HEMATOLOGY

EXAMINATION

NAME: ____________________________________________________ DATE:_______

1. All of the following belong to the thrombin sensitive group of coagulation factors, except:
a. Fibrinogen c. Proaccelerin
b. Prothrombin d. Factor VIII
2. A blood smear is viewed through the microscope. In there, the erythrocytes appear redder than normal, the neutrophils are barely visible, and
the eosinophils are bright orange. What is the most probable cause?
a. The slide was not stained.
b. The stain was too alkaline.
c. The slide was not rinsed sufficiently.
d. The buffer was too acidic.
3. The intrinsic coagulation system is initiated when this factor is exposed to damaged epithelium:
a. III b. IV c. VII d. XII
4. The prothrombin time (PT) screens for deficiencies of factors:
a. III, VII c. I, II, V, VII, and X
b. I, II, V, VIII, IX, X, XI, and XII d. I, II, V and X
5. After centrifugation of a blood specimen contained in a capillary tube, the platelets and the leukocytes may be found in the:
a. Top layer c. Third layer
b. Second layer d. Fourth layer
6. Assay of this enzyme had become a routine procedure in anemic patients, especially if it occurs after administration of a drug or after
consuming fava beans:
a. Glucose-6-phosphate dehydrogenase c. Glutathione reductase
b. Glutathione peroxidase d. Pyruvate kinase
7. The term “Hodgkin Disease” is preferred to “Hodgkin Lymphoma” because:
a. Many of the cells in nodes affected by HD are neoplastic in appearance, and only a minor population of cells have normal
features. In contrast, the infiltrates of NHL are more uniformly composed of similar-appearing normal cells.
b. Fever and severe bacterial infection accompany this form of malignancy.
c. Many of the cells in nodes affected by HD are normal in appearance, and only a minor population of cells have neoplastic
features. In contrast, the infiltrates of NHL are more uniformly composed of similar-appearing neoplastic cells.
d. Hodgkin Disease was the first form of lymphoma discovered and in those times, the term “lymphoma”has not yet been made.
8. Tart cell is different from a lupus erythematosus (LE) cell in that the ingesting cell is commonly a:
a. Lymphocyte c. Neutrophil
b. Monocyte d. Thrombocyte
9. According to studies, persons who have sickle cell trait are said to be resistant to:
a. Plasmodium vivax c. Plasmodium knowlesi
b. Plasmodium ovale d. Plasmodium falciparum
10. The morphology of red cells that one would typically find in the blood smear of Sickle Cell Disease patients is:
a. Microcytic, hypochromic c. Macrocytic, normochromic
b. Normocytic, normochromic d. Any of these
11. In agranulocytosis, the usual finding is:
a. Neutropenia b. Leukocytosis c. Lymphopenia d. Neutrophilic metamyelocytes
12. Which of the following RBC anomalies is detectable ONLY by examination of a blood smear?
a. Hypochromia b. Microcytosis c. Anisocytosis d. Poikilocytosis
13. Spherocytes are characterized by the following, except:
a. They are easily deformed.
b. The defect in shape is caused by cell membrane damage.
c. They are round red blood cells lacking central pallor.
d. They have diameters less than normal red blood cells.
14. Macroscopic examination of a capillary hematocrit tube after spinning should include:
a. Buffy coat c. All of these
b. Red cell column d. Plasma layer
15. Which of the following test results is expected on a patient with hypofibrinogenemia?
a. Thrombin time: Prolonged, Reptilase time: Normal c. Thrombin time: Normal, Reptilase time: Prolonged
b. Thrombin time: Prolonged, Reptilase time: Prolonged d. Thrombin time: Normal, Reptilase time: Normal
16. Which of the following stains is helpful in the diagnosis of suspected erythroleukemia?
a. Peroxidase c. PAS
b. Nonspecific esterase d. Acid phosphatase
17. Which of the following is a glycoprotein produced by the liver and is considered as the major inhibitor of blood coagulation?
a. Antithrombin III c. Protein C
b. Heparan sulfate d. Protein S
18. Which of the following situations below may lead to temporary increase in a patient’s leukocyte count?
1. Jogging for thirty minutes 2. Experiencing a vehicular accident 3. Cigarette smoking
a. 1 and 2 b. 2 and 3 c. 1 and 3 d. 1,2,3
19. A medical technologist was asked to determine the WBC count of a patient. During the differential count procedure, the medtech
observed 12 nucleated RBCs out of the 100 leukocytes he classified. To determine the leukocyte count, he used the Improved Neubauer
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R.J.A.R.DINGLASAN, RMT
e-mail: direnjan@gmail.com
and diluted the specimen 1:20. He was able to count 19, 25, 23, and 24 WBCs from the four large squares on one side of the
hemocytometer. On the other four large squares on the other side, he counted 18, 24, 22, and 21 leukocytes. Assuming that he performed
the procedure correctly, what is the real leukocyte count of this patient?
a. 4, 400/mm3 b. 3, 929/mm3 c. 3, 929 X 109/L d 3, 900/ mm3

