Maam Arian

Question Answer Rationale

1. General characteristics of an Highly Basophilic

immature cell

A. Indented Nucleus Immature cells are bluish

B. Highly Basophilic in color (basophilic) and
C. Less Basophilic becomes less basophilic
D. Low N:C ratio as they mature

2. Index of variation in red cell size RDW

A. PDW
B. MPV
C. RCMI
D. RDW

3.

4.

5. How many cells counted in the 2nd 92

Chamber?

A. 85
B. 88
C. 90
D. 92

6. Most commonly used RBC count Isotonic Saline Isotonic saline is the most
diluent used; Dacies is the
preferred diluent
A. Isotonic saline
B. Dacies
C. Hayem’s Solution
D. Bethell’s

7. In manual WBC counting, up to 11 0.5 mark is where you draw

what mark would you draw the the blood sample
diluting fluid?
101 mark is where you
A. 101 draw the RBC diluent
B. 11
C. 0.5
D. 1

8. In the cyanmethemoglobin method Methemoglobin

for hemoglobin determination,
Potassium ferricyanide converts
 iron from ferrous to ferric to form
what compound?

a. Methemoglobin
b. Cyanmethemoglobin
c. Sulfhemoglobin
d. Hemoglobin

9. In hematocrit determination, the dry 4-6 mm

end of the microhematocrit tube
should be sealed for?

a. 4-6 mm
b. 5-6 mm
c. 4-5 mm
d. 5-7 mm

10. Which of the following is NOT MCH: Hypochromic

matched?

a. MCV: macrocytic
b. MCV: microcytic
c. MCH: Hyperchromic
d. MCHC: Hypochromic

11. Which of the following causes 1, 2, 4, 5

Basophilia?

1. Allergies
2. CML
3. Autoimmune Disease
4. Hodgkin’s Disease
5. Oral Contraceptives
6. Parasitic Infections

12. Each scale in Neubauer’s slide 3x3 mm

measures?

a. 3x3 mm
b. 1x1 mm
c. 9x9 mm
d. 4x4 mm

13. Uses Brilliant Cresyl Blue as stain Reese Ecker

for Manual Platelet Counting

a. Brecker Cronkite
b. Reese Ecker
c. Guy and Leake
d. Duke and Ivy’s
14. Uses Low-angle and high-angle ADVIA 2120i
light and refractive index scatter for
platelet counting. What is this hema
analyzer?

a. Unicel DxH 800

b. XN series
c. CELL-DYN Sapphire
d. ADVIA 2120i

15. Associated with round, solid 1, 2, 3

staining, dark blue to purple
inclusion that is frequently seen in
mature erythrocyte but may also be
seen in immature nucleated cell

1. Hemolytic Anemia
2. Pernicious Anemia
3. Physical dystrophy of the
spleen
4. Defective or accelerated
heme synthesis

16. Associated with multiple, spiny

projection, irregularly spaces and of
variable size and may be seen in
cirrhosis of the liver and hemolytic
anemia?
a.

17. Slight decrease in platelet 100,000 -

concentration 149,000/uL
a. 50,000-99,000/uL
b. 100,000-149,000/uL
c. 150,000-199,000/uL
d. 0-49,000/uL

18. Uses a pattern of consecutive Bettlement/Serpenti

fields beginning near the tail in a ne
horizontal edge: count 3
consecutive horizontal edge fields,
count two fields towards the center
of smear, count two fields
horizontally, count two fields
vertically to the edge

19. In hematocrit determination, Decrease

hemolysis causes
● Increase
● Decrease
 ● Unaffected

20. RBC inclusions will lead to _____ Increase

platelets
● Increase
● Decrease
● Unaffected

21. Maximum hemoglobin capacity of 37

an RBC
● 35
● 40
● 37
● 42

22. This pathway is responsible for the Rapoport-Luebering

production of 2,3 BPG Pathway
● Hexose Monophosphate
Pathway
● Embden-Meyerhof Pathway
●
● Methemoglobin Reductase
Pathway

23. Normocytic, normochromic anemia Myelopthisic

● Myelopthisic Anemia anemia
● Sideroblastic Anemia
● Pernicious Anemia
● Anemia of Chronic Disease

