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CENTRO ESCOLAR UNIVERSITY

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School of Medical Technology
HEMATOLOGY 1 – LECTURE
Midterm Examination – First Semester – SY 2023-2024

INSTRUCTIONS: CHOOSE THE BEST ANSWER THAT CORRESPONDS TO EACH QUESTION/STATEMENT.

1. Type of myeloblast that has no visible granules when viewed under the microscope:
a. Type I b. Type II c. Type III d. Type IV
2. Leukocyte maturation stage that is characterized by the appearance of primary or azurophilic granules:
a. Myeloblast b. Promyelocyte c. Myelocytes d. Metamyelocytes
3. Leukocyte maturation stage that is characterized by the appearance of secondary or specific granules:
a. Myeloblast b. Promyelocyte c. Myelocytes d. Metamyelocytes
4. Last stage of leukocyte development wherein cell is still capable of undergoing mitosis:
a. Myeloblast b. Promyelocyte c. Myelocytes d. Metamyelocytes
5. Stage of leukocyte development that is characterized by the appearance of tertiary granules specific for neutrophils
only:
a. Myeloblast b. Promyelocyte c. Myelocytes d. Metamyelocytes
6. Stage of granulocytic development that first appears in the peripheral blood:
a. Myelocytes b. Metamyelocyte c. Band Stage d. Myeloblast
7. This is also referred to as tissue monocyte:
a. Macrophage b. Mast Cell c. Phagocytes d. Immunocytes
8. Precursor cell of immunoglobulin production:
a. Basophil b. Monocyte c. Lymphocyte d. Neutrophil
9. A single megakaryocyte may produce about how many platelets during thrombopoiesis:
a. 1000-2000 b. 2000-6000 c. 2000-4000 d. 1000-4000
10. Reticulated or Stress platelets appears in the peripheral blood circulation in compensation with:
a. Leukocytopenia b. Leukocytosis c. Thrombocytopenia d. Thrombocytosis
11. In the peripheral blood smear examination, the following are being observed, except:
a. RBC Morphology b. WBC’s Nucleus c. Platelets d. RBC Indices
12. Which of the following blood cells is considered as the precursor cell of thrombocytes:
a. Erythrocytes b. Granulocytes c. Megakaryocytes d. Lymphocytes
13. Platelets are not considered as true cell, because they are just a product of:
a. nuclear fragmentation of megakaryoblast c. nuclear fragmentation of megakaryocyte
b. cytoplasmic fragmentation of megakaryoblast d. cytoplasmic fragmentation of megakaryocyte
14. Which of the following cells is considered as immunocytes:
a. Eosinophil b. Macrophage c. Lymphocytes d. Monocytes
15. Polychromatic Erythrocytes resides in the bone marrow for about:
a. 1-2 Days b. 3 Days c. 120 Days d. 2 Weeks
16. RBC developmental stage wherein hemoglobin production is already completed:
a. Basophilic Erythroblast c. Polychromatic Erythroblast
b. Orthochromic Erythroblast d. Polychromatic Erythrocyte
17. How many day/s does reticulocyte resides in the peripheral blood circulation before reaching its maturity:
a. 1 Day b. 2 Days c. 3 Days d. 4 Days
18. During the late stage of this erythrocyte development, the nucleus is ejected from the cell:
a. Rubriblast b. Prorubricyte c. Rubricyte d. Metarubricyte
19. An enveloped extruded nuclei from the red blood cell which is engulfed by the bone marrow macrophages is
called:
a. Pyknocyte b. Pyrenocyte c. Pykrenocyte d. Pynorecyte
20. Last stage of RBC development wherein the cell is still capable of undergoing mitosis:
a. Basophilic Normoblast c. Orthochromic Normoblast
b. Polychromatic Normoblast d. Pronormoblast
21. Stage of RBC development where the globin production for hemoglobin synthesis begins:
a. Basophilic Normoblast c. Orthochromic Normoblast
b. Polychromatic Normoblast d. Pronormoblast
22. Polychromatic/Polychromatophilic means:
a. many colors hating b. many colors loving c. acidophilic d. basophilic
23. Erythrocyte developmental stage that has a characteristic of large, round nucleus with fine chromatin pattern and a
distinctive basophilic color of cytoplasm.
a. Basophilic Normoblast b. Proerythroblast c. Orthochromic Erythroblast d. Rubricyte
24. Erythrocyte developmental stage that has a characteristic of round nucleus with more clumped chromatin pattern
and a distinctive basophilic color of cytoplasm.
a. Basophilic Normoblast b. Rubriblast c. Polychromatic Erythroblast d. Orthochromic Normoblast
25. Erythrocyte developmental stage that has a characteristic of round nucleus with an increased clumped of
chromatin pattern and pink-staining mixed with basophilia color of cytoplasm.
a. Basophilic Erythroblast b. Rubricyte c. Polychromatlic Erythrocyte d. Orthochromic Normoblast
26. Erythrocyte developmental stage that has a characteristic of round nucleus with a tightly condensed chromatin
pattern and a reddish-pink color of cytoplasm.
a. Prorubricyte b. Proerythroblast c. Orthochromic Normoblast d. Polychromatic Erythroblast
27. The earliest morphologically discernible granulocytic precursor [Auer Rods], aggregation of merged lysosomes
shows as RED, NEEDLE-LIKE Crystalline Cytoplasmic Inclusions:
a. Metamyelocyte b. Myeloblast c. Myelocyte d. Promyelocyte

