemolytic anemia
b. Will have an increase ESR reading III. Low BP
c. Result cannot be predicted due to lack IV. Kidney failure
of information a. I, II
b. III, IV
30. Using the data on question 28, and if the c. I, II, III
retic count of the patient is 4.5%, what will be d. All of the above
the interpretation regarding the response of
the bone marrow on the patient’s anemia? 38. Extremely high leukocyte counts, greater
than will give high result in Hgb determination
using the Cyanmethemoglobin method, to ● Rel. retic ct - 4.5%
correct this, one must:
a. Centrifuge the mixture and determine 43. What is the corrected WBC ct?
Hgb in supernatant a. 23.6x10⁹/L
b. Stand the mixture for 30mins and b. 22.7x10⁹/L
allow the settling of the WBC c. 21.7x10⁹/L
c. Shake the mixture to lyse theWBC d. 20.6x10⁹/L
present in the sample
d. Either B or C 44. What is the computed corrected retic ct?
a. 4.2%
39. Which of the following will falsely b. 4.0%
decrease ESR reading? c. 3.2%
a. Presence of bubble d. 3.0%
b. Presence of sickle cell
c. Presence of spherocytes 45. What is the possible interpretation
d. B and C regarding compensation due to low Hgb
e. A, B, and C value?
a. There is an effective response of bone
40. Which of the following may give a high marrow
sensitivity on EOFT studies? b. There is not enough response of bone
a. Presence of macrocytes marrow
b. Sickle cell anemia c. Cannot be determined due to lack of
c. Thalassemia data
d. A and B
e. A and C 46. Which of the following will cause
increased M:E ratio, EXCEPT
41. Which of the following cells will have a a. Infection
lilac color of cytoplasm using the b. Leukemia
Romanowsky stain? c. Normoblastic hyperplasia
a. Platelets d. Leukemoid reaction
b. Neutrophil
c. Lymphocyte 47. Which of the following will eventually lead
d. Monocyte to increased fat layer and decreased M/E
layer?
42. The parameter that interprets the degree a. Aplastic anemia
of size variation on a single specimen? b. Leukemia
a. MCV c. Severe infection
b. RDW d. Hyperplastic marrow
c. MPV
d. MCHC 48. Which of the following conditions will have
e. A and B a normocellular marrow?
a. Aplastic anemia
For nos. 43-45, use the CBC result: b. Leukemia
● Hgb - 109 g/L c. Severe infection
● Hct - 0.32 d. Hyperplastic marrow
● RBC ct - 3.7x10¹²/L
● WBC ct - 25x10⁹/L 49. If the BM’s fat layer is 8%, while the buffy
● Plt ct - 140x10⁹/L coat is about < 3%, this indicates:
● Diff. count: a. Hypocellular BM
❖ Neu - 0.62 b. Hepercellular BM
❖ Lympho - 0.28 c. Normocellular BM
❖ Mono - 0.09 d. Hypo to normocellular BM
❖ Eo - 0.01
● nRBC - 15/100 WBC
50. Which of the following statements is 55. How many basophilic normoblasts are
FALSE? formed after its immediate precursor divides?
a. Rubriblasts are the first precursor that a. 4
can be recognized by the light b. 2
microscope c. 8
b. Reticulocyte is the first stage to d. 16
synthesize Hgb
c. Metarubricyte is the last stage with 56. The disappearance of multiple nucleoli
nucleoli occurs in:
d. Reticulocytes contains mitochondria a. Orthochromatophilic erythroblast
and ribosomes b. Basophilic erythroblast
c. Reticulocyte
51. Not true regarding a normal mature RBC d. Polychromatophilic erythroblast
a. Approx. 7.2um in diameter
b. Biconcave disc 57. The following may falsely elevate the Hct
c. Central pallor is approximately >3um EXCEPT
of the cell a. Sickle cell
d. No organelles b. Inadequate centrifugation
c. Interstitial fluid contamination
52. True regarding hematopoiesis d. Prolonged tourniquet application
I. Blood islands are first detected
at 19-20days of gestation 58. What are the dimer proteins present in
II. RBC are the first cell produced Gower I?
III. The bone marrow is the final a. 2 zeta 2 epsilon
area of hematopoiesis in normal b. 2 alpha 2 gamma
adults c. 2 beta 2 gamma
IV. The liver is the major area of d. 2 gamma 2 zeta
hematopoiesis in the 2nd
trimester of pregnancy 59. Which of the following will Hgb migrates
a. All of the above faster to anode area in cellulose acetate
b. II, IV medium used?
c. I, III a. Hgb A
d. I, II, III b. Hgb F
c. Hgb S
53. False regarding the energy metabolism of d. Hgb C
RBC
a. 90-95% of its energy are derived from 60. A confirmatory test for PNH
EMP a. Dithionite solubility
b. 10-15% of its energy undergoes the b. HAM’s test
aerobic process c. Isopropanol denaturation test
c. ATP regulation is dictated by the d. None
production of 2,3 DPG
d. 2,3 DPG is essential for normal tissue 61. Which of the following is used to evaluate
oxygenation Hgb F concentration?
a. Kleihauer betke
54. High levels of CO2 in blood, like b. DAT
hypoventilation, will lead to the following c. Alkali denaturation test
events EXCEPT d. HAM’s test
a. The Hgb becomes a strong base
b. The curve shifts to the left 62. Test for evaluating G-6PD deficiency
c. Haldane effect a. Fluorescence spot test
d. More Hgb binds with H+ ions b. Autohemolysis test
c. Dithionite solubility test
d. A and B
 70. Alkaline phosphatase is specific with what
63. Which of the following tests can be used type of cell?
to evaluate the level of Hgb F in blood a. PMN
samples? b. B-cell
a. Hgb electrophoresis c. T-cell lymphoblast
b. Alkali denaturation test d. Eosinophil
c. Acid elution test
d. All 71. What is the use of adding cyanide in
ascorbate cyanide test?
64. Which of the following parameters is used a. To convert Hgb to cyanmethemoglobin
to determine the size of the RBC? test
a. RPI b. To prevent action of catalase
b. RDW c. To inhibit EMP and PPP
c. MCH d. To manufacture reduce glutathione
d. MCV
72. Which of these may lead to Heinz bodies
65. Which of the following is a criterion of a formation?
well stained smear? I. Eating fava beans
a. RBC - salmon pink II. Streptomycin drug intoxication
b. Eosinophil granules - bright red orange III. Nitrate toxicity
c. Basophil - blue black granules IV. Chlorates toxicity
d. All a. I, II
b. II
66. Which of the following actions is not c. II, III
accepted in doing EOFT? d. I
a. Using heparin as anticoagulant e. I, II, III, IV
b. The last test tube that shows initial
hemolysis recorded 73. If the laboratory scientist did a differential
c. 0.50% is the initial salt solution used count and obtained the results below, what
d. None should he do next?
● DIff. ct
67. Parameter that can be used to evaluate ❖ PMN 60%
microcytic RBC? ❖ Lymphocyte 30%
a. MCV ❖ Eosinophil 5%
b. PBS ❖ Monocyte 5%
c. MCHC ❖ Band cell 0%
d. A and B a. Report and release the result obtained
e. B and C b. Collect another specimen
c. Repeat the manual diff. ct on the same
68. Special stain used to stain iron storage smear
a. Pearl’s stain d. Repeat the same manual diff. ct on a
b. ALP new smear
c. TRAP
d. Chloroacetate esterase chain 74. True about sickling solubility test
a. The dithionite reagent induce
69. What cell usually contains hemolysis in the sample
myeloperoxidase on its granules? b. Saponin reagent oxidizes the blood
a. Eosinophil specimen
b. Neutrophil c. It determines the presence of both
c. Monocytes Hgb SS and Hgb AS in the sample
d. A and B d. All
e. B and C
75. A non-hematological cell that could be
mistaken as a plasma cell
 a. Osteoclast 82. Which of the following can activate the TH
b. Osteoblast cell to transform into TH2 effector cell?
c. Mast cell a. IL-4,5,6
d. Macrophages b. IL-4,10
c. IL-4-6
d. IL-4,10,6
76. Which of the following cells is usually e. None
mistaken as a variant lymphocyte?
a. Neutrophil 83. What is the net ATP yield during the red
b. Monocyte cell metabolism under EMP?
c. Eosinophil a. 2
d. Basophil b. 0
c. 3
77. Which color reaction is not acceptable on d. 4
a well stained blood smear?
a. Neutrophil cytoplasm - lilac 84. Secondary lymphoid organs includes:
b. RBC - bright red orange a. Bone marrow
c. Basophilic granules - blue black b. Lymphocytes
d. A, B, C c. Spleen
e. None d. A and B
e. B and C
78. Which of the following will show high RDW
and low MCV 85. Normal reference range of normal
a. Pernicious anemia lymphocyte in the peripheral blood?
b. IDA a. 37-77%
c. Megaloblastic anemia b. 0-7%
d. A and B c. 2-10%
d. 10-44%
79. Which of the following statements is false?
a. B cell is activated by the production 86. The cofactor needed to reduce the ferric
IL-4,6 by the CD8+ cell iron to ferrous state is ______
b. IFN-g is responsible in the initiation of a. NADPH
cell cytolysis b. NADH
c. Plasma cell not normally circulates in c. NADP+
the blood and always in the lymphoid d. NAD+
organs
d. A and B 87. Deficiency of G-6-PD enzyme will result to
a. Methemoglobin formation
80. LAK cells are activated directly by b. Heinz body formation
a. IL-1 c. Spherocytosis
b. IL-2 d. Formation of ferric state
c. IL-3
d. IL-4 88. Which of the following which of the
following will NOT commonly occur during
81. How does NK cell kill its target cell? acidosis?
a. By releasing cytokines like g-IFN to a. Shifting of curve to the right
stimulate CD8+cell b. Increase O2 uptake
b. By using its CR to initiate killing ADCC c. H+ ion uptake by red cells
c. By releasing its granule content like d. Increase oxygenation to the tissues
granzyme that directly inhibits DNA
synthesis 89. High levels of CO2 in blood, like
d. A,B,C hypoventilation, will lead to the following
events EXCEPT
a. The Hgb becomes a strong base
 b. The curve shifts to the left d. Reticulocyte
c. Haldane effect
d. More Hgb binds with H+ ions 97. How many basophilic normoblasts are
formed after its immediate precursor divides?
90. True about hemoglobin acid-base balance a. 4
a. Nonoxygenated Hgb is a strong acid b. 2
b. Carbonic anhydrase is responsible for c. 8
carbonic acid synthesis d. 16
c. Chloride diffuses out the RBC when
bicarbonates build up within RBC
98. A red cell precursor that divides twice
91. The gene that codes for alpha globin during erythropoiesis:
chain formation is located at chromosome #: a. Prorubricyte
a. 1 b. Basophilic normoblast
b. 11 c. Metarubricyte
c. 16 d. B and C
d. None of them
99. The last stage that divides during
92. The Hgb A2 is composed of erythropoiesis
a. Alpha and beta chains a. Orthochromatophilic erythroblast
b. Alpha and delta b. Metarubricyte
c. Alpha and gamma c. Polychromatophilic erythroblast
d. Alpha and zeta d. A and B

