Deck 2: Bone Marrow

Question 1

The most appropriate site for a successful bone marrow aspiration in an adult patient would be:

A) Calvariae
B) Scapula
C) Iliac crest
D) Long bones
E) None of the above

Answer 1

Iliac crest

Question 2

In a normal adult hematopoiesis is observed primarily in which location?

A) Liver
B) Spleen
C) Yolk sac
D) Bone marrow
E) Lymph nodes

Answer 2

Bone marrow

Question 3

Hematogones are thought to be committed progenitor cells of what lineage?

A) Granulocytic
B) Platelets
C) Erythrocytic
D) Monocytic
E) Lymphoid

Answer 3

Lymphoid

Question 4

Which cells have the two unique biologic characteristics of self-renewal and multilineage differentiation?

A) Pronormoblasts
B) Stem cells
C) Myeloblasts
D) Lymphoblast
E) Eosinophil

Question 5

The average life span of a circulating neutrophil is:

A) 6 to 10 hours
B) 6 to 10 days
C) 1 to 3 hours
D) 1 to 3 days
E) 24 hours

Question 6

How many nucleated cells must be classified in a bone marrow differential count?

A) 50-100
B) 100-500
C) 500-1000
D) >1000
E) None of the above

Question 7

At what age do fat cells begin to increase in the bone marrow?

A) 10 years
B) 6 months
C) 4 years
D) 2 years
E) None of the above

Question 8

Under which magnification should bone marrow initially be examined?

A) ( $\times$ 40)
B)( $\times$ 4)
C) ( $\times$ 10)
D) ( $\times$ 100)
E) None of the above

Question 9

Which would be the appropriate site for marrow studies in a young child?

A) Upper tibial bone
B) Lower tibial bone
C) Iliac crest
D) Sternum
E) None of the above

Question 10

Under appropriate stimulation the mature lymphocytes of the peripheral lymphoid organs undergo

A) Antigen-dependent effect on cell proliferation
B) Kinin or antibody production
C) Antibody production only
D) A and B
E) All of the above

Question 11

One-third of all circulating platelets are sequestered in which organ?

A) Bone marrow
B) Lymph nodes
C) Spleen
D) Thymus
E) Liver

Question 12

Which of the following nondividing cells comprise the granulocytic maturation storage pool in the bone marrow?

A) Segmented neutrophils
B) Bands
C) Metamyelocytes
D) All of the above
E) None of the above

Question 13

The hematopoietic system consists of which of the following?

A) Bone marrow
B) Lymph node
C) Spleen
D) Liver
E) All of the above

Question 14

Why is the bone biopsy the most reliable assessment of cellularity?

A) A large amount of tissue is evaluated.
B) A small amount of tissue is evaluated.
C) It offers a more sterile procedure.
D) Marrow iron can be demonstrated with appropriate stain.
E) None of the above

Question 15

The myeloid-to-erythroid ratio represents:

A) The ratio of granulocytic and their precursors to nucleated erythrocytes and their precursors
B) The ratio of myeloid to non-nucleated erythroid cells
C) The ratio of myeloid to eosinophilic cells
D) The ratio of monocytoid to erythroid cells
E) None of the above

Question 16

What is the site of erythropoietin production?

A) Spleen
B) Kidney
C) Liver
D) Bone marrow
E) None of the above

Question 17

What is the main function of the bone marrow?

A) To provide oxygenated cells to the tissues
B) Self-renewal of stromal cells
C) To maintain a steady supply of mature hematopoietic cells to circulation
D) To regulate iron storage and transfer
E) None of the above

Question 18

Which blood cell aids hematopoiesis by the direct transfer of iron to erythroid precursors?

A) Monocyte
B) Macrophage
C) Erythrocyte
D) Lymphocyte
E) None of the above

Question 19

Why is a clotted marrow specimen unacceptable for hematologic smears?

A) Cells would not stain.
B) Fibrin threads would impede spreading.
C) Fluid would be discolored.
D) All of the above
E) None of the above

Question 20

In adults, fat cells average about what percentage of the total volume in the vertebrae and flat bones of the pelvis?

A) 20%
B) 80%
C) 50%
D) 10%
E) 90%

Question 21

On Wright's stain hemosiderin will stain as:

A) Brownish-blue
B) Golden-yellow
C) Reddish-orange
D) Purple
E) None of the above

Question 22

How is iron stored in the bone marrow?

A) Hemosiderin
B) Transferrin
C) Ferritin
D) Erythropoietin
E) None of the above

Question 23

Which of the following granulocytic cells are included in the proliferating pool of the bone marrow?

A) Myeloblasts
B) Promyelocytes
C) Myelocytes
D) All of the above
E) None of the above

Question 24

Marrow erythroblasts containing bright-blue iron specks when stained are called:

A) Sideroblasts
B) Siderocytes
C) Histiocytes
D) Erythrocytes
E) None of the above

Question 25

What bone marrow interpretation would be assessed to a complete count that showed neutrophilia with an increase in bone marrow cellularity, and increased myeloid-to-erythroid ratio?

A) Granulocytic hypoplasia
B) Marrow hypoplasia
C) Granulocytic hyperplasia
D) Marrow hyperplasia
E) None of the above

Question 26

The presence of megakaryocytes clusters and promegakaryocytes in every field of a bone marrow differential is indicative of:

A) Megakaryocytic hypoplasia
B) Thrombocytopenia
C) Megakaryocytic hyperplasia
D) Christmas disease
E) None of the above

Question 27

The normal myeloid-to-erythroid ratio in a bone marrow aspirate from a normal adult is approximately:

A) 1:1
B) 2:1
C) 4:1
D) 6:1
E) None of the above

Question 28

The EDTA chelation method is used for iron studies in bone biopsy. What purpose does it serve?

A) Binds hemosiderin
B) Binds magnesium
C) Binds calcium
D) Binds ferritin
E) None of the above

Question 29

An increase in erythroid cellularity without disruption of the normal myeloid-to-erythroid ratio is termed:

A) Erythrocytic hypoplasia
B) Erythrocytic hyperplasia
C) Granulocytic hyperplasia
D) Granulocytic hypoplasia
E) None of the above