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28. Theory about the origin of hematopoietic progenitor cells which states that: all blood cells are derived from a single
progenitor cell named as “pluripotent hematopoietic stem cell”:
a. Committed Theory b. Monophyletic Theory c. Non-Committed Theory d. Polyphyletic Theory
29. Theory about the origin of hematopoietic progenitor cells which states that: each of the blood cell lineages is
derived from its own unique stem cells:
a. Committed Theory b. Monophyletic Theory c. Non-Committed Theory d. Polyphyletic Theory
30. Primitive hematopoiesis during the mesoblastic phase takes place in the:
a. AGM region of the embryo c. Fetal Liver
b. Mesenchyme of the embryo d. Bone Marrow
31. Definitive hematopoiesis during the mesoblastic phase takes place in the:
a. AGM region of the embryo c. Fetal Liver
b. Mesenchyme of the embryo d. Bone Marrow
32. Production of embryonic hemoglobin are done by the:
a. Fetal Liver b. Blood Islands c. Primitive Erythroblasts d. Primitive Erythrocytes
33. The following blood cells begins its production during the mesoblastic phase of hematopoiesis, except:
a. Erythrocytes b. Lymphocytes c. Granulocytes d. Thrombocytes
34. During the hepatic phase of hematopoiesis, this organ becomes the primary site of blood cell production:
a. Bone Marrow b. Fetal Liver c. Spleen d. Yolk Sac
35. Definitive hematopoiesis during the hepatic phase begins at:
a. 5th to 6th week of gestation c. 19th to 20th day of gestation
th th
b. 4 to 5 month of gestation d. 6th month of gestation
36. All statements are true, except:
A. The RBC lacks a nucleus, has biconcave shape, and average vol. of 90 fL
B. Hemoglobin molecule has four globin chains, and each chain contains a heme molecule with an iron in the
ferric state.
C. The RBC transport CO2 and Bicarbonate from the tissues back to the lungs.
D. Without mitochondria, ATP is produced through Embden Meyerhof Pathway.
E. All statements are correct.
37. After 120 days, RBCs are disassembled into its reusable components. Which of the following components are
reusable?
I. Globin chains II. Iron III. Phospholipids IV. Protoporphyrin ring
A. I and II D. I, II, III, IV
B. I, II, III E. IV only
C. I and III
38. Which of the following enzymes are not involved in the First Phase of Embden Meyerhof Pathway?
I. Fructose-biphosphate aldolase III. Glyceraldehyde-3-phosphate dehydrogenase
II. Glucose-6-Phosphate isomerase IV. Hexokinase
A. I and II D. III only
B. I, II, IV E. None of the above
C. I, II, III, IV
39. The _________ detoxifies peroxide which arises from O2 reduction in the cell’s aqueous environment.
A. Hexose Monophosphate Pathway D. Both A and C
B. Embden Meyerhof Pathway E. Methemoglobin reductase pathway
C. Pentose Phosphate Pathway
40. The reduction of methemoglobin by NADPH is rendered more efficient in the presence of the enzyme _______.
A. Methemoglobin reductase D. Both A and B
B. Cytochrome b5 reductase E. All of the above
C. NADH
41. Phospholipids are asymmetrically distributed in the RBC membrane. Which of the following phospholipids
predominate in the outer layer?
I. Phosphatidylcholine II. Phosphatidylserine III. Phosphatidylethanolamine IV. Sphingomyelin
A. II and III D. All of the above
B. I and II E. None of the above
C. I and IV
42. A membrane defect caused by a functional defect in the “horizontal” protein interactions that hold the cytoskeleton
together.
A. Hereditary Elliptocytosis D. Hereditary Stomatocytosis
B. Hereditary Spherocytosis E. None of the Above
C. Hereditary Ovalocytosis
43. All of the following diseases are commonly associated with Microcytes, except
I. Iron deficiency anemia III. Sideroblastic Anemia V. Reticulocytosis
II. Anemia of Chronic Inflammation IV. Thalassemia
A. I and II D. V only
B. I, II, III E. None of the above
C. I, II, III, IV
44. Which among the following diseases are associated with an RBC abnormality that is described as small, round,
dense with no central pallor?
A. Sickle cell anemia D. Hereditary Stomatocytosis
B. Hb C disease E. Liver disease
C. Hereditary Spherocytosis