93. What hemoglobin is NOT present during 100. What is the rationale why the blue tube is
the adult stage? filled first with blood before the green tube?
a. Hgb A1 a. To prevent hemodilution of blood
b. Hgb A2 sample
c. Hgb F b. To ensure that hemolysis
d. A and B c. To prevent the possible error in
e. None of the choices coagulation studies
d. To prevent the possible error in gas
94. The stage of the red cell maturation where analysis
the Hgb is admixed with the basophilic
property of the cytoplasm, giving a red-blue 101. The reason why should a phlebotomist
color: not to prolong the application of the torniquet:
a. Rubricyte a. Prevent possible increase WBC ct
b. Prorubriblast b. Prevent RBC lysis
c. Metarubricyte c. To ensure blood will be free from
d. None possible tissue fluid contamination
d. All of the above
95. The reticulocyte resides for how many
days in the marrow before it will gain exit and 102. Anticoagulant that prevents clotting by
goes to circulation? chelation process
a. 3-4 days a. EDTA
b. 3 days b. Sodium citrate
c. 5 days c. Heparin
d. 2 days d. Double oxalate

96. The RBC precursor cell that is usually 103. Anticoagulant ideal to prevent platelet
mistaken with myeloblast stage satellitism
a. Rubriblast a. Anticoagulant in a black tube
b. Prorubricyte b. Heparin
c. Metarubricyte c. Anticoagulant in a yellow tube
 d. Sodium citrate c. Protein rich in arginine and lysine
d. A and B
104. The following statements are true e. A, B, C
regarding venipuncture except
a. Avoid areas with hematomas, burns, 110. A positive acid elution slide test indicates
scars, amd edema the presence of:
b. Cephalic vein is the ideal site for a. Hemoglobin A1
puncture b. Hemoglobin A2
c. Draw blood below IV sites after the c. Hemoglobin F
infusion was stopped for 120 secs. d. Hemoglobin 5
d. torniquet application should be applied
no longer than 2 mins, 111. Which of the following is only
demonstrated by supravital staining?
105. Rearrange the order of draw if multiple a. Heinz bodies
tests such as CBC, FBS, PTT, and serum b. Hemoglobin H
enzyme test should be done c. Reticulocytes
a. Red, gray, lavender, blue, green top d. A and B
b. Red, blue, lavender, gray top
c. Blue, red, green, lavender, gray top 112. This is the characteristic red cell
d. Red, blue, green, gray top abnormality associated with G6DP deficiency
a. Acanthocyte
106. True regarding EDTA as anticoagulant b. Echinocyte
I. The optimal concentration is c. Heinz bodies
1.25mg/ml d. A and B
II. Preserves cellular morphology
when blood smears are made 113. Imerslund Grasbek Syndrome results to
within 2 hrs an anemia with a ____ blood picture.
III. Inhibits ccoagulatiiion by chelation a. Macrocytic hypochromic
IV. Prevents platelet aggregation, b. Macrocytic normochromic
thus it is preferred for platelet ct c. Microcytic hypochromic
a. I, II, III d. Normocytic hypochromic
b. II, III, IV e. Normocytic normochromic
c. I, III, IV
d. II, IV 114. Which of the following can help
distinguish between anemia of chronic
107. Hemolysis is not corrected after adding disease and iron deficiency anemia?
ATP and glucose in autohemolysis test is a. Serum ferritin
indicative of: b. TIBC
a. PNH c. Serum iron
b. G6PD deficiency d. A and B
c. PK deficiency e. A,B,C
d. Hereditary spherocytosis
115. Washington monument crystals are seen
108. Which of the following is not an antigen in
presenting cell? a. Hemoglobin CC disease
a. B-cell b. Hemoglobin SC disease
b. Kupffer cell c. Sickle cell disease
c. Dendritic cell d. A and B
d. PMN e. A, B, C

109. The inner core of eosinophilic granules 116. Which of the following is associated with
contains the following dehydration?
a. Melanin a. Primary absolute erythrocytosis
b. MBP b. Relative erythrocytosis
 c. Secondary absolute appropriate b. Hereditary spherocytosis
erythrocytosis c. PK deficiency
d. Secondary absolute inappropriate d. A and B
erythocytosis
e. A and D only

117. Which of the following people will be the

most likely to have megaloblastic anemia?
a. A patient with chronically bleeding
ulcer
b. A trauma patient with massive acute
blood loss
c. A strict vegetarian
d. A and B
e. A, B, C

118. Hemoglobin Gun Hill involves____ of the

amino acids at positions 91-95 of the beta
globin chain
a. Deletion
b. Elongation
c. Substitution
d. A and B
e. A, B, C

119. Which of the following are likely findings

in acute hemolytic anemia?
a. Decreased carbon monoxide
b. Increased haptoglobin
c. Reticulocytosis
d. A and B
e. A, B, C

120. What term describes the change in

shape of RBC seen on a Wright stained blood
smear?
a. Anisocytosis
b. Anisochromia
c. Poikilocytosis
d. Polychromasia
e. A and B

121. A decreased osmotic fragility test would

be associated with which of the following
conditions?
a. Acquired hemolytic anemia
b. Hemolytic anemia
c. Hereditary spherocytosis
d. Sickle cell anemia
e. A and C