20. Your answer here should be the same as your answer in number 19. 

21. The APTT reagent consists of two components, which are:

a. Barium sulfate and aluminum hydroxide c. A platelet substitute and an activator
b. Thromboplastin and calcium chloride d. Thromboplastin and an activator
22. If the anticipated WBC count of the patient is around 110 X 10 9/L, then the recommended dilution and the type of Thoma pipet
to use is:
a. 1:20, WBC Thoma pipet c. 1:200, RBC Thoma pipet
b. 1:10, WBC Thoma pipet d. 1:100, RBC Thoma pipet

For numbers 23 to 27, select the best answer from the choices that follow.
A. Statement 1 is correct but statement 2 is incorrect.

B. Statement 1 is incorrect but statement 2 is correct.

C. Statements 1 and 2 are both correct.

D. Statements 1 and 2 are both incorrect.

23. Toxic granulations and Auer rods:

1.) Both may be seen in leukocytes with severe malignant disorders
2.) Both leukocytic inclusions are believed to be transformed azurophilic granules.
24. May-Hegglin inclusions and Dohle-Amato bodies:
1.) Both of these inclusions are composed of RNA
2.) Both of these inclusions may be observed in neutrophils.
25. Pernicious Anemia and Pelger-Huet Anomaly:
1.) Both disorders affect the appearance of the neutrophil nucleus.
2.) The nuclei in both disorders have a characteristic “pince-nez” appearance
26. The rubricyte:
1.) Considered as the first stage in the RBC maturation stages to produce hemoglobin
2.) Considered as the last stage in the RBC maturation stages to bear a nucleus
27. Ethylenediaminetetraacetic acid (EDTA):
1.) Present only in lavender top blood collection tubes
2.) May induce platelet clumping in some blood specimens

28. In the hematocrit determination procedure, one should seal the capillary tubes at the:
a. End of the tube without the colored ring c. Either a or b
b. End of the tube with the colored ring d. Neither a nor b
29. Burr cells are found in large numbers in which of the following conditions?
a. Liver disease b. Uremia c. Erythroblastosis fetalis d. Leukemia
30. The Hemoglobin S and the Hemoglobin D can be distinguished from one another by which test?
a. Autohemolysis test c. Acid serum test
b. Hemoglobin electrophoresis at pH 8.6 d. Solubility test
31. What is the primary source of iron bound to transferrin in normal individuals?
a. Absorption of iron from the small intestines
b. Breakdown of old red blood cells
c. Release of iron from the liver
d. Release of iron from muscle myoglobin
32. Which of the following functions as the plasma transport protein for Vitamin B 12?
a. Transcobalamin II b. Albumin c. Transferrin d. Hemopexin
33. The most common glycolytic enzyme deficiency associated with the aerobic pathway of RBC metabolism is:
a. Pyruvate kinase
b. Methemoglobin reductase deficiency
c. Hexokinase deficiency
d. Glucose-6-phosphate dehydrogenase (G6PD)
34. In which stage of erythrocytic maturation does hemoglobin formation begin?
a. Reticulocyte b. Pronormoblast c. Basophilic normoblast d. Polychromatic normoblast
35. Paroxysmal Nocturnal Hemoglobinuria episodes are commonly associated with:
a. Cold temperatures b. Hot tempeartures c. Sleep d. Certain drugs
36. The definitive technique for detecting hemoglobin in which the substitution of an amino acid leads to change in electrical charge is:
a. Hemoglobin electrophoresis c. Heat stability test
b. Solubility test d. Kleihauer-Betke
37. In men and postmenopausal women whose diets are sufficient, iron deficiency anemia most commonly results from:
a. Impaired absorption of iron in the small intestines

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e-mail: direnjan@gmail.com
 b. Low transferrin levels
c. Increased resistance to hookworm infections
d. Chronic gastrointestinal bleeding

●For nos. 38 to 39, use the data below:

RBC count = 4.19 X 10 12/L Hct = 0.40 L/L Hb = 11.98 g/dL

38. What is the MCV?
a. 95.47 fL b. 72.13 fL c. 0.9546 fL d. 28.59 fL
39. What is the MCHC?
a. 3.34 g/dL b. 28.59 pg c. 29.95 g/dL d. 3,000 g/dL