24. Which of the following cytokines is FLT3 Ligand

required very early in the
differentiation of a hematopoietic
stem cell?
● IL-2
● IL-8
● EPO
● FLT3 ligand

25. Which one of the morphologic Condensation of

changes occur during normal blood nuclear chromatin
cell maturation?
● Increase in cell diameter
● Development of cytoplasm
basophilia
● Condensation of nuclear
chromatin
● Appearance of nucleoli
Ma’am Isid

Question Answer Rationale

1. Among the choices, which of the Yellow top tube,

following is the correct order of Sodium Citrated
draw in performing venipuncture? tube, Plain tube,
Heparinized tube,
EDTA tube, Gray

2. One of the examples of clot Factor VII (Factor

activators include glass/silica XII is considered)
particles that activate what factor to
the coagulation pathway?
●

3. Tubes with anticoagulant must be Immediately

gently inverted _____ after
collection.
● Immediately
● After 1 minute
● When the wound heals
● As time pass by

4. The advantage of using 1-inch It provides better

needle is that: control during
● It provides better control venipuncture.
during venipuncture.
● It provides very nice blood
● It is very easy to manipulate
● Used to avoid blind shooting

5. OSHA stands for: Occupational

● Occupational Exposure to Exposure to
Bloodborne Pathogens Bloodborne
Standard Pathogens
● Occupational Exit to Standard
Bacteriology and other
Pathogens Standard
● Occupation Exposure to
Bacteria and other
Pathogens Standard
● Occupational Expelled to
Blood Banking with other
Partners Standing

6. Common skin antiseptic: 70% isopropyl

● 70% isopropyl alcohol alcohol
● 10% povidone iodine
● 40% alcohol
 ● Distilled water and
hypochlorite

7. Why basilic vein is last choice of All of the choices

site to perform venipuncture?

● All of the choices

● Due to increased risk of
injury to the median nerve
● Due to the possibility of
accident puncture to the
brachial artery
● because it is movable

8. How does a phlebotomist palpate With his/her index

the vein before blood collection? finger

9. Is there a possibility that a Yes

collection tube has insufficient
vacuum?

10. What happen if you puncture infant Osteomyelitis

uging lancet more than 2 mm
deep?

11. The following are the reasons why 2,3,4,5,6

we need to reject blood sample,
1. Request details & tube
identification matches- ACCEPT
2. Unlabeled tubes
3. Hemolyzed samples
4. Right date but wrong time
collection
5, Clotted EDTA tube
6. Lipemic samples

12. Why the blood is slightly alkaline? Because the ratio of Characteristics of the blood
bicarbonate and 1
carbon dioxide in Fluid in vivo
our blood is 20:1 2
Red colored- hemoglobin
3.
Slightly alkaline- 7.35-7.45
(Bicarbonate:Carbon
dioxide) (20:1)
4. Average specific gravity
of 1.005
5,
Thick and viscous (3,5-4.5
times thicker than water)
 6.
Makes up to 75-85 mL
blood per kg bu
7. There are about 20
grams of solids per 100 mL
of blood.

13. 1,3,4,5,6,7,9
The following are the functions of
our blood:
1. Respiratory
2. Have a shelf life of 6 days.- NOT
A FUNCTION OF BLOOD
3. Excretory
4. Buffering action
5. Maintenance of body
temperature.
6. Transport hormones.
7. Defense mechanism
8. Normally excreted in the urine.-
NOT NORMALLY EXCRETED
9. Nutritional

14. The tests that are conducted when It measures the

Heparinized tube was used are resistance of red
ABG & OFT, what is OFT? blood cells against
hemolysis by
adding saline
solution.

15. Black top contained ________ 3.8% Sodium citrate

and used for ESR & Westereren
________ &_______.

16. What is/are the basic components All Of the choices BASIC COMPONENTS OF
of hematology analyzers? Hydraulics MOST HEMA ANALYZERS
pneumatics
Hydra Aspirating unit,
Electrical systems
ulics dispensers,
dilutors,
mixing
chambers,
aperture
baths, flow
cells and
hemoglobinom
eter.

pneum Vacuums,
 atics pressure for
operating
valves, moving
the sample
through the
systems.

Electri Electronic
cal analyzers and
Syste computing
ms circuitry for
processing
data

17. The doctor requested for Protime, Citrated tube

CBC and FBS in a certain patient.
As a MTOD, which collection tube
you must fill
with the blood sample first?