122. The fluorescent spot test is useful for

identifying patients with
a. G6DP deficiency
PRELIMS Which of the following will give an increase
Normal marrow cell that is morphologically M/E layer?
confused with plasma cell. 1. Polycythemia vera 3. Fanconi’s
A. Osteoclast anemia
B. Osteoblast 2. CML 4. Leukemoid rx
C. Mast cell A. 1,2
D. Macrophages B. 2,4
Normal reference range of Fat and C. 1,2,4
Perivascular layer of the aspirated bone D. 1,2,3
marrow. The following conditions will definitely have
A. 1-3 % a hypercellular bone marrow
B. 3-5 % A. ALL
C. 6-8 % B. Leukoerythroblastoid reaction
D. 8-10 % C. Aplastic anemia
Which of the following stains is used for D. A and B
determining the iron store in the bone E. A, B, C
marrow? If the fat end perivascular layer is 8% and the
A. PAS stain M:E layer is 2% the bone marrow is said to
B. Pearl’s stain be:
C. TRAP A. Normocellular
D. Chloroacetate esterase B. Hypocellular
What is the ideal fixative used for bone C. Hypercellular
marrow biopsy? D. Slightly hypercellular
A. 80% Alcohol Which of the following will have a decrease
B. 5-10% formalin M:E ratio?
C. Zenker’s fluid A. Normoblastic hyperplasia
D. B and C B. Leukemoid reaction
What reagent is used for particle aggregates C. Leukemia
preparation in bone marrow evaluation? D. A and B
A. 0.025 M CaCl2 E. B and C
B. 0.015 M CaCl2 Which of the following will have an increase
C. 0.030 M CaCl2 M:E ratio?
D. 0.035 M CaCl2 A. Normoblastic hyperplasia
Which of the following will give a decrease B. Leukemoid reaction
M:E ratio? C. Aplastic anemia
1. Leukemia 3. Aplastic Bone Marrow D. A and B
2. Infection 4. Leukemoid reaction E. A,B,C
A. 1,2 Which of the following stains can
B. 3.4 differentiate CML from leukemoid reaction
C. 4 A. TRAP stain
D. 3 B. NBT stain
 C. Romanowsky stain C. H+ ion uptake by red cells
D. LAP stain D. Increase oxygenation to the tissues
E. Esterase stain High levels of CO2 in blood, like in
The co-factor needed to reduce the ferric hypoventilation, will lead to the following
iron to ferrous state is _______. event, EXCEPT:
A. NADPH A. The Hgb becomes a strong base
B. NADH B. The curve shifts to the left
C. NADP+ C. Haldane effect
D. NAD+ D. More Hgb binds with H+ ions
Deficiency of G-6-PD enzyme will result to: The primary raw material needed for
A. Methemoglobin formation protoporphyrin IX production:
B. Heinz body formation A. Glycine
C. Sperocytosis B. Succinyl Co-A
D. No ATP production C. Both
Which among the components of the red cell D. Neither
membrane proteins create a negative cloud The major protein that transports iron;
around the membrane which is known as A. Ferritin
ZETA potential? B. Transferrin
A. Spectrin C. Transcobalamin
B. Ankyrin D. Ceroluplasmin
C. Sialic acid Production of EPO is regulated by:
D. Band 5 A. Hb O2 saturation
Deficiency of this enzyme will eventually B. 2,3 DPG levels
result to methemoglobin formation C. Metabolic rate
A. Methemoglobin reductase D. A and B
B. G-6-PD E. A,B and C
C. Both True about hemoglobin Acid-Base balance
D. Neither A. Nonoxygenated Hgb is a strong acid
Which of the ff events will NOT usually B. Carbonic anhydrase is responsible for
happen to reduce hypoxia (low CO2 in carbonic acid synthesis
tissue)? C. Chloride diffuses out the RBC when
A. Increasing 2,3 DPG labels bicarbonates build up within RBC
B. More EPO is released D. A and B
C. The O2 dissociation curve shifts to the E. A,B,C
right Which of the following may cause a right
D. The O2 dissociation curve shifts to the shift in the oxygen dissociation curve?
left A. Hypoxia
Which of the following will NOT commonly B. Living at high altitude
occur during Acidosis? C. Fever due to infection
A. Shifting of curve to the right D. A and B
B. Increase O2 uptake E. A,B,C
The gene that codes for alpha globin chain Which of the following statements is NOT
formation is located at chromosome #: true regarding Hgb formation
A. 1 A. The heme molecules bind in the crevice
B. 11 between E and D helices of Hgb
C. 16 molecule.
D. 9 B. 2,3 DPG is inserted last in the Hgb
The Hgb A2 is composed of: molecule.
A. Alpha and beta chains C. The myoglobin has to heme molecule
B. Alpha and delta attached to it
C. Alpha and gamma D. A and B
D. Alpha and zeta E. A and C
The enzyme responsible for inserting ferric The bone marrow assumes the
iron into the heme ring: responsibility of blood cell production during
A. Diaphorase the ___ of gestation.
B. Ferrochelatase A. 150th day of gestation
C. Both B. 120th day
D. Neither C. 110th day
Which of the following statement is False? D. 100th day
A. When the hemoglobin is oxygenated it What are the dimer protein present in the
becomes a strong acid. Fetal hemoglobin (HgbF)?
B. The basic property of the Hgb causes A. 2į 2Ɛ
the conversion of carbonic acid to water B. 2𝛂 2𝛄
and CO2. C. 2β 2𝛄
C. The H2CO3 formation is enhance by D. 2𝛄 2𝛇
carbonic anhydrase action What hemoglobin is NOT present in during
D. A and B the adult stage?
Which of the following statement is True? A. Hgb A1
A. Neuraminic acid contributes to the B. Hgb A2
negativity of the RBC membrane C. Hgb F
B. About 85% of CO2 in carried in the lungs D. A and B
in the form of plasma bicarbonate. E. None
C. Nonoxygenated Hb has lesser affinity The delta chain differs from the beta chain
with CO2 that ocygenated Hb. by how many amino acids?
D. A and B A. 36
E. A,B,C B. 20
About how many % of CO2 transported by C. 10
Hb to from carbaminohemoglobin during? D. 30
A. 20 Globin chain/s that is/are present during the
B. 15 first 3 month of embryonic life:
C. 10 A. Alpha
D. 5 B. Epsilon
 C. Beta The stage of red cell maturation where the
D. A and C Hgb is admixed with the basophilic property
Stored iron is usually in the form of ferritin of the cytoplasm, giving red-blue color:
which is composed of: A. Rubricyte
A. Ferrous and apoferritin B. Prorubriblast
B. Ferrous and transferrin C. Metarubricyte
C. Ferric and apoferritin D. None
D. A and B The chromatin materials are free in the
In the formation of heme; glycine must be nuleoplasm usually seen on what stage of
acted upon by ____ to from ______. red cell maturation?
A. 𝛂 - ALA; porphobilinogen A. Rubriblast
B. succinyl-CoA; urophorphyrinogen III B. Proerythroblast
C. succinyl-CoA; 𝛂 - ALA C. Metarubricyte
D. Porphobilinogen; protophorphrin IX D. None
The enzyme responsible for conversion of Multiple nucleoli is still present at what
porphobilinogen to urophorphyrinogen III stage?
A. Urophorphyrinogen synthase A. Rubricyte
B. Urophorphyrinogen decarboxylase B. Orthochromatophilic erythroblast
C. alpha-ALA synthase C. Prorubricyte
D. None of the above D. None
If the Hgb is on its T form, the affinity of O2 The reticulocyte resides for how many days
with Hgb is said to be _______. in the bone marrow before it will gain exit
A. Increased and goes to the circulation?
B. Strongly increased A. 3-4 days
C. Decreased B. 3 days
D. In moderation C. 5 days
Which of the following is NOT the function of D. 2 days
the protein part of the RED CELL The RBC precursor cell that usually
membrane? mistaken with Myeloblast stage:
A. For blood group identification A. Rubriblast
B. For transport of hormones in & out of the B. Prorubricyte
cell C. Metarubricyte
C. For RBC-RBC repulsion D. reticulocyte
D. For glucose active transport How many basophilic normoblast are
E. C and D formed after its immediate precursor
The immediate precursor cell of diffusely divides?
basophilic erythtrocyte? A. 4
A. Reticulocyte B. 2
B. Metarubricyte C. 8
C. Basophilic erythroblast D. 16
D. Rubricyte
A red cell precursor that divides during E. A,B,C
erythropoiesis: How many cell division took place to
A. Prorubricyte produce 16 mature red cells?
B. Basophilic normoblast A. Two
C. metarubricyte B. Four
D. B and C C. Three
Extrusion of nucleus happens during the D. Five
stageS same choices in #53. D The nucleus occupies at least 75% of the
The chromatin materials show slight entire cell:
compactness and the nucleoli is not A. Prorubricyte
anymore present. B. Basophilic normoblast
A. Metarubricyte C. Both
B. Late rubricyte D. Neither
C. Pronormoblast The parachromatin is first seen on this
D. Basophilic erythroblast stage:
The average size is 8-12 um. Choices on #52. A. Rubriblast
A B. Basophilic erythroblast
The cytoplasm shows blue-gray-violet color: C. Metarubricyte
EXCEPT: D. None
A. Metarubricyte What is the rationale why the blue tube is
B. Late rubricyte filled first with blood before the green tube?
C. Orthochromatophilic erythroblast A. To prevent hemodilution of blood
D. none sample
FALSE about spectrin protein B. To ensure that hemolysis will not occur
A. It is a part of peripheral blood C. To prevent the possible error in
B. Each segment are bound by actin coagulation studies
C. Also known as band 1 and 2 D. To prevent the possible error in gas
D. A part of integral protein analysis
Which of the ff contributes to the regulation The reason why should a phlebotomist not
of the membrane deformability? to prolong the application of the tourniquet:
A. Cholesterol A. To prevent possible increase WBC count
B. Peripheral proteins B. To prevent RBC lysis
C. Sialic acid C. To ensure blood will be free from
D. A and B possible tissue fluid contamination
E. A,B,C D. All of them
The site of adult erythropoiesis which is Anticoagulant with anti-thrombin activity:
used for Bone marrow collection: A. EDTA
A. Skull B. Sodium citrate
B. Sternum C. Heparin
C. Ribs D. Double oxalate
D. A and B
If EDTA is not available what anticoagulant 3. Inhibits coagulation by chelation
is used for CBC? 4. Prevents platelet aggregation, thus is
A. Anticoagulant in a black tube preferred for platelet count
B. Heparin A. 1,2,3
C. Anticoagulant in a yellow tube B. 2,3,4
D. Sodium citrate C. 1,3,4
Blood capillary is a mixture of: D. 2 and 4
A. Arterial venous blood and tissue fluid TRUE about Mesoblastic period:
B. Arterial blood and tissue fluid only A. It begins as early as 9-10 days of
C. Venous blood and tissue fluid only gestation
D. Arterial and venous blood only B. The primitive erythroblast are large and
The following statements are TRUE cannot extrude the nucleus
regarding venipuncture EXCEPT: C. Globin chains produces are beta,alpha
A. Avoid areas with hematomas, burns, and epsilon
scars, and edema D. A and B
B. Cephalic vein is the ideal site for E. A,B,C
puncture The hepatic period of hematopoiesis begins
C. If both arms are with IV line, draw blood at
below the IV site after infusion was A. 5th and 6th week of gestation
stopped for 120 secs B. 3rd week of gestation
D. Tourniquet application should be applied C. Before 120 days of gestation
no longer than 2mins D. A and C
Rearrange the manner of draw if multiple E. None of them
test such as CBC, FBS, PTT and serum Which of the following statements pertaining
enzyme test should be done: to medullary period of hematopoiesis?
A. Red,gray,lavender,blue,green A. Liver and spleen contributes to blood
B. Red,blue,lavender,gray cell production
C. Blue,red,green,lavender,gray B. It usually starts 5th month of gestation
D. Red,blue,green,gray C. The bone marrow becomes the normal
What method of blood collection is used for site of blood production after 3 weeks
small, fragile or damaged veins that easily postpartum
collapse? D. A and C
A. Evacuated tube system E. A,B,C
B. Syringe method What globin chains do the Gower I
C. Butterfly infusion set haemoglobin is made of?
D. All A. Gamma and epsilon
TRUE regarding EDTA as anticoagulant B. Alpha and epsilon
1. The optimal concentration is 1.25 mg/ml C. Alpha and beta
2. Preserves cellular morphology when D. None of them
blood smears are made 24 within 2 False about myeloid period of
hours hematopoiesis:
 A. It begins at 5th and 6th week of gestation A. Presence of Hgb M
B. Liver is the major site of blood cell B. Methmoglobin formation
production C. Hyperthermia
C. Hgb A1 gradually increases in D. A and B
concentration during this period E. None
D. A and B Which of the following will make the oxygen
E. A,B,C curve shift to the right?
Which of the following stimulates the CFU- A. The production of 2,3,DPG is dictated or
E? influenced by tissue hypoxia
A. EPO B. The T-form of Hgb mean that the Hgb is
B. IL-4 fully oxygenated
C. IL-9 C. 50% oxygen saturation happens if the
D. CFU-Meg pO2 mmHg is at 26.6
E. A and C D. A and B
Which of the following is true regarding E. A,B,C
erythrocyte maturation? Which of the following is acceptable in
A. There are four cell division takes place handling the specimen for Hematology
from blast to mature RBC tests?
B. RBC maturation takes place A. Citrated tube is used for PTT studies and
approximately 72 hrs EOFT
C. Multiple nuclei are present in rubriblast B. Blood with EDTA stored >3 hrs at room
D. A and B temp prior testing
E. A,B,C C. 3-5 tubes inversion is done on blue tube
False regarding energy metabolism of RBC for complete mixing of blood and
A. 90-95% of its energy are derived from anticoagulant
EMP D. A and B
B. 10-15% of its energy undergoes the E. B and C
aerobic process The reason why we should use 3.2% sodium
C. ATP regulation is dictated by the citrate for coagulation studies in case the
production of 2,3, DPG patient has polycythemia?
D. 2,3, DPG is essential for normal tissue A. Prevent excess Calcium in the blood
oxygenation sample
High levels of CO2 in blood, like in B. Prevent excess citrate in the blood
hypoventilation, will lead to the following sample
events EXCEPT, C. Prevent excess plasma in the blood
A. The high Hgb becomes a strong base sample
B. The curve shifts to the left D. A and C
C. Haldene effect E. B and C
D. More Hgb binds with H+ ions Which of the following action needs
Which of the following will make the oxygen correction during blood collection
curve to shift towards left? procedure?
 A. The IV fluid infusion was stopped for 3 E. Anti-malarial drugs
mins before collecting blood specimen
B. The EDTA was filled first with blood MODIFIED TRUE OR FALSE
followed by the red tube during capillary RED- CORRECT
blood collection
C. The standard skin wound depth created 90. In heme synthesis, the ferric iron is inserted
was approximately 2 mm x 2.3 in heel to the ring by ferrochelatase AND it usually
puncture happen outside the mitochondria
D. A and B
E. B and C 91. The particle aggregates can be used for the
Which of the following cells are found in the study of bone marrow architecture AND its
marginal zone of the white pulp of the preparation is done by adding 0.15 CaCl2 to the
spleen? aspirated BM liquid.
A. B cells
B. Macrophage 92. Promyelocyte has bluish red cytoplasm
C. Metamyelocyte AND it has red blue granules.
D. B and C
E. A,B,C 93. Monocyte has a grayish color of the
Which of the following statement/s is/are cytoplasm WHILE neutrophil has pinkish tan
