PathMD Quizes, Hematopathology Peripheral Blood – 01 October 29, 2017 peferguson Author: Philip Ferguson, M.D. Make sure to subscribe to PathMD to stay up to date with new content and features!! 1. Which of the following methods is most accurate in quantitating HbA2 (important in β-thalassemia)?Electrophoresis on cellulose acetate Flow cytometry Ion-Exchange chromatographyHigh Performance Liquid Chromatography (HPLC) 2. The images for Case #1 below are characteristic of which of the following: Peripheral Blood Part 1, Case #1 Peripheral Blood Part 1, Case #1 Peripheral Blood Part 1, Case #1Normal PMNs Chronic myelogenous leukemia MetamyelocytesPseudo Pelger-Huet cells Bands 3. A 70 y/o male presents with a WBC count of 2.1, Hb of 8.7 g/dL, and plts. of 88K. There is no evidence of hepatosplenomegaly or lymphadenopathy. Given this history and the image findings in the images below for Case #6 (blast percentage = 17%), which of the following is the most likely diagnosis? Peripheral Blood - Part 1, Case #6 Peripheral Blood - Part 1, Case #6 Peripheral Blood - Part 1, Case #6ALL - Acute Lymphoblastic Leukemia/LymphomaCML - Chronic Myelogenous LeukemiaLPL - Lymphoplasmacytic LymphomaAML - Acute Myelogenous LeukemiaMDS - Myelodysplastic Syndrome 4. When considering hemoglobin electrophoresis on cellulose acetate at pH 8.4, which of the following is the correct order of Hb migration from the cathode towards the anode?C S F AS C A FS C F AA F S C C S A F 5. The best diagnosis for the peripheral smear illustrated in Case #3 in the images below is: Peripheral Blood Part 1, Case #3 Peripheral Blood Part 1, Case #3Hb Bart’s disease ElliptocytosisIron deficiency anemia ThalassemiaHereditary spherocytosis 6. At what age is the best time to screen for sickle cell disorders?At birth 6 months > 1 year of age2 months 7. An otherwise healthy 50 y/o white female is undergoing a transthoracic echocardiogram to evaluate possible mitral regurgitation. To suppress the gag reflex lidocaine spray is used liberally on the posterior pharynx. As the procedure begins the patient is noted to become short of breath and anxious. Immediately the procedure is stopped and the physician notes the patient’s lips are blue. A blood gas is drawn, which shows a pO2 = 98 mmHg and a pCO2 = 30 mmHg. The best treatment of the patient would be?Supplemental oxygen by face mask and other supportive therapy None of the answersConsult surgery for an acute development of a right to left shunt Start unfractionated heparin or low molecular weight heparin Give methylene blue 8. Given the findings in the peripheral blood smear in Case #4 in the images below, which of the following is the best diagnosis: Peripheral Blood Part 1, Case #4 Peripheral Blood Part 1, Case #4Chediak Higashi Iron Deficiency Anemia May-Hegglin Anomaly Reactive changes None of the answers 9. Which of the following is the cause of target cells found in HbCC disease?Decrease in membrane lipid loss Increase free cholesterol in the plasma Loss of Hb, which causes an increase in the surface to volume ratio Collection of Hb in the thicker areas of the cell as water evaporates 10. A 30 y/o Asian female is found to have a homozygous hemoglobinopathy. She has a hypochromic anemia and splenomegaly. Which of the following is the most likely the etiology?Hb EHb SCHb Dβ thalassemiaHb S 11. Which of the following is the best diagnosis given the findings in the peripheral smear in Case #2 below: Peripheral Blood Part 1, Case #2 Peripheral Blood Part 1, Case #2 Peripheral Blood Part 1, Case #2Iron deficiency anemiaMalariaβ-thalassemia HbCC disease HbSS disease 12. An amino acid substitution of lysine for glutamic acid in position 6 of the β hemoglobin molecule is characteristic of which Hb?β thalassemiaHb CHb EHb S Hb H 13. A 65 y/o male patient presents with increasing fatigue, a WBC count of 65K, and the findings illustrated on the peripheral blood smear in Case #5 in the images below. The most likely diagnosis is: Peripheral Blood Part 1, Case #5 Peripheral Blood Part 1, Case #5 Peripheral Blood Part 1, Case #5ALL - Acute Lymphoblastic Leukemia/LymphomaAML - Acute Myelogenous LeukemiaAcute infection MDS - Myelodysplastic SyndromeCML - Chronic Myelogenous Leukemia Loading...