18. A blood culture and sensitivity test Using the two-step

were requested by a pedi doctor to procedure with the
the newborn baby suspected of use of 70%
neonatal isopropy/ alcohol &
sepsis. When collecting blood 4-20% povidone
sample for this certain test, what is iodine,
the one thing you need to do as a
MTOD?

19. An intern collected a blood, after it All of the choices

clotted the staff noticed the red
coloration of the serum. What is/are The intern uses too
the small needle.
possible reason why the blood
hemolyzed? The intern looked
for the vein about 5
minutes before
collecting.

The patient was

diagnosed with
erythrocyte disorder

20. The hematology analyzer was Allot the choices Types of errors
ringing and projected red light at the encountered in Hematology
top of the screen. What is/are the Because of Analyzer
possible Excessive lysing
Instrument 1-Aperture
reason/s why? RBCs
al Errors plugs-
most
Because of
common
Improper settings of
problem in
aperture
cell
current/threshold
counting
[Link]
Because of the
in the
instrumental error
sample-
vigorous
mixing
3.
Extraneous
electrical
pulses
4.
Excessive
lysing
RBCs
[Link]
settings of
aperture
current/thre
shold

Nature of [Link]
the platelets-
Specimen may be
counted as
RBCs and
WBCS
[Link]
s of WBC
cytoplasm
(leukemla
therapy)-
counted as
platelets or
RBÇ
[Link]
abnormal
RBCs-
falsely
Increase
WBC
counts.
21. In hematology analyzer, giant False increase
platelets can cause: WBCs

22. A patient diagnosed with leukemia All of the choices

were collected a blood sample 6
hour after her therapy, what will be False increase
seen in the platelets
hematology analyzer?
False increase
RBCs

Increases
Fragments of WBCs

23. It is provided by many high-volume Blood Cell

instruments to provide size Histogram
distribution of the different cell
population.

24. The use of cuff to obese patients >40mmHg

was advised when collecting blood,
we must inflate the cuff up to:

25. In electrical impedance, it is the All the choices RF/ Radiofrequency/'

current that measure conductivity. High-voltage
RF resistance electromagnetic current

Radiofrequency

High-voltage
electromagnetic
current
 DAY 2 TOPIC LONG QUIZ

QUESTION ANSWER RATIONALE

1. The ISI in the INR Sensitivity The International Normalised Ratio

represents the reagents: (INR)/International Sensitivity Index (ISI)

2. Which of the following best Monitors heparin

describes APTT? therapy

3. Which of the following Factor XII Factor XII and Prekallikrein

factor deficiencies is ● No bleeding, Increased thrombotic
associated with either no tendency
bleeding or only minor
bleeding tendency, even
after trauma or surgery?

4. Prothrombin is: A protein formed

by the liver in the
presence of
Vitamin K

5. Platelet aggregation is Calcium ions

dependent in vitro on the
presence of:

6. The presence of excessive Erythrocyte

rouleaux formation on a sedimentation rate
blood smear is often
accompanied by an
increased:

7. Which of the following Small fibrin clots in

factor will cause a sample
decrease erythrocyte
sedimentation rate?

8. Medical Technologist Raffy Stop the test

Tulfo received a request method and inform
for Clotting Time test for the Resident on
Duty present
patient Cardo Dalisay who
due for surgery tomorrow.
Raffy went on conducting
the Clotting Time Test, but
15 minutes has passed the
blood still not able to clot,
what should be done next?
9. APTT PT is extrinsic

Test that measures the

integrity of Intrinsic and
Common Pathway

10. Some specimens

have low
Why do we need to do hematocrit thus,
corrected reticulocyte the percentage of
reticulocytes may
count? be falsely elevated
and the whole
blood contains
fewer RBCs

11. In the Routine Method of 100x

Reticulocyte counting what
is the magnification of
microscope is used?