TRUE? cytoplasm due to its granules.
A. Pormegakaryocte doesn’t have
cytoplasmic granules 94. The fetal Hgb is composed of an alpha and
B. EDTA anticoagulant may cause platelet a beta chain AND it is usually produced after
satellitism on some blood specimen 3rd month of gestation
C. Heinz bodies formation is usually caused
by enzyme defect on EMp pathway 95. The anticoagulant used for platelet count is
D. A and B EDTA BUT this cannot be used for blood smear
E. A,B,C preparation.
What is the ideal concentration of citrate
used for clotting time tests? 96. A LAP stain is used to differentiate kinds of
A. 0.109M leukemia AND it is used to differentiate
B. 0.110M leukemia from leukemoid reaction
C. 0.129M
D. 0.139M 97. In EMP, the production of 2,3 DPG will
The following drugs can influence the result to produce efficient ATP production
formation of Heinz bodies in the RBC , WHILE a decrease of 2,3 DPG will allow the
EXCEPT? shifting of the dissociation curve to the left
A. Streptomycin
B. Aspirin 98. Hyperventilation leads to increase Carbonic
C. Sulfonamides Acid formation in the plasma AND acid
D. Nitrofuran formation increase the O2 affinity with oxygen
99. The RES destroy senile Red cell by
intravascular hemolysis AND the major sire of
red cell killing is the liver
100. About 1-3% of iron in hemoglobin is on its
ferric state AND non-reduction of this will lead
to HEINZ bodies formation
1. Which condition will cause increase in A. Dohle inclusion bodies
bone marrow production of neutrophils C. Phagocytic vacuoles
resulting to neutrophilia? B. Inclusions in May Hegglin Anomaly
A. Strenuous exercise D. Autophagocytic vacuoles
B. Acute infection 10. True of toxic granulation except:
C. Pregnant woman in labor A. They are peroxidase positive
D. Tachycardia C. Seen also in band forms and
metamyelocytes
2. Which finding is not consistent with B. Inversely proportional to CRP level
leukemoid reaction? D. should be differentiated from
A. Absence of eosinophils Reilly bodies
B.Absence of basophils 11. A blood smear with myeloid cells that are
C. LAP score of more than 100 seen in various stages of maturation from
D. Few neutrophils with bilobed nuclei the most imm? Composed of occasional
3. The following are performed to determine blast to the most mature has what degree
the LAP score, except: of left shift?
A. 100 neutrophils are counted A. Mild left shift
B. Band forms are also counted to complete C. Marked left shift
100 cells B. Moderate left shift
C. Grading the staining reaction from 0 to 4+ D. No left shift
D. None of these 12. Vacuoles in neutrophils that are formed
4. Severe chronic neutropenia is defined as: due to effect of EDTA are:
A. Agranulocytosis for at least 6 months A. Smaller than phagocytic vacuoles
C. Neutrophil count of <2 x 10 9/L for at least 6 C. Formed only in patients with sepsis
month B. Usually 6 um in size
B. Neutrophil count of <2 x 10 9/L for 1 month D. None of these
D. None of these 13. Reactive lymphocytes appear with
5. Frequently, this is the first sign of recovery increased basophilia of the cytoplasm due
from acute overwhelming infection with to:
agranulocytosis A. Increased in cytoplasmic RNA
A. Absolute monocytosis C. Defective phagosome and
C. Toxic granules lysosome
B. Relative monocytosis B. Engulfed bacteria in the cytoplasm
D. Absolute count of >1.1 x 109/L D. None of these
6. Lymphocytosis with morphologic 14. Pince-nez appearance in Pelger-Huet
alteration will be seen in the following anomaly is due to mutation in:
cases except in: A. LYST gene
A. Infectious mononucleosis C. NADPH oxidase gene
C. Pertussis B. Lamin B receptor gene
B. Viral influenza D. IL-2 receptor gene
D. CMV Infection 15. Which finding will favor Pelger-Huet
7. Eosinophilia may be seen in the following anomaly over other conditions that will
cases except in: cause neutrophils to have a pince-nez
A. CML appearance?
C. Allergic conditions A. >20 % of neutrophils are with bilobed nuclei
B. Parasitic infection
D. None of these C. <50 % of neutrophils are with bilobed
8. A patient who is on steroid therapy will nuclei
have: B. >30 % of neutrophils are with bilobed nuclei
A. Monocytopenia
C. Monocytosis D. >40 % of neutrophils are with bilobed nuclei
B. Lymphocytosis 16. Hypersegmented neutrophils may be seen
D. B and C in the following cases except in:
9. Small, oval, pale blue structures that are A. Myelokathesis
peripherally located in the cytoplasm and C. Megaloblastic anemia
seen only in neutrophils are most B. WHIM syndrome
probably: D. None of these
17. Reilly bodies in Alder-Reilly anomaly are 26. What is the term used for neoplasms that
found in: presents with widespread involvement of
A. Nuclei of the involved cells the bone marrow and sometimes
C. Both A and B involvement of the peripheral blood?
B. Cytoplasm of the involved cells A. Left shift
D. Neither A and B C. Leukemia
18. This condition is brought by abnormality B. Lymphoma
in fusion of lysosome and phagosome D. Leukocytosis
which will result in the following findings in 27. For pathologists to come up with a
the blood smear of the patient diagnosis of acute leukemia, the cellularity
A. Giant neutrophilic cytoplasmic granules of the bone marrow should be composed of
C. Giant monocytic cytoplasmic granules at least _______________?
B. Decreased in the number of neutrophils A. 20% leukocytes
D. All of the above C.50% blasts
19. MYH9 gene mutation will result to B. 2% blasts
prominent, plae-blue cytoplasm inclusions D. 30% plasmacytoid cells
in: 28. The subtyping of B cell ALL is based on:
A. Neutrophils A. Genetic abnormality
C. Basophils C. Age group affected
B. Eosinophils B. Morphology of the cells
D. All of the above D. None of these
20. Test/s that can be used in the diagnosis of 29. Involved cells in T cell ALL are expected to
chronic granulomatous disease: be positive for:
A. Nitroblue Tetrazolium Test A. CD3
C. Both A and B C. CD20
B. Flow Cytometry B. CD19
D. Neither A nor B D. CD79a
21. The defect in Leukocyte Adhesion 30. Smudge cells are usually seen in:
Disorder I is in: A. Burkitt lymphoma
A. Margination C. Plasma cell myeloma
C. Adhesion B. Chronic lymphocytic leukemia
B. Rolling D. Follicular lymphoma
D. Transmission 31. Involved in cells in hairy cell leukemia
22. What type of Leukocyte Adhesion exhibit the following features except:
Disorder is caused by mutation in genes A. Abundant fine hairy projections
encoding for G-protein coupled receptors? C. TRAP (+)
A. Leukocyte Adhesion Disorder IV B. Positivity for CD19 and CD20
C. Leukocyte Adhesion Disorder II D. None of these
B. Leukocyte Adhesion Disorder III 32. The most specific test for hairy cell
D. Leukocyte Adhesion Disorder I leukemia is:
23. What is the cause of the poor function of A. Annexin 1
neutrophils among patients with diabetes C. DBA-44
mellitus? B. TRAP
A. Abnormal oxidative burst D. CD19 and CD22
C. Dysregulated cytokine production immunohistochemistry
B. Abnormal actin and myosin filaments 33. Bone marrow plasmacytosis should be at
D. None of the above least ____ in plasma cell myeloma
24. In sex-linked agammaglobulinemia, the A. 20%
block in B cell development is due to: C. 10%
A. 22q11.2 microdeletion B. 30%
C. Btk gene mutation D. 40%
B. Absence of thymus 34. Reed-Stemberg cells are seen in:
D. None of these A. Burkitt lymphoma
25. Nuclei of reactive lymphocytes are seen: C. Follicular lymphoma
A. With prominently clumped chromatin B. Hodgkin lymphoma
C. With less clamping of chromatin D. ALL
B. Hypersegmented
D. B and C
35. Promyelocytes with prominent 43. Leukocytosis with marked left shift in the blood
cytoplasmic rods in cases of AML are and a blast count of <20% in the marrow,
known as: pers? Monocytosis of >1 x 109/L are findings
A. Faggot cells compatible with:
C. Smudge cells A. CML
B. Reed-Stemberg cells C. CMML
D. None of these B. AML
36. The below stated staining profile is D. ALL
compatible with this cell lineage: 44. Atypical chronic myeloid leukemia will
(+) MPO (+) Alpha-naphthyl acetate have the following features, except:
(-) AS-D chloroacetate esterase A. (+) Philadelphia chromosome
A. Monocytic C.
C. Granulocytic B. Basophilia
B. Lymphocytic D. None of these
D. Plasmacytic 45. The bone marrow blast count of patients
37. Of the myeloproliferative neoplasms with refractory anemia with excess blasts 2
provided in the choices below, which one should be:
is not expected to have MPL point A. <20% but at least 10%
mutation? C. >20%
A. Primary myelofibrosis B. <5% but >1%
C. Polycythemia vera D. None of these
B. Essential thrombocythemia 46. Myelodysplastic syndromes have the
D. None of these following general features, except:
38. Philadelphia chromosome is a fusion of: A. Cellular bone marrow
A. ABL in gene chromosome 9 with BCR gene C. Dyspoiesis
in chromosome 22 B. Peripheral cytopenias
B. ABL in gene chromosome 22 with BCR D. None of these
gene in chromosome 9 47. Which is not a mature B cell neoplasm?
C. The translocated BCR gene from the A. CLL
chromosome 22 with ABL gene in C. Mycosis fungoides
chromosome 9 B. Burkitt lymphoma
D. None of these D. Hairy cell lymphoma
39. A CML patient who is not in blast crisis is 48. An AML patient who was prevsly
expected to have ___________ LAP score diagnosed to have a myelodysplastic
A. Increased syndrome will be under class (in the new
C. Slightly increased classification)?
B. Decreased A. Class I
D. None of these C. Class III
40. In polycythemia vera, there is increased B. Class II
production of this/these cells in the D. Class IV
marrow: 49. Which is not true about TRAP test in the
A. Granulocytes laboratory diagnosis of hairy cell
C. Platelets leukemia?
B. Red cells A. In general, all cells stain positive for acid
D. All of these phosphatase before addition of tartrate
41. The hemoglobin level among patients with B. Upon addition of tartrate, staining of normal
polycythemia vera should be: cells for acid phosphatase will be inhibited
A. Men ->18.5 g/dL, Women – 16.5 g/dL C. Hairy cells stain positive for acid
C. Men and Women – 16.5 g/dL phosphatase even after addition of tartrate
B. Men ->16.5 g/dL, Women – 18.5 g/dL D. None of these
D. None of these 50. Which is not a B cell marker?
42. In patients with essential A. CD19
thrombocythemia, there should be a C. CD20
sustained platelet count of at least: B. CD8
A. 450 x 109/L D. None of these
C. 500 x 109/L
B. 400 x 109/L
D. None of these
51. Given the following results: 56. The patient has a history of drug induce
RBC ct: 3.4 x 106/uL hemolytic anemia and the med techhecked
the PBS of the patient and obseved that
MCV: 60fL there is the presence of this poikilocyte
Hgb: 180g/L shown below, what additional testing
MCHC: 38g/dL should be done on this patient to help the
Hvt: 27% diagnosis?
MCH: 25pg A. EOFT
WBC ct: 10,500/uL B. Deoxyrudine suppression test
C. Shilling’s test
Which among the parameter above needs D. DAT
to be corrected? E. Serum microbiological assay
1. RBC ct. 2. WBC ct. 3. Hgb 57. Given below is the CBC result of a male
4. Hct 5. MCV patient:
A. 1, 2, 5 RBC ct: 3.2 x 1012/L
B. 2 only MCV: 130fL
C. 3 only Hgb: 11 g/dL
D. 1, 3 MCH: 36 pg
E. 1, 2, 3, 4 Hct: 38%
52. Using the above data on #51, what do you MCHC: 34 g/dL
think causes the discrepancy? WBC ct: 3,500/uL
A. Presence of precipitating proteins Platelet estimate: decreased
C. presence of cryoglobulins
B. High leukocyte count What additional testing should be
D. possible lipemic sample requested on this patient to establish a
E. C and D concrete diagnosis?
53. As a medical lab scientist, what proper A. EOFT
action should be done to correct the B. Serum Ferritin Assay
identified discrepant result on the given C. Serum microbiological assay
data on #51: D. Dithionite solubility test
A. centrifuge the plasma before retesting it on E. HAM’s test
Drabkin’s solution 58. The above result on #57 is consistent with:
B. Warm the specimen at 37 oC before A. IDA
retesting B. B-thalassemia
C. Use citrate as anticoagulant before C. Megaloblastic anemia
retesting D. H. spherocytosis
D. Collect new EDTA sample and retest E. PNH
E. Add plasma on Drabkin’s reagent solution 59. What is the abnormality that the med tech
for blanking and retest is expected to see on the PBS of this
54. Given the result below of a female patient patient with d? On #57?
RBC ct: 3.2 x 10 A. Occasional nRBC
Hct: 34% B. Numerous Fragmented RBC
Hgb: 11g/dL C. Giant cytoplasmic inclusions on WBC
The above result is most likely seen in D. Presence of hypersegmented PMM
patient with: E. Non
A. Fanconi’s anemia 60. What is the cause of the abnormal result of
C. Myelopthesic anemia the patient on #57?
B. Vit. B12 deficiency A. Bone marrow failure
D. Renal dysfunction B. Space occupying lesion in the bone marrow
E. IDA C. Abnormal nuclear development
55. The above data on #54 has D. Abnormal Heme formation
______________ blood picture E. trauma on RBC
A. Macrocytic, normochromic 61. The med tech examines the PBS of one
B. Microcytic, hypochromic patient and the observed this poikilocyte
C. Macrocytic, hyperchromic below:
D. Microcytic, normochromic Which among the disorder is associated
E. Normocytic, normochromic with it?
A. IDA
 B. Megaloblastic anemia A. MCV
C. Microangiopathic hemolytic anemia B. MCHC
D. Drug induce hemolytic anemia C. PBS
E. Hemic anemia due to HDN D. A and C
62. Given the following data below: E. A, B, C
RBC ct: 3.0 x 1012/L 67. Which of the folllowing poikilocyte is
MCV: 110 fL associated with myelofibrosis
Hgb: 10g/dL A. Dacrocyte
MCH 39 pg B. Burr
Hct: 31% C. Echinocyte
MCHC: 40 g/dL D. Schistocyte
WBC ct: 5,000/uL E. None of the choices
Platelet estimate: with normal number 68. Which of the following is associated with
abetalipoproteniemia? Choices on #67
Which of the following disorder most likely A. Darcocyte
will give such result? B. Burr
A. IDA C. Echinocyte
B. PNH D. Schistocyte
C. Vit. B12 deficiency E. None of the choices
D. Presence of cryoglobulins 69. Which of the following is consistent with
E. C or D patient suffering from Polycythemia Vera?
63. What sample should be used to correct the 1. Hyperuricemia
discrepancy of the above result on #62 2. Pancytopenia
A. new EDTA sample 3. High LAP score
B. A prewarm EDTA sample 4. Thrombotic episode
C. use citrate blood instead of EDTA blood 5. High WBC count
specimen
D. A or B A. 1,2
E. C or D B. 1,2,3,4
64. CBC result obtained from an automated C. 1,3,4
cell counting machine shows D. 1,2,4
RBC ct: 3.0 x 1012/L E. 1,3,5
RDW: High 70. Which of the following is consistent with
Hgb: 8g/dL megaloblastic anemia?
MCV: High 1. Presence of Howell-Jolly bodies
Hct: 28% inclusion
MCH: High 2. Hypersegmented PMN on PBS
WBC ct: 2,000/uL 3. High WBC ct
MCHC: Normal 4. Low platelet ct.
Platelet estimate: decreased 5. High iron loss