40. Falsely decreased ESR can result from:

a. Tilted ESR tube b. Excess anticoagulant c. Vibration of test area d. 70 minutes standing
41. An abnormal red cell with a thin rim of hemoglobin and a large central area is called:
a. Anulocyte b. Spherocyte c. Meniscocyte d. Drepanocyte
42. Which of the following test results is expectedly abnormal in Christmas disease?
a. Platelet count c. Prothrombin time (PT)
b. Tourniquet test d. Activated partial thromboplastin time (APTT)
43. The tourniquet should be securely wrapped around the unclothed arm about how many centimeters above the selected site?
a. 15-16 b. 3-4 c. 7.5-10 d. 1-2
44. All of the following tests will demonstrate normal results in a patient with Factor VII deficiency, except:
a. Activated Partial Thromboplastin Time c. Thrombin time
b. Prothrombin time d. Platelet count
45. Cyanide-resistant Peroxidase stain may be used to detect:
a. Hairy Cell Leukemia b. Hodgkin’s Lymphoma c. Chronic Myelogenous Leukemia d. Eosinophilic leukemia
46. The medical technologist stained a blood smear. He then held it up to the light and noticed that the smear is bluer than normal. What
abnormality may be expected on this smear?
a. Leptocytes b. Lymphocytosis c. Rouleaux d. Sickle cells
47. From the following choices, identify which one will demonstrate a low serum ferritin test result.
1. Plumbism 2. Thalassemia 3. Sideroblastic anemia 4. Iron deficiency anemia
a. 1 and 2 c. 1,2,3
b. 2 and 4 d. 4 only
48. The most common clinical application of flow cytometry is:
a. Diagnosis of Sickle Cell Disease
b. Detection of fetomaternal hemorrhage
c. Diagnosis of leukemias and lymphomas
d. Differentiation of anemias
49. The coagulation factors that require vitamin K for their production include all of these, except:
a. Stuart factor b. Factor IX c. Fibrinogen d. Proconvertin
50. A blood specimen showed an elevated MCV with an increased RDW. These results would suggest that the patient has:
a. Iron deficiency anemia
b. Sickle cell anemia
c. Normal blood specimen
d. Vitamin B12 or folate deficiency
51. Which of the following will NOT increase the ESR?
a. Rouleaux b. Increased globulins c. Poikilocytosis d. Increased fibrinogen
52. Paroxysmal Nocturnal Hemoglobinuria may be detected through:
a. Ham’s Acidified Serum Test c. Flow cytometry
b. Sugar Water Test d. All of these
53. The sol-gel zone lies directly beneath the platelet membrane and is composed of:
a. Microfilaments c. Both A and B
b. Microtubules d. Neither A nor B
54. To properly mix the blood and the anticoagulant in the light blue top tube, the medtech must invert the tube:
a. Five to eight times c. Eight times
b. Three to four times d. Twice
55. The PT is most sensitive to a deficiency of which clotting factor?
a. Fibrinogen b. VII c. VIII d. XI
56. Lipemia may affect which of the following hematologic parameters?
1. Hemoglobin 2. MCH 3. Hematocrit
a. 1 and 2 c. 1 and 3
b. 2 and 3 d. 1,2, and 3