12. A storage pool disorder Hermansky-pudlak Gray platelet

that is characterized by the syndrome ● Abnormal dense tubular system
lack of beta/dense ● Lacks alpha granules
granules ● Platelets appear larger and have light
gray color
Hermansky-pudlak syndrom
● Lacks beta/dense granules
● Tyrosine positive occulocutaneous
albinism
● Ceroid-like pigment accumulation in
macrophages
● Bleeding tendencies
WAS(Wiskot-Aldrich Syndrome)
● Sex linked (affecting males)
● Lacks storage pool nucleotides
● Recurrent infections
● Eczema
● Trombocytopenia caused by ineffective
production and increase sequestration
Chediak-higashi
● Associated to deficiency of beta
granules
● Increased ATP: ADP ratio
● Albinism, recurrent infections, and
giant lysosomes
13. All of the following are the NOTA
activators used in APTT
testing EXCEPT:

14. Characterizes by normal Glanzmann

platelet count and thrombasthenia
morphology, significantly
prolonged bleeding time
and Platelet aggregometer
profile shows failure to
aggregate with all agents,
except von Willebrand
factor

15. Increase in mean platelet Idiopathic

volume (MPV), decreased Thrombocytopenia
platelet count, increased Purpura
bone marrow platelet
production, increased
marrow megakaryocyte, a
normal bleeding time, and
platelet-associated IgG.
Refers what condition? TTP- three times more prevalent in women
than men at an average of 35 years.
Microangiopathic hemolytic anemia,
thrombocytopenia, neurologic symptoms (e.g.
headaches, seizures), fever, and renal
disease. Prothrombin time (PT) that is
normal, an activated partial thromboplastin
time (APTT) that is normal, and fibrinogen
level that is normal.

Thrombocytopenia associated with HIV:

*Characteristics similar to classic ITP:
● Abundant megakaryocytes
● Occasional giant platelets
● Immune origin
● Absence of splenomegaly
*Characteristics diff. from ITP:
● Greater levels of bound antibody
● Involvement of immune complexes

16. An in vivo screening test of Bleeding time

platelet function by timing
the length it takes for
platelets to plug broken
capillaries
17. In ESR, clotted sample Decrease
causes

18. External diameter of 3.0mm 2.5 mm is internal

Wintrobe tube for
Erythrocyte Sedimentation
Rate

19. The sedimentation rate is directly

______________ to the proportional,
weight of the cell inversely
proportional
aggregate and
_____________ to the
surface area.

20. 1,2,3
Which of the following Midas III-Plus Automated Stainer Fully automated, benchtop
hematology machines can stainer with a small footprint. It is
designed to perform routine
perform automated hematology and bacteriology
smearing? staining effortlessly. It utilizes the
dip slide staining technique
which ensures uniform staining
1. Midas III for every sample. This reduces
stain consumption up to 50%
Rodak’s
2. Hema-Tek HEMA-TEK 2000 Provides a continuous-feed
loading platform that eliminates
3. Coulter wasted time associated with
batch staining methods
4. Horiba H500
Beckman DxH Slidemaker System delivers first pass, high
Stainer II Cellular Analysis quality slides that help speed up
System the decision-making process and
aids with cell classification and
diagnosis

Horiba Humizen H500 27-parameter hematology

analyzer

21. Which cell/inclusion bodies All the choices

can be stained by RBC Inclusions stained by New Methylene Blue
supravital stain? Hemoglobin H
Color Remarks
Heinz bodies
Howell Jolly Deep purple Nuclear DNA fragment
Bodies
Reticulocyte
Heinz Bodies Light blue Present in peripheral edge of RBC
green
Denatured and precipitated
hemoglobin

Pappenheimer Purple Appear as several granules in a

bodies small cluster

Confirmation of presence, use:

-Wright-stained
-Prussian blue stained
 -Hemosiderin in the mitochondria

Hemoglobin H Greenish- Multiple small dots

bodies blue
Seen in a form of alpha
thalassemia

22. In which of the following All the choices

condition is basophilic Inclusion Content Visualization Associated Condition
stippling a possible Lead poisoning
Basophilic Aggregated Wright stain Lead poisoning
finding? Megaloblastic
stippling RNA (deep blue-
purple) Arsenic poisoning
anemia
Supravital Pyrimidine-5-
stain nucleotidase
Sideroblastic deficiency
anemia Anemias with Impaired
hemoglobin synthesis
(thalassemias)

Refractory anemias

Alcoholism

Megaloblastic anemias

23. Which of the following They are remnants

statements is true about of the mitotic Inclusion Content Visualization Associated
cabot rings? spindle Condition