Which of the disorder low most likely A. 1,2,3,4,5

consistent with the result above? B. 1,2,3,5
A. IDA C. 2 only
B. Renal failure D. 1,2,4,5
C. Heterozygous thalassemia E. 1,4,5 only
D. Megaloblastic anemia 71. This abnormal inclusion is commonly
E. Compensated reticulocytosis associated with: (insert pic)
A. Lead or arsenic poisoning
65. Which additional testing will be helpful in B. CDA type II
the diagnosis of refer to #64 C. Sideroblastic anemia
A. Serum ferritin assay D. IDA
B. Vit. B12 and Folate serum assay E. Megaloblastic anemia
C. Serum electrophoresis 72. This abnormal RBC distribution is
D. DAT test consistent with which of the following:
E. EOFT 1. Multiple myeloma
66. Which of the following parameter can be 2. DIC
used to evaluate anicocytosis 3. Macroglobulinemia
 4. M. pneumonia infection A. Glutathione reductase deficiency
B. G-6PD deficiency
A. 1,2,3,4 C. Pyrimidine reductase deficiency
B. 1,2,3 D. Pyruvate kinase deficiency
C. 1,3 E. A and C
D. 3,4 78. Which of these veins is generally chose for
E. 1,3,4 venipuncture because it is large, close to
73. Passage of red to brown urine upon rising the skin, and does not roll when
from sleep is highly suggestive of what of venipunctured?
the following conditions? A. Median cubital veins
A. Cryoglobulins B. Median antibracial veins
B. Cold agglutinin disease C. Median basilica
C. PCH D. Cephalic
D. PNH E. Femoral veins
E. Spherocytosis 79. What is the immediate precursor of mature
74. The following results were obtained and neutrophils
the med tech noticed that there is A. Promyelocyte
consistency B. Band neutrophil
WBC ct: 6,500/uL C. Myelocytes
RBC ct: 4.5 x 1012/L D. Metamyelocyte
MCV: 90.1 fL E. Myeloblast
Hgb: 18g/dL 80. What is the anticoagulant of choice if there
MCH: 39.6 pg is pseudoleukocytosis?
Hct: 41.5% A. EDTA
MCHC: 43.4 g/dL B. Sodium Citrate
C. Double-Oxalate
The first step that the med tech should do D. Heparin
in obtaining valid results is to: E. Acid citrate dextrose
A. Perform a microHct 81. When collecting blood specimen into
B. Correct the hemoglobin for lipemia additive containing tubes, which of the
C. Dilute the blood following tubes should never be the first
D. A and B tube collected?
E. A,B,C A. EDTA
75. How many gnes are obtained in Bart’s High B. Fluoride
A. 1 D. Heparin
B. 2 C. Citrate
C. 3 E. Plain tube
D. 4
E. 5
82. Given a leukocyte count of 15 x 10 9/L and
a NRBC of 25/100 WBC, what is the
corrected WBC count?
76. A CBC showed that a patient is anemic. A. 13 x 109/L
RBC indices are as follows: B. 10 x 109/L
MCV: 78 fL C. 11 x 109/L
MCH: 28.9 pg D. 12 x 109/L
MCHC: 37g/dL E. None of the choices
A PBS showed many microcytes and
polychromasm. Reticulocyte count is 6%. 83. In the myeloid series, the first appearance
What laboratory test might be ordered next of cytoplasmic granules is seen in what
to support the diagnosis? cell?
A. DAT A. Myelocytes
B. Autohemolysis test B. Metamyelocyte
C. EOFT C. Promyelocyte
D. Serum haptoglobulin D. Myeloblast
E. Ascorbate cyanide test E. Band cell
77. Marked basophilic stippling of the red cell
may be observed in:
84. Which of the following diluting fluids exposed to complement containing serum at
contains substances that will NOT lyse low pH?
RBCs? A. Sideroblastic anemia
A. Turk’s fluids B. PNH
B. 2% acetic acid C. Hereditary eliptocytosis
C. Hayeffe’s D. Stomatocytes
D. 3% HCL E. PCH
E. C and D 92. Numerous and unevenly distributed
85. Basophils contain large amounts of which granules which may obscure the nucleus
of the following secretory products? are frequently observed in what normal
A. Histamine cell?
B. Acid phosphatase A. Lymphocyte
C. Immunoglobulins B. Basophils
D. Myeloperoxidase C. Neutrophils
E. A and B D. Eosinophils
86. What is the action of the potassium E. Myeloblast
ferricyanide in Drabkin’s reagent? 93. Which of these disease is commonly
A. Provide cyanide ion associated with anti-I production causing
B. Enhances lysis of RBC autoimmune hemolytic anemia?
C. Shortens conversion time to Hb to HICN A. PCH
D. Oxidizes hemoglobin to haemoglobin B. PNH
E. None C. Cold agglutinin disease
87. Which of the following is NOT a diluents in D. Infectious mononucleosis
manual WBC count? E. IDA
A. Glacial Acetic Acid 94. What test tube is used if the med tech
B. Toisson’s fluid observes platelet satellitism in the
C. Turk’s fluid peripheral blood smear?
D. 1% HCL A. Blue top
E. A and C B. Lavander top
88. Total WBC count times % of each type of C. Gray top
leukocyte in the differential count is the for D. Red top
A. Corrected cell count E. Yellow top
B. Direct relative cell count 95. Which of these is NOT a function of NK
C. Absolute count cell?
D. Indirect relative count A. Kill virally infected cells
E. RDW B. Cytolysis via antibody dependent
89. A 5 yr old male from the Middle East has C. Destroys senile cells
falling Hematocrit, H, RBC count. He has D. A and B
abnormal red cell morphology and E. A,B,C
darkened urine. Two nights before the 96. To perform its function in the circulation a
onset of symptoms, he ate fava beans. to survive 12 days, a RBC requires a
What is the cause of the abnormal membrane that has high
laboratory findings in this disorder? A. Lipid-to-membrane ration
A. Damage RBC membrane B. Impermeable
B. Splenic macrophages C. Rigidity
C. Drugs D. Deformability
D. Autoimmune hemolytic anemia E. Surface to area ratio
E. None 97. Which of the following will likely to
90. What evacuated tube is needed to collect increase the ESR reading?
blood for methemolobin determination? A. A blood specimen with a WBC count of
A. Blue top >30,000 cells/uL
B. Red top B. A blood specimen with spherocytic RBC
C. Lavander top C. A blood specimen with high protein level
D. Green top D. A blood specimen with sickle cell
E. Pink top 98. This Red cell parameter indicates the
91. Which of the following condition will average concentration of Hgb in the
demonstrate excessive hemolysis when erythrocytes of any specimen.. This?
A. Hematocrit
 B. MCH 104. Using a Coulter counter, an
C. MCV increase RDW should correlate with:
D. MCHC A. Anisocytosis
E. Hgb B. Leukocytosis
99. Which of the following disease will show C. Presence of NRBC
no elevated ESR value even the anemia is D. Spherocytosis
present? E. Anisochromia
1. Sickle cell anemia 105. The Coulter aperture impedance
3. Hereditary spherocytosis principle states that a cell does all the
2. Presence of Hgb CC following except:
4. Chronic hemorrhage A. Conducts electricity
B. Increase the electrical resistance to the
A. 1 and 2 current flow
B. 4 and 3 C. Produces a pulse height which is
C. 2,3,4 proportional to its volume
D. 1,2,3 D. Produces pulses which are proportional in
100. WBC that commonly associated number to the number of cells in suspension
with bacterialfection E. Creates voltage pulses
A. Neutrophil 106. What does the image below most
B. Eosinophil likely indicate? (insert pic)
C. Basophil A. The sample is expected to show a high
D. Lymphocyte MCV
E. Monocyte B. The patient is probably folate deficient
101. A histogram is a graph that can be C. the MCH and MCV will likely to be low
generated and printed by hematology D. A and B
analyzers and that shows the: E. A, B and C
A. Normal ranges for hemoglobin
B. Calibrator standard for most hematoloest 107. In flow cytometry analysis, right
C. Size and frequency distribution of blood cell angle (90 degrees) or side scatter of a laser
populations light beam provide information that
D. Voltage used in the electrode pertains to a cell’s
E. A, B, and C A. Volume
102. The Coulter principle in counting of B. Viability
cells is based on the fact that: C. Granularity
A. Isotonic solutions conduct electricity D. Lineage
less than cells E. A and C
B. Conductivity varies proportionately with the
number of cells INSERT PIC for 108-110
C. Cells conduct electricity less than saline 108. Erythrocyte - D
does 109. Granulocyte - C
D. Isotonic solutions cannot conduct electricity 110. Lymphocyte - B
E. A and C 111. Refer to the illustration below
103. What is meant by the term
“coincidence” as it refers to the Coulter What does the histogram indicate?
principle for counting cells A. The sample is likely to show high RDW
A. Some cells will not be counted by the B. The sample is likely to show anisocytosis
instrument because they are above the C. The sample is likely to show high MCV
threshold limit D. A and B
B. Some cells will not be counted by the E. A, B and C
instrument because they are below the 112. A patient has a high cold agglutinin
threshold limit titer. Automated cell counter results reveal
C. Some interferences in the blood sample will an elevated MCV, MCH, and MCHC.
cause a falsely elevated hemoglobin value Individual erythrocytes appear normal on a
D. Occasionally more than one cell goes stained smear, but agglutinates are noted.
through the aperture at the same time, but only The appropriate course of action would be:
one cell is counted A. Perform the RBC, Hgb, and Hct
E. A and B determination using manual methods
 B. Perform the RBC determination by a 5. Which of the ff test results will be best
manual method; use the automated results for describes a microcytic normochromic type
the Hgb and Hct of anemia
C. Report the determinations using a A. MCV = 105fL, MCH = 24pg
microsample of diluted blood
D. Repeat the determination using a pre B. MCV = 85fL, MCH = 30pg
warmed microsample of diluted blood C. MCV = 79fL, MCH = 32pg
E. A and B only D. None of the above
113. Refer to the results below: 6. TRUE of stage III iron deficiency anemia
A. Patients have symptoms of anemia
A. Cold Agglutinin Syndrome
B. Iron deficiency B. Iron deficient erythropoiesis
C. Megaloblastic Anemia C. Start of iron depletion
D. Acute Myelogenous Leukemia D. All of the above
E. Thalassemia 7. Which of the ff test results is indicative of
114. Which of the following automated iron deficiency anemia?
CBC parameters will be affected by A. Normal serum ferritin
hyperglycemia B. Increased TIBC
A. Hematocrit C. Normal transferrin saturation
B. MCV D. Bone marrow sideroblast present
C. RBC count 8. This is an acute phase reactant in the
D. A and B neutrophil granule which also scavenges
E. A, B, and C available irom
115. Refer to the illustration below: A. Hepcidin
A. Acute Myelogenous Leukemia B. Lactoferrin
B. Granulocytosis C. Ferritin
C. Lymphocytosis D. All of the above
D. Multiple Myeloma
E. Sickle Cell Disease 9. Complications of beta thalassemia major
for mainly caused by which of the ff?
ERYTHROCYTE DISORDER A. Iron overload
1. Which of the ff is true about infective
erythropoiesis B. Profound anemia
A. There is defective erythroid precursor C. Marrow hyperplasia
B. There is insufficient erythroid precursor D. All of the above
C. Seen in iron deficiency anemia 10. What is the usual morphology pattern of
D. All of the above anemia scene in anemia of chronic
2. Which of the ff test is a better indication of inflammation?
RBC production A. Normochromic, normocytic
A. Reticulocyte count
B. Corrected reticulocyte count B. Hypochromic, microcytic
C. Reticulocyte production index C. Normochromic, macrocytic
D. Absolute reticulocyte count D. Hypochromic, normocytic
3. This test serves as a quality control to 11. These are a diverse group of anemia
verify results of automated analyzer? caused by defect in incorporation of iron in
A. Bone marrow smear heme molecule?
A. Megaloblastic anemia
B. Histogram B. Sideroblastic anemia
C. Peripheral blood smear C. Iron deficiency anemia
D. All of the above D. Anemia of chronic inflammation
4. Which of the ff is not a characteristic of a 12. Which of the following is the enzyme
normal RBC deficient in congenital erythropoietic
A. 7 um porphyria
B. Abundant Eosinophilic Cytoplasm A. Ferrochelatase
C. Central pallor 1/3 of its diameter B. Urophorphyrinogen III
D. Biconcave C. ALA synthase
D. None of these
13. A patient came to the laboratory for certain 21. A patient presented with acquired
tests. You noticed that the patient’s skin is intravascular hemolytic anemia,
bronze in color. The FBS what’s elevated as thrombosis in the hepatic vein and
well as the liver enzymes. What condition moderate pancytopenis. Which of the ff
could have caused of the above findings? best describes this disorder?
A. Multiple blood transfusion A. This is an acquired stomatocytosis
B. Iron overload B. The patient has proximal nocturnal
C. There is already organ damage hemoglobinuria
D. All of the above C. The patient is positive for Ham’s test
14. Why is excess iron and harmful to the D. All of the above
body? 22. Laboratory findings seen in hereditary
A. Causes impaired protein synthesis spherocytosis
A. Polychromasia
B. Free radical formation B. Increased osmotic fragility test
C. Causes cell injury and fibrosis C. Increased reticulocyte count
D. All of the above D. All of the above
15. Megaloblastic changes is caused by which 23. True of hereditary elliptocytosis
abnormality A. It is autosomal recessive
A. DNA synthesis B. There is vertical protein defect
B. Enzyme deficiency C. Problem in spectrin
C. Free radical formation D. All of the above
D. Protein substitution 24. The manifestation of G6PD deficiency are
16. What is the mechanism of anemia in mainly brought about by which
megaloblastic anemia mechanism?
A. Insufficient erythropoiesis A. In ability to generate NADPH
B. Blood loss
C. Ineffective erythropoiesis B. Cannot detoxify H2O2
D. Iron loss C. Oxidative stress
17. Which of the ff is the most common type of D. All of the above
aplastic anemia 25. Which of the ff best describes Paroxysmal
A. Inherited cold hemoglobinuria
B. Acquired, idiopathic A. Auto Ab is IgG class

