ASCP Hematology Technologist

What is the normal range for a white blood cell (WBC) count in adults?

• A1,000-3,000/mcL
• B4,500-11,000/mcL
• C15,000-25,000/mcL
• D50,000-100,000/mcL

Which RBC index measures the average size of red blood cells?

• AMCH
• BMCHC
• CMCV (mean corpuscular volume)
• DRDW

What does an elevated RDW (red cell distribution width) indicate?

• AUniform RBC size
• BIncreased variation in RBC size (anisocytosis)
• CNormal hemoglobin
• DHigh platelet count

Which cell appears as a large, bilobed nucleus with bright pink cytoplasmic granules on a peripheral blood smear?

• ANeutrophil
• BEosinophil
• CBasophil
• DMonocyte

What RBC morphology is characterized by target-shaped cells with a central area of hemoglobin surrounded by a pale ring?

• ASpherocytes
• BTarget cells (codocytes)
• CSchistocytes
• DSickle cells

What is the normal prothrombin time (PT) range?

• A5-8 seconds
• B10-14 seconds
• C25-35 seconds
• D45-60 seconds

An aPTT mixing study corrects to normal. What does this indicate?

• AThe presence of an inhibitor (e.g., lupus anticoagulant)
• BA factor deficiency that is corrected by the normal plasma in the mix
• CThe patient is on heparin therapy
• DThe test is invalid

What is the characteristic peripheral blood smear finding in iron deficiency anemia?

• AMacrocytic, hyperchromic cells
• BMicrocytic, hypochromic cells with increased RDW
• CNormocytic, normochromic cells
• DSchistocytes and helmet cells

What does a left shift in the WBC differential indicate?

• AIncreased mature neutrophils
• BIncreased immature granulocytes (bands, metamyelocytes, myelocytes) in peripheral blood,…
• CIncreased lymphocytes
• DDecreased eosinophils

Which hemoglobin variant causes sickle cell disease?

• AHemoglobin C
• BHemoglobin S
• CHemoglobin E
• DHemoglobin F

What is the difference between alpha-thalassemia and beta-thalassemia?

• AAlpha affects adults only; beta affects children only
• BAlpha-thalassemia involves reduced or absent alpha-globin chain production; beta-thalasse…
• CThey are the same disease
• DAlpha causes sickling; beta causes target cells

Which WHO classification criterion defines acute leukemia?

• AGreater than 5% blasts in bone marrow
• BGreater than 10% blasts in bone marrow
• CGreater than 20% blasts in bone marrow or peripheral blood
• DGreater than 50% blasts in bone marrow

What is the characteristic cytochemical stain for acute myeloid leukemia (AML)?

• APAS (periodic acid-Schiff)
• BMyeloperoxidase (MPO) positive
• CTerminal deoxynucleotidyl transferase (TdT) positive
• DNonspecific esterase negative

What is the significance of Auer rods in blast cells?

• AThey indicate ALL
• BThey are pathognomonic for myeloid lineage and confirm AML
• CThey indicate chronic lymphocytic leukemia
• DThey are normal findings in monocytes

What bone marrow finding is characteristic of aplastic anemia?

• AHypercellular marrow with increased blasts
• BHypocellular marrow with replacement by fat and reduced hematopoietic cells
• CMarrow packed with abnormal plasma cells
• DFibrosis with dry tap

What CD marker combination is characteristic of B-cell acute lymphoblastic leukemia (B-ALL)?

• ACD3+, CD7+
• BCD19+, CD10+, TdT+
• CCD13+, CD33+, MPO+
• DCD14+, CD64+

What is the INR, and what therapeutic range is targeted for most patients on warfarin?

• AINR standardizes aPTT results; target 1.0-1.5
• BINR standardizes PT results; target 2.0-3.0 for most indications
• CINR measures platelet function; target 3.0-4.0
• DINR measures fibrinogen; target 0.5-1.0

What does an elevated D-dimer indicate?

• ANormal coagulation
• BActive fibrinolysis and clot breakdown, suggestive of DVT, PE, DIC, or other thrombotic c…
• CPlatelet dysfunction
• DFactor VIII deficiency

What is the most common inherited bleeding disorder?

• AHemophilia A
• BHemophilia B
• CVon Willebrand disease
• DFactor V Leiden

Hemophilia A is caused by a deficiency of which coagulation factor?

