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 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 #2Malariaβ-thalassemia Iron deficiency anemiaHbSS disease HbCC disease 2. 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 Give methylene blue Start unfractionated heparin or low molecular weight heparin None of the answersConsult surgery for an acute development of a right to left shunt 3. 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 LeukemiaALL - Acute Lymphoblastic Leukemia/LymphomaAcute infection AML - Acute Myelogenous LeukemiaMDS - Myelodysplastic Syndrome 4. Which of the following is the cause of target cells found in HbCC disease?Loss of Hb, which causes an increase in the surface to volume ratio Increase free cholesterol in the plasma Decrease in membrane lipid loss Collection of Hb in the thicker areas of the cell as water evaporates 5. At what age is the best time to screen for sickle cell disorders?> 1 year of ageAt birth 2 months 6 months 6. 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 #3Iron deficiency anemia Hb Bart’s disease ThalassemiaHereditary spherocytosis Elliptocytosis 7. 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/LymphomaMDS - Myelodysplastic SyndromeAML - Acute Myelogenous LeukemiaLPL - Lymphoplasmacytic LymphomaCML - Chronic Myelogenous Leukemia 8. Which of the following methods is most accurate in quantitating HbA2 (important in β-thalassemia)?Electrophoresis on cellulose acetate Ion-Exchange chromatographyFlow cytometry High Performance Liquid Chromatography (HPLC) 9. 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 Pseudo Pelger-Huet cells BandsMetamyelocytes 10. 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 HHb CHb S 11. 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 AA F S C S C A FC S A FS C F A 12. 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 #4Iron Deficiency Anemia None of the answersReactive changes Chediak Higashi May-Hegglin Anomaly 13. 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 DHb SCHb Eβ thalassemiaHb S Loading... Share this: Share on X (Opens in new window) X Share on WhatsApp (Opens in new window) WhatsApp Share on Facebook (Opens in new window) Facebook Email a link to a friend (Opens in new window) Email Print (Opens in new window) Print Share on LinkedIn (Opens in new window) LinkedIn Related