C. Acquired, secondary B. Clonal B cell lymphoproliferative disorder

D. A & B C. Targets P antigen
E. B & C D. All of the above
18. Which of the following is NOT TRUE of the 26. The most distinguishing feature of sickle
pathophysiology of aplastic anemia? cell disease
A. Bone marrow stromal cells are functionally A. Pain crisis
abnormal B. Vaso-occlusion
B. Hematopoietic stem cell problem C. Anemia
C. Shortened telomeres D. Infarction
D. None of the above 27. Bro of hemoglobin E disease
19. This is a group of disorder characterized by A. Valine substituted by glutamic acid at 6th
severe decrease in RBC precursor in position
otherwise normal marrow B. Lysine substituted by glutamic acid at 26th
A. Myelophthisic anemia position
B. Pure red cell aplasia C. Lysine substituted by glutamic acid at 6th
C. Dyserythropoetic anemia position
D. Anemia of chronic kidney disease D. Valine substituted by glutamic acid at 26th
20. True of extravascular type of hemolysis position
A. Excessive fragmentation hemolysis 28. The characteristic cell seen in the
peripheral blood smear of sickle cell
B. Excessive macrophage mediated disease patient?
hemolysis A. Sickle cell, target cell
C. RBC contents seen in plasma
D. All of the above B. Sickle cell, Burr cell
 C. Sickle cell, bite cell B. Tachycardia
D. Any of the above
29. Which of the ff chromosome is affected by C. Giving birth
beta thalassemia D. Inflammation
A. Chromosome 11 37. Reactive lymphocytes typically appear:
B. Chromosome 16 A. With homogenous nuclear chromatin
C. Chromosome 6
D. Chromosome 1 B. Fried egg, if B cell
30. Fetus with hemoglobin bart die in utero or C. With homogeneously blue cytoplasm, if T
shortly after birth because of what cell
mechanism? D. All of these
A. Profound anemia 38. Which is not true about toxic granules
B. Marked tissue hypoxia A. They are primary granules
C. Precipitation of RBC in the bone marrow B. Presence correlateswell with increase in
D. All of the above CRP
30 Which of the following cells will not have a C. Granules are peroxidase negative
normal function? D. None of these
A. Neutrophils in heterozygous Pelger-Huet 39. The most common neutrophils of normality
anomaly patients presents with:
B. Monocytes in Chediak-Higashi syndrome A. Abnormal chemotactic activity due to poor
C. Neutrophils in May-Hegglin anonaly response to chemotactic agents
D. Monocytes in mucopolysaccharidoses B. Neutropenia with abnormal actin and
31. Small, oval, cytoplasmic, ribosomal RNA myosin filaments
inclusions seen only in mature and band C. Decreased microbial killing due to defective
forms of neutrophils are: MPO-H202 system
A. Toxic granules D. A and B only
B. Giant granules in Chidiak-Higashi E. All of the above
syndrome 40. Which is not true about leukocyte adhesion
C. Reilly bodies disorder?
D. Dohle inclusion bodies A. Type I has adhesion defect
32. Which of the findings below is not
consistent with leukemoid reaction? B. Patient with type II will have neutropenia
A. Absence of eosinophils in blood smear C. Patients with type III have failure in
B. Normal looking neutrophils activation of integrin
C. Decreased LAP score D. A and C only
D. None of these E. All of the above
33. Agranulocytosis is a term used with the 41. A patient who was admitted to the hospital
neutrophil count is a few hours ago will undergo
A. >5 x 109/L appendectomy (removal of appendix). His
B. <5 x 109/L surgeon is considering rupture of the
C. >0.5 x 109/L appendix with the contents of the
D. <0.5 x 109/L appendix, including microbial organism,
34. Eosinophelia may be seen in spilling out into the peritoneal cavity. His
A. Allergic disorders WBC count is 52 x 109/L and the white cells
B. Parasitic infection are predominantly neutrophils with a few
C. Hypersensitivity reaction band forms and metamyelocytes. The
D. All of the above patient has ____ left shift.
35. Which of the following is not considered a A. No
toxic cellular change in WBC? B. Mild
A. Dohle inclusion bodie C. Moderate
D. Marked
B. Bilobed nucleus in neutrophils 42. (Refer to the case in the immediately
C. Dark blue cytoplasmic granules preceding item) Which of the findings
D. Nuclear hypersegmentation below may also be seen together with
36. Which of the following conditions below is leukocytosis in the patient’s case?
associated with pathologic neutrophilia? A. Toxic granulation
A. Strenuous exercise B. Toxic vacuolation
C. Both A and B
 D. Neither A nor B 53. The following markers are found on the
43-50 Choose from columns surface of T cells, except:
I II III A. CD3
A.dohle A.hypersegment A.lyst B. CD4
bodies ed nucleus gene C. CD8
B. lazy B.bilobed B.1q41- D. CD19
leukocyte nucleus 43 54. Which of the neoplastic WBC disorder
syn below is a T cell disorder?
C.chediak- C. blue C.22q11. A. Hodgkin lymphoma
higashi cytoplasmic inc 2 B. Hairy cell leukemia
D.chronic Lymphocyte w D.MYH9 C. Burkitt lymphoma
granulomato flared skirt gene D. Mycoses fungoides
us 55. Majority of cases of acute lymphoblastic
D.alder reilly Lymphocyte D.BTK leukemia involves:
anomaly appears fried gene A. B cells
egg B. T cells
C. NK cells
WBC Disorder Morphologic Gene Involved D. All of these
Feature 56. Which is true about the most common type
43. ______ Resembles of leukemia in adults?
E toxic granules A. It is also the most common leukemia
Pelger-Huet 44. ____B 45. ____B inpatient less than 1 year of age
Anomaly
46. _____C Cytoplasmic 47. ____A B. Depressant categorization follows the WHO
classification which has 4 classes
giant granules
C. The disorders with distinct genetic
May-Hegglin 48. ____D
aberrations are classified under class II
Anomaly
D. A and B only
49. _____ Genes for
E. A, B, and C
components of
NADPH
57. Which of the following stains is/are useful
oxidase
in differentiating lymphocytic from
system
myelogenous neoplastic disorders?
Alder-Reilly 50. ____ A. Myeloperoxidase
Anomaly
B. SBB
C. AS-D chloroacetate esterase
NEOPLASTIC WBC DISORDERS D. A and B only
51. You are performing a complete blood count E. All of these
for a new patient of the hospital and while 58. Translocation involving genes on
doing the differential count, you saw chromosome 9 and 22 may be
abnormal cells in the smear which are demonstrated in:
probably neoplastic. What should you do? A. Lymphoblastic leukemia
A. Issue the differential count with the other B. Chronic myelogenous leukemia
blood parameters after counting C. Both A and B
B. Exclude the abnormal cells in the counting D. Neither A nor B
C. Continue counting and issue the CBC 59. The chromosome with diffusion of ABL and
without the differential count but with remarks BCR genes is called:
“smear for referral” A. Pennsylvania chromosome
D. Refer the smear of the patient to another
laboratory for confirmation B. Philippine chromosome
52. Which of the findings below is consistent C. Philadelphia chromosome
with leukemia? D. None of these
A. Blood leukocytosis of 50 x 109/L, all cells are 60. A patient who was diagnosed to have
mature chronic myelogenous leukemia now has
B. Bone marrow hyper cellularity, 30% are increased blasts in the bone marrow of
blasts more than 20%. Which is/are true about the
C. 10% of the cells in the marrow are blasts present condition of the patient?
D. None of these
 A. The patient is in blast crisis E. B and D
72. The CBC result obtained from cell analyzer
B. The blood will have increased blasts will obliged the medical technologist to
check the PBS and look for:
C. The case may transform to ALL A. Platelet clumping
D. All of these B. Platelets satellitism
61. The following myeloproliferative disorders C. nRBC
may exhibit constitutive JAK2 kinase D. A and B
activation, except: E. A, B, C
A. Primary myelofibrosis 73. This CBC result may show what cell
B. Essential thrombocythemia histogram flag?
A. R1
C. Chronic myelogenous leukemia B. R2
D. Polycythemia vera C. R3
62. Which of the cells below will be increased D. R4
in patients with polycythemia vera? E. R5
A. Red cells 74. Blood sample from a patient with a high
B. Granulocytic white blood cells titer agglutinin, analyzed at room
C. Platelets temperature with an electronica cell
D. All of the above particle counter, would cause error in the:
63. Which of the following findings are seen in A. High and MCV
plasma cell myeloma? B. MCHC and WBC
A. >30% of cells in the marrow are plasma C. WBC and RBC
cells D. MCV and MCHC
B. Bone lesions E. Plt ct and MCV
75. On an electronic cell counter, hemoglobin
C. Monoclonal proteins in the urine determinations may be falsely elevated
D. All of these owing to thepresence of:
64. In performing TRAP, what cell will exhibit A. Lipemia or bilirubineria
staining for acid phosphatase after B. Low WBC count or Lipemia
addition of tartrate? C. High Bilirubin or rouleaux
A. Normal lymphocytes. D. Rouleaux or lipemia
B. Leukemia hairy cells E. Hemolysis and high platelet ct
C. Both A and B 76. A 36 yr old female patient who suffers with
D. Neither A nor B a viral infection had her CBC. Upon
65. A strong staining reaction with alpha- checking the blood film of this patient the
naphthyl acetate is exhibited by: MLS observed the cell shown below. This
A. Granulocytic leukemic cell cell may cause alarm to the cell counting
B. Monocyte leukemic cells machine and may register at what WBC
C. Leukemic cells in ALL histogram flag:
D. Promyelocytic cells in AML A. R1
66. Smudge cell - C A. AML, Promyelocytic B. R2
67. Sezary cell - C B. Hodgkin lymphoma, C. R3
lymphocyte predominance D. R4
68. Faggot cell- A C. Acute lymphoblastic E. R5
leukemia 77. Which area of the automated cell counter
69. Reed-Sternberg cell – D D. Hodgkin histogram indicates the nonlymphocyte
lymphoma, Nodular sclerosis curve? – C
70. Popcorn cell - B E. None of these 78. Which area of the cell histogram indicates
71. The cell histogram shows the following the lymphocyte curve? – D
curve 79. Which area of the automated cell counter
Which of the following option is represents the RBC histogram? – D
appropriate on this particular result? 80. The medical technologist observed this
A. Check for lipemia in the sample cell in the blood film of a patient. This will
B. Look for non-lysing RBC in the blood film affect the result of the cell counting
C. Do not compute for WBC ct correction machine and may give which of the
D. Check the blood feeling for platelet following?
aggregation A. High WBC volume and low Hgb count
 B. Low WBC size and low MPV This result is consistent with which of the
C. High WBC count and low platelet number following factor?
D. Increase WBC count and low platelet A. Cryofibrinogen in the plasma
number B. Using old specimen
E. Increase WBC count and low platelet C. Using a hemolyzed sample
volume D. Inadequate blood mixing
81. The picture showing on number 80 may E. Platelet clumping
cause 88. Which of the following tests might be
A. skew to the left red cell histogram affected with it?
B. a broader curve on platelet histogram A. Hgb using the cyanmethemoglobin method
C. a sharp peak of curve on a lymphocyte
curve B. Microhematocrit
D. a broader curve for granulocyte curve C. ESR determination
E. a broader curve for red cell histogram D. A and B
E. A, B, C
82. What cell histogram flag is expected on a 89. The following will NOT falsely elevate the
patient sample if the medical technologist Hct
observed a lot of band cell and A. Presence of sickle cell
metamyelocyte in his peripheral blood B. Inadequate centrifugation
smear C. Interstitial fluid contamination
A. R1
B. R2 D. Prolonged tourniquet application
C. R3 E. A, B, C only
D. R4 90. The following may interfere with CCN miss
E. R5 hemoglobin due to increase absorbance
83. Given a sample CBC result shown below absorbance ca
A. Rouleaux forming Red Cell A. Lipemic blood samples
B. Blood with CBC count of 15 x 10 9/L
B. Presence of non-lysing red cell C. Presence of sulfhemoglobin
C. Macrocytosis or ovalocytes D. Presence of adult hemoglobin
D. Atypical lymphocytes E. A and B only
E. Leuko.. Reaction 91. The following inclusions may not be
stainrd by Romanowsky stain?
84. High RDW with low MCV registered by a A. Heinz bodies
cell automated analyzer connected with:
A. Megaloblastic anemia B. Neutrophil granules
B. Sideroblastic anemia C. Eosinophil granules
C. Reticulocytosis D. Platelets
D. Heterozygous thalassemia E. A and B only
E. Homozygous thalassemia 92. False regarding ESR:
85. Hydronamic focusing is employed to the 1. Measure the degree of RBC
cell counting analyzer to prevent which of setting in plasma
the following? 2. Enhanced by fibrinigen or alpha
A. Passage loss and beta globulin.
3. Detects specific disease
B. False increase of blood cell volume 4. Higher values in female than male
C. False decreased number of cell A. 1,2
D. A and B B. 2, 3, 4
E. A, B, C C. 3, 4
86. The CBCresult above is consistent with: D. 3 only
A. Hemolyzed sample E. 1, 2, 3, 4
B. Clotted sample
C. Using old specimen 93. The following may falsely increase ESR our
D. Presence of cold agglutinin values:
E. Presence of cryofibrinogeN A. Tilting of tube
87. The CBC result obtain from a Cell-DYN B. Macrocytosis
H500 shows the following results: C. Soherocytes
D. B and C
 E. A and B 3. Excessive exercise
94. Which of the following conditions will have 4. Severe diarrhea
an elevated Hct reading A. 1,2, 3, 4
1. Burt patient B. 2, 3, 4
C. 3, 4