57. Inactivation of factors Va and VIIIa is caused by:

a. Thrombin b. Protein S c. t-PA d. Activated protein C

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e-mail: direnjan@gmail.com
58. In the granulocytic series of maturation, what is the last stage to undergo mitosis?
a. Myeloblast b. Promyelocyte c. Myelocyte d. Metamyelocyte
59. If the medtech multiplies the RBC count of a normal individual by three, the resulting value will most probably reflect the:
a. Hemoglobin of the patient c. Mean cell volume of the patient
b. Hematocrit of the patient d. Weight of the patient
60. The nuclear parachromatin of the lymphocyte tends to stain light purple with deep purple heterochromatin, giving the appearance of:
a. Purple necklace pattern c. Crushed velvet
b. Violet cake d. Checkerboard
61. The primary inhibitor of the fibrinolytic system is:
a. Antithrombin III b. α2-antiplasmin c. Protein C d. α2-macroglobulin
62. The first factor to be affected by warfarin is:
a. Factor V b. Factor VII c. Factor VIII d. Factor IX
63. Clinical conditions associated with DIC include:
a. Snake bites b. Acute infections (such as malaria) c. Acute promyelocytic leukemia d. All of these
64. One can expect an increased ESR result in all of the following conditions, except:
1. Rheumatic fever 4. Sickle cell anemia
2. Hereditary spherocytosis 5. Myocardial infarction
3. Tuberculosis
a. 1,2,3,4 b. 2, 3, and 4 c. 1, 3, and 5 d. 2 and 4
65. Thrombocytopenia may be observed in all of the following conditions, except:
a.Chronic myelogenous leukemia c. TAR syndrome
b. Gaucher’s disease d. DIC
66. From the choices below, select the ones which are found in the alpha granules of the platelets.
1. Beta-thromboglobulin 3. Fibrinogen
2. Thrombospondin 4. Factor V
a. 1,2,3,4 b. 1 and 2 c. 1,2 and 3 d. 1 only
67. The patient’s APTT failed to correct after addition of normal fresh plasma. What would be the most probable cause?
a. Factor XII deficiency b. Factor VIII deficiency c. Afibrinogenemia d. Circulating anticoagulants
68. Which of the following tests can be used to differentiate vitamin K deficiency from hepatic disease?
a. Factor V assay c. Factor VII assay
b. PT d. Bleeding time
69. This is the term used to describe a condition where the red cells vary in size greatly.
a. Anisocytosis c. Both A and B
b. Poikilocytosis d. Polychromasia
70. What is the critical value for the hemoglobin level?
a. < 50 g/L and > 100 g/L c. < 50 g/L and > 110 g/L
b. < 70 g/L and > 300 g/L d. < 70 g/L and > 200 g/L
71. This red cell inclusion is composed of ferric iron and appear as bluish green-staining bodies in Prussian blue reaction:
a. Siderotic granules b. Hb H c. Cabot rings d. Heinz bodies
72. The “pince-nez” appearance of neutrophil nucleus may be seen in:
a. Pernicious anemia b. Hypersplenism c. Pelger-Huet anomaly d. Alder-Reilly anomaly
73. The critical value for reticulocyte counts (adults):
a. 0.8% b. 5.80% c. 7.8% d. Greater than 20%
74. If the phlebotomist has no other alternative than to extract blood from an intravenous site, he should ask the nurse to stop the infusion for a
period of:
a. 2 minutes after drawing specimen c. 2 minutes before drawing specimen
b. 5 minutes before drawing specimen d. 1 minute after drawing the specimen
75. The granulation in this anomaly results from an abnormal deposition and storage of mucopolysaccharides:
a. Alder-Reilly anomaly c. Pelger-Huet anomaly
b. May-Hegglin anomaly d. Toxic granulations
76. Which of the descriptions below properly depict Hb SC crystals?
a. Hexagonal, elongated crystals c. Formed within cell membrane
b. “Washington Monument” d. None of these
77. RBC basophilic stippling may be found in which of the following conditions?
1. Pyrimidine-5’-Nucleotidase (PN) Deficiency
2. Thalassemia
3. Lead poisoning
a. 1 and 3 b. 1,2, and 3 c. 2 and 3 d. 3 only
78. Which of the following is considered as the storage site for vWF in the blood vessel cells?
a. Platelet alpha granules b. Weibel-Palade bodies c. Both A and B d. Neither A nor B
79. The mean plasma concentration of fibrinogen is:
a. 8 to 10 mg/dL b. 1 mg/dL c. 200 to 400 mg/dL d. 5 mg/dL
80. In an electronic cell counter, clumped platelets may interfere with which of the following laboratory results?
1. WBC count 2. Hemoglobin 3. Platelet count 4. Hematocrit
a. 1,2,3 b. 1 and 3 c. 2 and 3 d. 3 only
81. The primary granules of the neutrophils contain all of the following, except:
a. Lactoferrin c. Both A and B
b. Myeloperoxidase d. Neither A nor B
82. A diluting solution for manual platelet count is:
a. Hayem’s solution c. 0.1 N HCl
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e-mail: direnjan@gmail.com
 b. 1% aqueous solution of ammonium oxalate d. 2% acetic acid

For no. 83, refer to the following case:

The following data were obtained from a 23-year old Filipino female who is currently admitted in a public hospital.
WBC count = 13,900/mm3
Differential count:
Neutro: 71%
Lympho: 25%
Eosinophils: 2%
Monocytes: 2%
83. In the case given, there is:
1. Absolute lymphocytosis 3. Absolute neutrophilia 5. Absolute eosinophilia
2. Relative eosinophilia 4. Absolute monocytopenia 6. Relative neutrophilia
a. 1,3,5 b. 1,2,3 c. 3 and 5 d. 3 and 6