• AFactor IX
• BFactor VIII
• CFactor VII
• DFactor XI

What laboratory findings are characteristic of disseminated intravascular coagulation (DIC)?

• AProlonged PT and aPTT, decreased fibrinogen, elevated D-dimer, decreased platelets, and s…
• BNormal PT and aPTT with elevated fibrinogen
• CIsolated prolonged aPTT with normal PT
• DNormal CBC with elevated D-dimer only

What is the Philadelphia chromosome, and which leukemia is it associated with?

• At(8;21) associated with AML
• Bt(9;22) creating BCR-ABL fusion, associated with chronic myeloid leukemia (CML)
• Ct(15;17) associated with APL
• Dt(14;18) associated with follicular lymphoma

What is the hallmark peripheral blood finding in chronic lymphocytic leukemia (CLL)?

• ACirculating blasts
• BMature lymphocytosis with smudge cells (basket cells)
• CPelger-Huet anomaly
• DDohle bodies

What causes polycythemia vera (PV)?

• AChronic hypoxia from lung disease
• BA JAK2 V617F mutation causing autonomous erythroid proliferation independent of EPO
• CIron overload from hemochromatosis
• DVitamin B12 excess

What is the reticulocyte count used for?

• AMeasuring platelet function
• BAssessing bone marrow erythropoietic activity and classifying anemias as hypo- or hyperpr…
• CMeasuring WBC maturation
• DDetecting hemoglobin variants

What is the most common cause of microcytic anemia worldwide?

• AVitamin B12 deficiency
• BFolate deficiency
• CIron deficiency
• DLead poisoning

What peripheral blood smear finding is characteristic of megaloblastic anemia?

• AMicrocytic, hypochromic RBCs
• BMacrocytic RBCs with hypersegmented neutrophils (6 or more lobes)
• CSchistocytes and helmet cells
• DSpherocytes and polychromasia

Schistocytes on a peripheral blood smear indicate what condition?

• AIron deficiency anemia
• BMicroangiopathic hemolytic anemia (TTP, HUS, DIC, or mechanical valve hemolysis)
• CVitamin B12 deficiency
• DSickle cell trait

What is hereditary spherocytosis, and what laboratory findings are characteristic?

• AAn acquired RBC disorder with normal osmotic fragility
• BAn inherited RBC membrane defect causing spherocytes, increased osmotic fragility, and po…
• CAn inherited RBC membrane defect causing spherocytes, increased osmotic fragility, and ne…
• DA hemoglobin disorder causing target cells

What is the significance of the PFA-100 (platelet function analyzer)?

• AIt measures coagulation factor levels
• BIt screens for platelet function disorders and von Willebrand disease by measuring closur…
• CIt measures D-dimer levels
• DIt identifies hemoglobin variants

What is the significance of rouleaux formation on a peripheral blood smear?

• ANormal finding in all patients
• BStacking of RBCs like coins, suggesting elevated plasma proteins (multiple myeloma, Walde…
• CIndicates iron deficiency
• DIndicates sickle cell disease

What is the normal aPTT range, and what pathways does it evaluate?

• A10-14 seconds; extrinsic pathway
• B25-35 seconds; intrinsic and common pathways
• C45-60 seconds; fibrinolytic pathway
• D5-10 seconds; platelet function

Heparin prolongs which coagulation test?

• APT only
• BaPTT primarily (also PT at high doses)
• CNeither PT nor aPTT
• DThrombin time only

What is the significance of Howell-Jolly bodies on a peripheral blood smear?

• AThey indicate lead poisoning
• BThey are nuclear remnants indicating functional asplenia or post-splenectomy state
• CThey indicate iron deficiency
• DThey indicate folate deficiency

What is the diagnostic triad of thrombotic thrombocytopenic purpura (TTP)?

• AAnemia, leukocytosis, and elevated liver enzymes
• BThrombocytopenia, microangiopathic hemolytic anemia with schistocytes, and organ damage (…
• CElevated PT, aPTT, and decreased fibrinogen
• DLeukocytosis, fever, and joint pain

What is the significance of basophilic stippling on a peripheral blood smear?

• ANormal finding
• BIndicates aggregated ribosomal RNA; seen in lead poisoning, thalassemia, MDS, and heavy m…
• CIndicates iron overload
• DIndicates viral infection