2. Hemodilution D. 1, 4
3. Excessive exercise E. 2, 4
4. Severe diarrhea 100. Which of the following test is used
A. 1,2 to diagnose paroxymal cold
B. 2, 3 hemoglobinuria?
C. 1, 3, 4 A. HAM’s test
D. 2, 3, 4
E. 1, 2, 3, 4 B. Donath-Landsteiner test
95. Which of the following will give you a too C. EOFT
blue stained blood smear D. Isopropanol precipitation test
A. Fast spreading E. Sugar water test
B. Low angle of spreading 101. What additional special test can be
C. Big drop of blood placed requested if the med tech observe a “shift
D. A and B to the right” differential count?
E. A, B, C A. Fluorescent spot test
96. True regarding cyanmethemoglobin method: B. EOFT
A. Quantitates all forms of Hgb C. Microbiological assay
B. Potassium ferricyanide oxidizes Hgb to Hi
C. Read at 640 nm D. A and C
D. A and B E. A, B, C
E. None 102. This is a stage of granulocyte
97. Given the following RBC parameter, production where the nucleus begins to
compute for the Red Cell indices, and flatten on one side and begins to constrict
choose among the following disorders that or indent, becoming kidney shaped or
would be appropriately associated with it peanut shape, what is this stage?
Rbc: 3.6 x 1012/L A. Juvenile cells
Hgb: 11g/dL B. Myelocyte
Hct: 32% C. Promyelocyte
1. Iron deficiency anemia D. Band or stab cells
2. Thalassemia E. A and B
3. Megaloblastic anemia 103. Which of the following has
4. Bone marrow failure increased sensitivity to EOFT study?
5. Anemia of chronic disease A. Sickle cell
A. 1,2 B. Extremely hypochromic cells
B. 4, 5 C. Target cells
C. 3 only D. A and B
D. 4 only E. A, B, C
E. 1, 2, 5 104. The following conditions may
98. The medical laboratory scientist is present red cell aggregation, EXCEPT
examining a PBS and noted the A. Hemolytic anemia
appearance and the Hgb concentration of B. Blood incompatibility
the Red Cell and what he have observed his C. Call agglutinin syndrome
shown below: D. Hyperproteinemia
A. Aplastic anemia E. B and D
B. Cobalamin deficiency 105. Which of the following statements
C. Thalassemia minor is false?
D. Spherocytosis A. Autohemolysis is used to confirm enzyme
E. C and D defect in RBC metabolism
99. Which of the following action/factor(s) will B. Sugar water test is the screening test for
falsely elevate the microhematocrit value? PNH
1. Prolong tourniquet application C. Schilling test is used to diagnose
2. Using more than 3 hour EDTA pernicious anemia
specimen
 D. Dithionate solubility test detects 112. Which of the following integral protein
spherocytosis transports the negatively charged nueraminic
106. What is the test for the diagnosis of acid within the red cell membrane?
hereditary spherocytosis? A. Alpha and beta spectrin
A. EOFT B. Protein band 3
B. HAM’s test C. Glycophorins
C. Autohemolysis D. RH antigen
D. A and C E. ICAM-4
E. B and C 113. Which of the following membrane
107. Which of the following will give an protein if defective is associated with
increase reading of ESR values? paroxysman nocturnal hemoglobinuria?
A. Hyperproteinemia A. Spectrin
B. Polycythemia B. Protein band 4.1
C. Presence of spherocytes C. Protein band 3
D. A and C D. GPI anchor protein
E. B and C E. ICAM-4
108. Poikilocyte caused by prolong 114. If the med tech notices that he
standing of the blood specimen in EDTA obtained a blue stained smear, what proper
anticoagulant: action should he do next to prevent this?
A. Microcytes A. Prolong the washing of the screens near
B. Spherocytes B. A just the pH of the buffer staining solution
C. Target cell to 8
D. A and B C. Increase the angle of spreading during
E. None blood smear preparation
109. If the medical technologies noticed D. Prevent water contamination on the
that the red cell pallor size is approximately hematological stains to prevent alkalinity
2/3 of the total diameter of red cell, the E. B and D
proper grade for this would be: 115. What globin chains do the Gower I
A. 4+ haemoglobin is made of?
B. 3+ A. Gamma and epsilon
C. 2+
D. 1+ B. Alpha and epsilon
E. 0 C. Alpha and beta
110. If around 20 among the 100 red cells D. Alpha and Delta
observed for oil immersion field exhibit E. Beta and zeta
polychromasia, this should be graded or 116. True about myeloid hematopoiesis
reported as: A. It begins at the 5th and 6th week of gestation
A. 4+ polychromasia B. Liver is the major site of blood cell
B. 3+ polychromasia production
C. 2+ polychromasia C. Hgb A1 gradually increases in
D. 1+ polychromasia concentration
E. Normal during this period
111. Which of the following statements D. A and B
is/are true regarding RBC metabolic E. A, B, C
system 117. Which of the following is true
A. The cytochrome b5 reductase is regarding erythrocyte maturation?
responsible for maintenance of the enough A. There are four cell divisions takes place
level of reduced glutathione from blast to mature RBC
B. The NADH+ that was formed from G3P B. RBC maturation takes place approximately
and 1,3BPG interaction served as a 72 hours
cofactor of methemoglobin reductase in C. Multiple nucleoli are present in rubriblast
reducing back hemoglobin on it’s D. A and B
functional oxygen carrier E. A, B, C
C. The HMP is responsible for converting the 118. Which of the following maturing red
NADP to its reduced form cells is capable of hemoglobin synthesis?
D. A and B A. Basophilic normoblast
E. B and c B. Diffusely basophilic erythrocyte.
C. Metarubricyte
 D. A and B A. Ringed sideroblast
E. A, B, C B. Micromegakaryocytes
119. In leukopenia, what part of C. Disseminated intravascular coagulation
anticoagulated bloodis used in making a D. Philadelphia chromosome
smear? 3. A chronic leukemia of lymphocytic origin
A. Plasma found to be positive to acid phosphatase
B. Well mixed blood A. Hairy cell leukemia
C. Erythrocyte sediment B. Chronic lymphocytic leukemia
D. Buffy coat C. Acute myelocytic leukemia
120. According to the double ruling D. Acute lymphocytic leukemia
method of Neubauer grid, WBC’s are 4. Which of the following is most closely
counted in 4 corners including those associated with chronic myelogenous
touching the leukemia?
A. Top or the left line A. Reed sternberg cells
B. Bottom or the right line
C. Either A or B B. Smudge cells
D. Neither A nor B
121. In what order from the highest to C. Disseminated intravascular coagulation
lowest percentage(%) of WBCs in Blood? D. Philadelphia chromosome
A. Neutrophil – eosinophil – monocyte – 5. Increased lecels of TdT activity are
lymphocyte – basophil indicative of:
B. Neutrophil – monocyte – lymphocyte – A. Burkitt lymphoma
eosinophil – basophil B. Acute lymphocytic leukemia
C. Neutrophil – lymphocte – monocyte – C.
basophil – eosinophil D.
D. Neutrophil – lymphocyte – monocyte – 6. A positive specific esterase stain indicates
eosinophil – basophil differentiation into which cell type?
122. Which of the following can A. Monocytic
differentiate reactive lymphocyte from B. Megakaryocytic
monocyte? C. Lymphoid
A. Irregular, indented nucleus. D. Granulocytic
B. Presence of vacuoles 7. Associated with HTLV-I
C. Color and indentation of cytoplasm A. Hairy cell leukemia
D. All of the above B. Chronic lymphocytic leukemia
123. In what order from the first the last C. Acute myelocytic leukemia
step of phagocytosis? D. Acute lymphocytic leukemia
A. Chemotaxis – adherence – digestion – 8. Which of the following is most closely
ingestion – killing associated with acute myelomonocytic
B. Chemotaxis – diapedesis – adherence – leukemia?
ingestion – killing A. Philadelphia chromosome
C. Chemotaxis – adherence – ingestion – B. Micromegakaryocytes
digestion – killing C. Disseminated intravascular coagulation
D. Chemotaxis – digestion – ingestion – D. Increased serum lysozyme
adherence – killing
REMOVAL EXAM – HEMATOLOGY I 9. Which of the following bone marrow
1. Based on the results obtained from the findings favor the diagnosis of multiple
evaluation of a leukocyte alkaline myeloma?
phosphatase (LAP) stain what is the total A. Presence of Reed-Sternberg cells
LAP score
A. 65 B. Presence of flame cells and Russell bodies
B. 95
C. 75 C. Sheaths of immature plasma cells
D. 130 D. Presence plasmacytic satellitosis
2. Which of the following is most closely 10. Which of the following have a B cell origin?
associated with acute promyelocytic A. Sezary syndrome
leukemia? B. Waldenstrom macroglobulinemia
C. Acute myelocytic leukemia
 D. Hodgkin’s disease 18. What is the most common chromosomal
11. The stain that selectively identifies abnormality found in chronic myelogenous
phospholipid in the membrane of primary leukemia?
and secondary granules within myeloid A. T(8;14)
cells is: B. T(1;12)
A. Sudan black B C. T(9;22)
B. Period acid-Schiff (PAS) D. Trisomy 12
C. Leukocyte alkaline phosphatase (LAP) 19. What is the most common chromosomal
D. Factor 8 stain abnormality found in FAM AML M3?
12. A useful chemical test for the diagnosis of A. AML with t(15;17)
megakaryotic leukemia is the: B. AML with t(8;21)
A. Peroxidase test C. AML with mixed lineage
B. Periodic acid-Schiff test D. T(9;22)
C. Sudan black test 20. CML is distinguished from leukemoid
D. Factor 8 Stain reaction by which of the following?
13. Which type of acute myeloid leukemia is A. CML: low LAP; leukemoid: high LAP
called the true monocytic leukemia and
follows an acute or subacute course B. CML: low WBC; leukemoid: normal WBC
characterized by monoblast, C. CML: high LAP; leukemoid: low LAP
promonocytes, and monocytes D. CML: high WBC; leukemoid: higher WBC
A. Acute myeloid leukemia, minimally 21. Which of the following cells cells is
differentiated considered pathognomonic for Hodgkin’s
B. Acute myeloid leukemia without maturation disease?
C. Acute myelomonocytic leukemia A. Niemann-Pick cells
D. Acute monocytic leukemia B. Flame cells
14. A peripheral smear shows 75% blast. C. Reactive lymphocytes
These stain positive for both Sudan Black D. D. Reed-Sternberg cells
B (SBB) and peroxidase. Given these 22. The JAK2 oncogene is strongly positive in
values, which of the following these orders this myeloproliferative disorders:
is most likely? A. ALL
A. Acute myelocytic leukemia (AML) B. PV
B. Hairy cell leukemia C. AML
C. CML D. CML
D. Acute lymphocytic leukemia (ALL) 23. EBV associated acute lymphocytic
15. Which of the following reactions are often leukemia:
positive in ALL but negative in AML? A. FAB L1
A. Terminal deoxynucleotidyl transferase and B. FAB L2
PAS C. FAB L3
B. Sudan black B and peroxidase D. FAB L4
C. Chloroacetate esterase 24. Translocation of t(8:21) is a common
D. Acid phosphatase chromosomal abnormality in:
16. In the French-American-British (FAB) A. FAB AML M2
classification, acute lymphocytic leukemia
is divided into groups according to: B. FAB AML M3
A. Prognosis
B. Molecular genes C. Chronic lymphocytic leukemia
C. Immunology D. Chronic myelocytic leukemia
D. Morphology 25. Lymphocytosis, homogeneous, small,
17. In addition to morphology, cytochemistry, hyperclumped lymphocytes and smudge
immunophenotyping, the WHO cells are seen in
classification of myelo- and A. Chronic lymphocytic leukemia
lymphoproliferative disorders is based B. Acute lymphocytic leukemia
upon which characteristics?
A. Proteomics C. Chronic myelocytic leukemia
B. Carbohydrate-associated tumor antigen D. Acute myelocytic leukemia
production. 26. The use of this diluent is discouraged
C. Cytogenetic abnormalities because it supports fungal growth
D. Cell signaling, adhesion markers A. Bethel’s
 B. NSS C. 2,4
C. Toisson’s D. 4
D. Dacie’s 34. The following are characteristics of aa
27. Reference method for hemoglobin spherocyte EXCEPT:
determination: A. Thin membrane
A. Falling-drop method B. No central pallor
C. Increase fragility
B. CuSO4method D. Increase MCH
C. Cyanmethemoglobin method 35. Acquired spherocytosis can be caused by:
D. Gasometric methof A. Lost of spectrin protein
28. Specific gravity of hemoglobin: B. Defective protein band 4.1
A. 1.052 C. Immunohemolytic anemia
B. 1.054 D. A and C
C. 1.056 36. Rod shape or egg shape from RBC is/an:
D. 1.060 A. Elliptocyte
29. Substituting this reagent for sodium B. Sickle cell
bicarbonate shortens the time needed for C. Acanthocyte
complete conversion og Hgb to HiCN from D. Burr cell
10 mins to 3 mins 37. A change in the plasma lipid ratio will
A. KCN promote for formation of what poikilocyte:
A. Target cell
B. K3Fe(CN)6 B. Codocytes
C. Sterox C. Mexican hat cell
D. KH2PO4 D. All
30. How much volume of blood is needed for 38. How many basophilic normoblasts are
cyanmethemoglobin method? formed after its immediate precursor
A. 10 uL divides?
A. 4
B. 20 uL B. 2
C. 8
C. 30 uL D. 16
D. 40 uL 39. The disappearance of multiple nucleioli
31. Used as an index of the presence of active occurs in:
disease like tuberculosis, rheumatoid A. Orthochromatophilic erythroblas
diseases and other inflammatory B. Basophilic erythroblast
processes: C. Reticulocyte
A. Hct D. Polychromatophilic application
B. Hgb ct 40. The following may falsely elevate the Hct,
C. ESR EXCEPT:
D. EOFT A. Sickle cell
32. Which of these anticoagulant is NOT used B. Inadequate centrifugation
for PBS staining due to giving off bluish C. IV fluid contamination
discoloration of the smears? D. Pronged tourniquet application
A. Heparin
B. EDTA 41. RBC inclusion that cannot be stained by
Wright stain
C. Citrate A. Heinz
D. All of them B. Howell-Jolly

