Question 1

A patient’s CBC shows thrombocytopenia. What is the next step

Accepted Answer

Do blood smear to check for platelet clumping

Answer

re-do the test on another machine.

Answer

Check for flags in the device. If no suspicion, report the result.

Answer

re-do the test on another freshly obtained sample.

Answer

Repeat CBC using citrate anticoagulant

Question 2

A blood sample processed with EDTA shows leukopenia and thrombocytopenia on the analyzer, but peripheral smear shows normal counts. What is the best next step?

Accepted Answer

Repeat CBC using citrate anticoagulant

Answer

Start hematinics trial

Answer

Order a bone marrow examination

Answer

Accept the automated results

Answer

Repeat CBC using heparin anticoagulant

Question 3

Pseudoneutropenia on automated CBC can be caused by:

Accepted Answer

Neutrophil aggregation due to EDTA

Answer

Hypogranular neutrophils

Answer

Monocytosis

Answer

Hypersegmented neutrophils

Answer

Neutrophil adherence to tube wall

Question 4

Spuriously elevated hemoglobin is most likely due to:

Accepted Answer

Lipemia

Answer

Hypovolemia

Answer

Iron overload

Answer

Polycythemia vera

Answer

RBC sickling

Question 5

In which of the following conditions might the MCHC be falsely elevated?

Accepted Answer

Cold agglutinins

Answer

Megaloblastic anemia

Answer

Hereditary spherocytosis

Answer

Thalassemia major

Answer

Sickle cell anemia

Question 6

A patient’s hematocrit is much higher than expected relative to hemoglobin. What is the likely explanation?

Accepted Answer

Extreme leukocytosis

Answer

Polycythemia vera

Answer

Dehydration

Answer

Reticulocytosis

Answer

Intravascular hemolysis

Question 7

A 50-year-old woman’s CBC upon routine checkup shows increased RDW but normal MCV. This suggests:

Accepted Answer

Early iron deficiency

Answer

RBC fragmentation

Answer

Technical error with the analyzer

Answer

Thalassemia trait

Answer

Anemia of chronic disease

Question 8

Cold agglutinins cause falsely:

Accepted Answer

High MCV

Answer

Low MCHC

Answer

Low MCV

Answer

high hematocrit

Answer

Low MCH

Question 9

Platelet satellitism is best resolved by:

Accepted Answer

Repeating CBC in another sample in citrate tube

Answer

Making smear and do an approximate estimate of platelet count

Answer

Count the platelet manually using chamber slide

Answer

Rerun the tube on the same machine

Answer

Adding heparin to the EDTA sample

Question 10

A falsely low hemoglobin reading may result from:

Accepted Answer

Sample dilution with IV fluids

Answer

Leukocytosis

Answer

Cold agglutinins

Answer

prolonged tourniquet application during blood sampling

Answer

Lipemia

Question 11

In a patient with high leukocyte count, spurious thrombocytopenia may be due to:

Accepted Answer

Giant platelets miscounted as leukocytes

Answer

Platelet satellitism

Answer

EDTA clumping

Answer

Presence of nucleated red blood cells

Answer

Platelet fragmentation

Question 12

In which situation is a manual cell count mandatory?

Accepted Answer

Severe cold agglutinin interference

Answer

Thrombocytosis with many giant platelets

Answer

Critically ill patient with severe leucopenia

Answer

RBC fragmentation

Answer

Sickle cell anemia

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