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. 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 #5CML - Chronic Myelogenous LeukemiaAcute infection ALL - Acute Lymphoblastic Leukemia/LymphomaAML - Acute Myelogenous LeukemiaMDS - Myelodysplastic Syndrome 2. 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 S β thalassemiaHb EHb DHb SC 3. 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 #2HbCC disease β-thalassemia Iron deficiency anemiaHbSS disease Malaria 4. An amino acid substitution of lysine for glutamic acid in position 6 of the β hemoglobin molecule is characteristic of which Hb?Hb Eβ thalassemiaHb S Hb HHb C 5. Which of the following is the cause of target cells found in HbCC disease?Decrease in membrane lipid loss Collection of Hb in the thicker areas of the cell as water evaporates Loss of Hb, which causes an increase in the surface to volume ratio Increase free cholesterol in the plasma 6. 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 #1MetamyelocytesPseudo Pelger-Huet cells BandsNormal PMNs Chronic myelogenous leukemia 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?Start unfractionated heparin or low molecular weight heparin Consult surgery for an acute development of a right to left shunt None of the answersSupplemental oxygen by face mask and other supportive therapy Give methylene blue 8. At what age is the best time to screen for sickle cell disorders?2 months > 1 year of ageAt birth 6 months 9. 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 #3ElliptocytosisHereditary spherocytosis Hb Bart’s disease ThalassemiaIron deficiency anemia 10. 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 #6AML - Acute Myelogenous LeukemiaCML - Chronic Myelogenous LeukemiaALL - Acute Lymphoblastic Leukemia/LymphomaMDS - Myelodysplastic SyndromeLPL - Lymphoplasmacytic Lymphoma 11. Which of the following methods is most accurate in quantitating HbA2 (important in β-thalassemia)?High Performance Liquid Chromatography (HPLC) Flow cytometry Electrophoresis on cellulose acetate Ion-Exchange chromatography 12. 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?A F S C S C F AC S A FS C A FC S F A 13. 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 #4None of the answersChediak Higashi Reactive changes May-Hegglin Anomaly Iron Deficiency Anemia Loading...