Cabot Rings are Wright stain Cases of

rings probably (reddish abnormal
microtubules violet) erythropoiesis
remaining
from a Pernicious
mitotic anemia
spindle
Lead poisoning

24. Presence of these Heinz bodies

inclusion indicate unstable Inclusion Content Visualization Associated
hemoglobins. Condition

Heinz Denatured Supravital G6PD

bodies and stain. (Not
precipitated demonstrated Drug induced
hemoglobin by wright`s hemolytic
stain) anemia

Unstable
hemoglobin
disease:
-Congenital
Heinz body
hemolytic
anemia
 Unstable
Hemoglobin
variants:
-Hb Koln, Hb
Casper, Hb
Genova, Hb
Gun Hill, Hb
M-Saskaatoon,
Hb Bristil, Hb
Torino, Hb
Seattle

Favism
(Sensitivity to
fava bean)

Howell Remnants Wright stain Megaloblastic

Jolly of nuclear (reddish-blue- anemia
bodies chromatin purple)
DNA After
New splenectomy
Methylene
Blue

Feulgen
reaction
(stain for
DNA)-
Positive

Appears
singly in a
cell, round

25. Which of the following are the 1,2,3

functions of the neutrophil? WBC Function and Remarks

1. Phagocytosis and Neutrophil 1. Phagocytosis and destruction

destruction of foreign of foreign material and
material and microorganisms
2. Generation of NET
microorganisms (Neutrophil Extracellular Tap)
2. Generation of NETs - Chains of DNA
3. Secretes variety of - Presence of
cytokines and enzymes attached
- Trap and kill gram
transcobalamin 1. positive and gram
4. Induce B cells to negative bacteria,
synthesize IgE fungi.
3. Secretory function (source of
cytokines and transcobalamin
1 for proper absorption of Vit.
B12)

Eosinophil Hallmark of allergic disorder.

Increase in helminthic infections

Basophils 1. Have IgE receptors on their

surface membrane resulting
 granule release
2. Induce B cells to synthesize
IgE
3. Involved in controlling
helminth infection (promote
eosinophilia and contribute to
efficient worm expulsion

Monocyte Largest cell in normal blood

Best identified with Non Specific
Esterase stain →Strong
positive reaction

Lymphocyte T cells and B cells - Adaptive

immunity
NK cells - innate immunity

26. Presence of holes all over increased level of

the blood smear film is lipids Unusual findings in Probable reason
caused by, PBS

27. Patient with increased blood bluer than

proteins can make the blood normal
Blood film bluer than Patient has increased
film _____ normal blood proteins (Plasma
cell myeloma)

Grainy appearance RBC agglutination (Cold

Hemagglutinin Disease)

Holes all over the film Patient has increased

lipid levels

Blue specks (out at the Markedly increased WBC

feather edge) counts and platelet
counts

28. CASE 1 regular,

spiculated
CASE 1 QUESTION 1 surface

Describe the cell shown

29. CASE 1 QUESTION 2 burr cell other name: echinocyte

The cell shown in the picture

is also known as,

30. CASE 1 QUESTION 3 uremia

The disease associated with

the poikilocyte shown,

31. CASE 2 18.8 x 10^9/L 94/10 x 2,000 = 18,800

Yuyin wanted to validate the

WBC count result released
by the hematology analyzer
which is 38 X109/L. She
performed PBS and counted
94 WBCs in 10 fields of
HPOs

CASE 2 QUESTION 1

What is the estimated WBC

count?

32. CASE 2 QUESTION 2 compare the kay malayo ang girelease ni machine sa
estimated WBC giestimate ni Yuyi
What must Yuyin do next? count and the
machine WBC
count
33. CASE 2 QUESTION 3 All of the choices
What are the possible
reasons in connection the Presence of
calculated WBC count platelet clump
released by the machine?
Presence of
immature/ blast
cell

34. A general indicator of the rate Reticulocyte

of erythrocyte production that Production Index
increases above normal in
anemias

35. Among the choices what is RPI = corrected

the formula used in reticulocyte
calculatRPI RPI? count/maturation
time in peripheral
blood

36. Statement 1:RPI >3 means Both statements

there is adequate bone are true
marrow response.
Statement 2:RPI <2 means
there is sufficient bone
marrow response

37. Nucleated RBC

38. Endothelial Cell

39. Supravital stain