84. Infection with Trichinella spiralis may cause:

a. Neutrophilia b. Monocytosis c. Eosinophilia d. Monocytosis
85. The early normoblast may otherwise be called as:
a. Rubriblast b. Prorubricyte c. Rubricyte d. Metarubricyte
86. Faggot cells are most commonly encountered in:
a. Acute promyelocytic leukemia c. Chronic myelogenous leukemia
b. Acute myelomonocytic leukemia d. Acute erythroleukemia
87. Complete the following statement: “When Factor XIII is present, the fibrin clot formed is _______________ in 5 M Urea and ___________
when left standing for ____________.”
a. Insoluble, 1% Hydrochloric acid, 24 hours c. Soluble, 1% Monochloroacetic acid, 48 hours
b. Insoluble, 1% Monochloroacetic acid, 24 hours d. Insoluble, 1% Monochloroacetic acid, 72 hours
88. Which of the following is produced by the liver and is considered as the major inhibitor of thrombin?
a. Antithrombin III c. Protein C
b. Heparan sulfate d. Protein S
89. Testing an old blood sample will demonstrate the following results:
a. ↑MCV, ↑MPV, ↓Platelet count c. ↓MCV, ↓MPV, ↑Platelet count
b. ↑MCV, ↑MPV, ↑Platelet count d. ↓MCV, ↓MPV, ↓Platelet count
90. Which of the following conditions will produce a falsely decreased RBC count?
a. Hemolysis b. Microcytosis c. Increased numbers of schistocytes d. All of these
91. Which of the following is improperly matched?
a. CD4: Helper/inducer T cells b. CD16: NK cells c. CD34: Cytotoxic T cells d. CD14: Monocytes
92. The last stage to synthesize hemoglobin is the:
a. Polychromatophilic normoblast c. Reticulocyte

b. Orthochromic normoblast d. Mature erythrocyte

93. The infective stage of the malaria parasites to humans is:
a. Sporozoites b. Merozoites c. Trophozoites d. Gametocytes
94. Which of the following stains is least helpful in differentiating the subtypes of acute lymphoblastic leukemias?
a. PAS b. ORO c. Sudan Black d. All of these
95. Which of the following conditions will produce a falsely increased WBC count?
a. Presence of lysis-resistant RBCs containing abnormal hemoglobins
b. Increased numbers of nucleated RBCs
c. Both A and B
d. Lipemia
96. What is the correct order of draw for the skin puncture procedure?
a. EDTA microcollection tubeSerum microcollection tubeOther microcollection tubes with anticoagulantsSlidesTube for
blood gas analysis
b. Tube for blood gas analysisSlides EDTA microcollection tube Other microcollection tubes with anticoagulants Serum
microcollection tube
c. EDTA microcollection tube Other microcollection tubes with anticoagulantsSerum microcollection tube SlidesTube for
blood gas analysis
d. Tube for blood gas analysis  EDTA microcollection tube Other microcollection tubes with anticoagulantsSerum
microcollection tubeSlides

●For nos. 97 to 100, analyze the following laboratory test results and identify the most probable factor deficiency.
A. Factor V deficiency

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e-mail: direnjan@gmail.com
 B. Factor VII deficiency
C. Factor VIII deficiency
D. Factor IX deficiency

Patient’s Substitution Test Results Most Probable Clotting Factor Deficiency (refer to the
choices above)
(PT = prolonged and APTT = prolonged)
Aged plasma= NOT CORRECTED 97. _______
Aged serum = NOT CORRECTED
Adsorbed plasma = CORRECTED

(PT = normal and APTT = prolonged)

Aged plasma= CORRECTED 98. ________
Aged serum = CORRECTED
Adsorbed plasma = NOT CORRECTED

(PT = normal and APTT = prolonged)

Aged plasma= NOT CORRECTED 99. ________
Aged serum = NOT CORRECTED
Adsorbed plasma = CORRECTED

(PT = prolonged and APTT = normal)

Aged plasma= CORRECTED 100. _________
Aged serum = CORRECTED
Adsorbed plasma = NOT CORRECTED

References:
1. Alba’s Medical Technology Board Examination Review
2. Compiled Medical Technology Licensure Examination (March 1990 to March 1998)
3. PER Questions and Answers Book (A Review Manual For Clinical Laboratory Examinations)
4. Medical Technology Hematology Review by: Mary Rose Te
5. Examination Review for Medical Technology by: Neville J. Bryant
6. Hematology Lecture Guide by: Rene J.A.R. Dinglasan
7. Other references (reliable websites and books) related to the medical technology profession

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R.J.A.R.DINGLASAN, RMT
e-mail: direnjan@gmail.com