MLT GlobeASCP exam preparation (USA · MLS / MLT) – page 9
1200 practice MCQs for the ASCP medical laboratory exam. Level: Advanced.
Children with sickle cell anemia are given penicillin prophylaxis mainly because functional asplenia greatly raises the risk of sepsis from:
Repeated splenic infarction causes loss of splenic function, and the spleen is key for clearing encapsulated bacteria such as S. pneumoniae. The other organisms are not linked specifically to asplenia.
Both parents have beta-thalassemia trait. What is the chance that each pregnancy will result in a child with beta-thalassemia major?
Beta-thalassemia is autosomal recessive. Two carriers have a 1 in 4 chance of an affected child, 1 in 2 of a carrier and 1 in 4 of an unaffected non-carrier child.
The normal life span of platelets in the circulation is about:
Platelets survive about 7–10 days and are then removed mainly by the spleen and liver. 120 days is the red cell life span.
Ten days after splenectomy for trauma, a previously healthy man's platelet count rises to 750 × 10^9/L. The best interpretation is:
Loss of the splenic pool and the stress of surgery commonly cause reactive thrombocytosis, which is often transient. ET needs persistent counts with a driver mutation or clonal marker.
If dietary intake stops completely, body stores usually last about:
The liver holds several milligrams of B12, enough for years, whereas folate stores last only a few months. So folate deficiency develops much faster than dietary B12 deficiency.
The fall in hemoglobin concentration seen in normal pregnancy is mainly caused by:
Plasma volume rises by about 40–50% while red cell mass rises less, diluting the Hb. Erythropoietin actually increases in pregnancy.
Dietary non-heme iron is absorbed mainly in the:
Non-heme iron is reduced to Fe2+ and taken up by DMT1 on duodenal enterocytes, then exported by ferroportin. The terminal ileum absorbs vitamin B12.
Helmet cells and triangular red cells with sharp angles seen in a patient with DIC are classified as:
Helmet cells and triangular forms are types of red cell fragments (schistocytes), formed when cells are cut by fibrin strands or damaged surfaces. Acanthocytes are whole cells with irregular spicules.
Nucleated red cells in the peripheral blood are a normal finding in:
Healthy term newborns commonly have a few nucleated RBCs, which disappear within about the first week. In adults they usually point to marrow stress or infiltration.
Heinz bodies are composed of:
Oxidized hemoglobin denatures and precipitates, sticking to the inner membrane as Heinz bodies. RNA forms stippling, iron granules are Pappenheimer bodies and DNA forms Howell-Jolly bodies.
Imatinib controls chronic myeloid leukemia mainly by:
Imatinib is a tyrosine kinase inhibitor that competes with ATP at the ABL1 kinase domain, stopping the constant signaling of BCR::ABL1. Differentiation therapy (ATRA) is used in acute promyelocytic leukemia, not CML.
A man with known CLL for 8 years develops fever, weight loss, a rapidly growing lymph node and very high LDH. The most likely event is:
Richter transformation is the change of CLL into an aggressive lymphoma, usually DLBCL, with B symptoms, rapidly enlarging nodes and high LDH. The other disorders are not typical outcomes of CLL.
A gastric biopsy shows a low-grade extranodal marginal zone (MALT) lymphoma. Which infection is most strongly linked to it?
Chronic H. pylori gastritis drives gastric MALT lymphoma, and many early cases regress after eradication therapy. EBV is linked to Burkitt and Hodgkin lymphoma; HHV-8 to primary effusion lymphoma.
A tumor mass of myeloblasts found in the orbit or skin, sometimes before marrow involvement, is called:
Myeloid sarcoma (granulocytic sarcoma, chloroma) is an extramedullary mass of myeloid blasts and is treated as AML. A plasmacytoma is a mass of clonal plasma cells.
A dehydrated patient has hematocrit 0.55 L/L, normal red cell mass, normal EPO and no mutation. The best term is:
Loss of plasma volume raises the hematocrit without increasing red cell mass; correcting dehydration normalizes it. Secondary polycythemia has a true rise in red cell mass with high EPO.
Flow cytometry shows CD19+ B cells with kappa:lambda ratio of 12:1. This most suggests:
Normal B cells show a kappa:lambda ratio of about 1–2:1 (roughly 0.5–3); a strongly skewed ratio indicates light chain restriction and clonality. T-cell clonality is not assessed by light chains.
A full-term newborn has a WBC of 22 × 10^9/L with mostly neutrophils on day 1 and no signs of infection. The best interpretation is:
Newborns normally have high WBC counts (about 9–30 × 10^9/L) with neutrophil predominance in the first days, falling over the first weeks. Lymphocytes then predominate in early childhood.
An analyzer flags 'blasts?' on a sample with a normal-looking scatter plot. According to good practice, the technologist should:
Suspect flags have limited specificity, so a smear review confirms or excludes abnormal cells. Rerunning or diluting does not answer the morphologic question.
A patient starting clozapine is followed with regular absolute neutrophil counts because this drug can cause:
Clozapine can cause sudden, severe neutropenia (agranulocytosis), so ANC monitoring is required. It is a classic example of drug-induced neutropenia.
A healthy woman's blood smear shows about 1–2% eosinophils and less than 1% basophils. These values are:
Normal adult differentials include about 1–5% eosinophils and 0–1% basophils. No abnormality is present.