Question 1

An instrument printout indicates an MCV of 63 fl and an MCHC of 26 g/dl.How will the red cells appear under the microscope?

Accepted Answer

The MCV (mean corpuscular volume) of 63 suggests that the red cells are smaller than normal (microcytic) and the MCHC (mean corpuscular hemoglobin concentration) of 26 indicates decreased hemoglobin concentration within each cell, making them appear pale or hypochromic. Therefore, the red cells will appear microcytic and hypochromic under the microscope. The best choice is C, microcytic and hypochromic.

Question 2

How does the mean cell volume value classify cells?

Accepted Answer

Mean cell volume (MCV) is a measurement of the average size of a red blood cell. It classifies cells into three categories based on size: normocytic, microcytic, and macrocytic.

Question 3

Which RBC inclusion is characterized by diffusely staining RNA precipitate that can be seen when blood is stained with Wright's stain?

Accepted Answer

Basophilic stippling is characterized by diffusely staining RNA precipitates seen in RBCs when stained with Wright's stain. Heinz bodies are denatured hemoglobin precipitates, Pappenheimer bodies are iron-containing granules seen in RBCs, and Howell-Jolly bodies are nuclear remnants found in RBCs.

Question 4

An instrument printout reveals an RDW of 33.Which of the following would best correlate with those results?

Accepted Answer

The RDW (Red Cell Distribution Width) measures the variation in the size of red blood cells. An RDW of 33 is significantly elevated, indicating a wide variation in red blood cell sizes. This is best correlated with the presence of a dimorphic cell population on the peripheral blood (PB) smear, as it suggests the coexistence of two distinct populations of red blood cells, which would result in a high RDW.

Question 5

Codocytes are associated with all of the following conditions except:

Accepted Answer

Codocytes, also known as target cells, are associated with conditions that affect the shape and flexibility of red blood cells, such as iron-deficiency anemia, thalassemias, and hemoglobinopathies. They are not typically associated with hemolytic anemia, which involves the destruction of red blood cells.

Question 6

A patient sample had a retic count of 5%.The patient's hematocrit was 25%.Normal hematocrit is 45%.What is the corrected reticulocyte count?

Accepted Answer

The corrected reticulocyte count formula is (patient retic count x normal hematocrit) / patient hematocrit. 
Plugging in the values, we get: (5% x 45%) / 25% = 0.222 or 0.22 (rounded to two decimal places) or 2.78%. Therefore, the corrected reticulocyte count is 2.78%.

Question 7

Which of the following laboratory values would best correlate with moderate polychromasia on the peripheral blood smear?

Accepted Answer

Polychromasia is an increase in the number of immature red blood cells (reticulocytes) in the peripheral blood smear. Therefore, a high retic count would best correlate with moderate polychromasia. A low RBC count would actually be contradictory to the presence of polychromasia, as it would indicate a decreased number of red blood cells in general. Schistocytes and a low PLT count are not related to polychromasia.

Question 8

All of the following laboratory tests can be used for evaluation of hemolysis except:

Accepted Answer

Haptoglobin, hemopexin, and bilirubin are all laboratory tests that can be used to evaluate hemolysis. Haptoglobin and hemopexin are both proteins that bind to free hemoglobin and prevent its oxidative damage to tissues, and their levels decrease in the presence of increased hemolysis. Bilirubin is a breakdown product of hemoglobin that accumulates in the blood when red blood cells are destroyed. Total protein, on the other hand, is not directly related to hemolysis and is a general measure of the amount of protein in the blood.

Question 9

How would you differentiate between an acanthocyte and an echinocyte?

Accepted Answer

Acanthocytes have irregularly spaced and varying length spikes or projections, while echinocytes have evenly spaced and uniform length spikes. The other options (B, C, and D) are not reliable distinguishing characteristics between the two types of cells.

Question 10

A peripheral blood smear has an even distribution of both normocytic normochromic cells and microcytic hypochromic cells.What is this phenomenon called?

Accepted Answer

A dimorphic cell population refers to the presence of two distinct populations of cells in a peripheral blood smear, which can be differentiated based on their size and/or color. In this case, the presence of both normocytic normochromic cells and microcytic hypochromic cells indicates a dimorphic cell population. Extramedullary hematopoiesis refers to the production of blood cells outside of the bone marrow, nuclear-cytoplasmic asynchrony refers to a mismatch between the size of a cell's nucleus and its cytoplasm, and monoclonal cell population refers to a population of cells that all originate from the same clone.

Question 11

Red blood cell survival is best measured by which of the following when hemoglobin levels are stable?

Accepted Answer

The best measure of red blood cell survival depends on the specific disorder being evaluated, as different tests may be more sensitive and specific for different conditions.

Question 12

What is the RPI for this patient with a reticulocyte count of 5% and hematocrit of 25%.Normal hematocrit is 45%.

Accepted Answer

The answer of What is the RPI for this patient...

Question 13

What is one of the disease states associated with the presence of target cells?

Accepted Answer

The answer of What is one of the disease states...

Question 14

A patient has hemolytic anemia.An instrument printout reveals a reticulocyte count of 8%, marked polychromasia and moderate schistocytes, and an MCV of 88 fl.What can be concluded about the bone marrow response to this hemolytic anemia?

Accepted Answer

The answer of A patient has hemolytic anemia.An instrument printout...

Question 15

All of the following are classic signs of anemia except:

Accepted Answer

Nosebleeds are not a classic sign of anemia. The other options are commonly associated with anemia.

Question 16

A patient sample has an RBC count of 4.30 x 10¹² ? This is a superscript ? /L and a reticulocyte count of 4%.What is the absolute retic count? This is a superscript

Accepted Answer

The absolute reticulocyte count is calculated by multiplying the RBC count by the reticulocyte percentage: 4.30 x 10^12/L * 0.04 = 172 x 10^9/L.

Question 17

Howell-Jolly bodies are red cell inclusions associated with what disease state?

Accepted Answer

Howell-Jolly bodies are seen in megaloblastic anemia, which is characterized by impaired DNA synthesis and abnormal maturation of blood cells. The presence of Howell-Jolly bodies indicates ineffective erythropoiesis, as these are remnants of the nucleus that are normally removed during maturation of red blood cells in the bone marrow.

Question 18

An instrument printout has an RPI of 1.3, a hemoglobin of 7 g/dL and an MCV of 112 fl.What can be concluded from this?

Accepted Answer

The elevated MCV and low hemoglobin suggest a macrocytic anemia, which is often due to a nuclear maturation defect such as vitamin B12 or folate deficiency.

Question 19

A patient with a bleeding problem is complaining to her physician about excessive fatigue.Physical examination reveals a thin, pale woman with pale mucosal membranes.Significant CBC findings include an MCV of 70 fl.Based on these findings follow-up testing should be ordered for:

Accepted Answer

The answer of A patient with a bleeding problem is...

Question 20

A patient presents with a RPI of greater than 2 and macrocytic morphology of the red blood cells.Which survival defect does this most likely represent?

Accepted Answer

A RPI (Reticulocyte Production Index) greater than 2 indicates an increased production of reticulocytes, which is typically seen in response to hemorrhage or hemolysis, where the body is compensating for the loss of red blood cells.

Quiz 8: Introduction to Anemia