33. Which of the following poikilocyte is C. Basophillic stippling

caused by trauma? D. Mayhegglin
1. stromatocytes 42. RBC inclusion commonly associated with
2. Spherocyte G-6PD deficiency:
3. Sickle cell A. Heinz
4. Darcocytes B. Howell-Jolly
A. 1,2,3
C. Basophillic stippling
B. 1,3 D. Mayhegglin
43. Confirmation of the RBC inclusion is by 51. What is the antibody associated with cold
using Perl’s staining reaction: agglutinin syndrome?
A. Heinz A. IgG
B. Howell-Jolly B. IgM
C. IgE
C. Basophillic stippling D. IgA
D. Mayhegglin
44. Poikilocyte associated with renal
insufficiency:
A. Echinoyte
B. Burr cell
C. Acanthocyte
D. Tear drop cell
45. Associated with Myelofibrosis:
A. Acanthocyte

B. Target cell
C. Codocyte
D. Elliptocyte
46. A non-cellular defect of the RBC
A. Sickle cell
B. Microangiopathic syndrome

C. G-6PD deficiency
D. Thallsemia
47. Which of the following abnormalities are
seen in patients with HIV/AIDS?
A. Neutropenia

B. Lymphopenia

C. Thrombocytopenia
D. Eosinophenia
48. Macrocytic anemia is not seen in which of
the following conditions?
A. Folic acid deficiency

B. latum infection
C. Thalassemia
D. Vit. B12 deficiency
49. Which of the following stains will
demonstrate ringed sideroblasts in a bone
marrow?
A. Wright’s
B. Peroxidase
C. Sudan Black
D. Prussian blue

50. What is the most specific test for

establishing a diagnosis of pernicious
anemia, differentiating the other causes of
Vit. B12 deficiency?
A. Heat stability test
B. RBC enzymes

C. Schilling’s test
D. Hb electrophoresis