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45. RBC abnormality with a single pointed extension resembling a teardrop or pear.
A. Dacryocyte D. Spur cell
B. Echinocyte E. None of the above
C. Codocyte
46. The gold standard for assessment of body iron stores:
A. Prussian blue staining D. Total-Iron Binding capacity
B. Serum Ferritin E. sTfR-log ferritin index
C. Serum Iron Level
47. The iron-storage protein that functions mainly within the cells.
A. Transferrin D. Ferritin
B. Apotransferrin E. Hemosiderin
C. Holotransferrin
48. In instances where there is true iron deficiency, stfR/log ferritin will be ______ and hemoglobin content of
reticulocytes will be ______.
A. High; Low B. High; Normal C. Normal; Low D. Normal; Normal
49. When iron is not incorporated into heme, ______ binds instead to protoporphyrin IX. This accumulates in the red
blood cells, and has the greatest value in testing for Lead Poisoning.
A. Magnesium D. Copper
B. Zinc E. None of the above
C. Calcium
50. What is the primary purpose of measuring serum ferritin levels?
a) Diagnose iron poisoning c) Assess iron storage status
b) Measure serum iron content d) Determine erythropoiesis rate
51. This metabolic shunt generates 2,3-BPG / 2,3-DPG:
a) Embden-Meyerhof Pathway c) Methemoglobin Reductase Pathway e) None of These
b) Hexose Monophosphate Pathway d) Rapoport-Luebering Pathway
52. Which condition is associated with increased TIBC levels?
a) Iron deficiency anemia c) Lead poisoning
b) Anemia of chronic disease d) Hemolytic anemia
53. What does the percent saturation of TIBC measure?
a) The amount of iron bound to ferritin c) Lead poisoning
b) The ratio of serum iron to TIBC d) The rate of iron absorption in the intestines
54. 14. What is the principle behind the measurement of Free Erythrocyte Protoporphyrin (FEP)?
a) Binding of zinc to protoporphyrin c) Measurement of serum iron levels
b) Oxidation of hemoglobin d) Binding of iron to transferrin
55. All of the following Erythrocyte Inclusions can be seen in a Wright-stained smear, except
A. Pappenheimer bodies D. Basophilic stippling
B. Howell-Jolly body E. Heinz body
C. Cabot ring
56. 13. Blue rings or figure-eight on a Wright-stained smear are commonly associated with _____.
A. Sideroblastic anemia D. Lead poisoning
B. Hb H Disease E. G6PD deficiency
C. Megaloblastic anemia
57. When stained with New Methylene Blue, this inclusion is described as fine, evenly dispersed, dark blue granules,
which imparts a “golf-ball” appearance to RBCs.
A. Hb H D. Heinz bodies
B. Pappenheimer bodies E. Basophilic stippling
C. Cabot ring
58. Pappenheimer bodies contain ______.
A. DNA D. Mitotic spindle remnant
B. Precipitated RNA E. Iron
C. Denatured hemoglobin
59. When the body has adequate stores of iron the hepatocytes sense that and will increase the production of
hepcidin, leading to _____.
A. Inactivation of Ferroportin D. Both A and B
B. Decreased iron absorption E. None of the above
C. Increased iron absorption
60. A protein of hepatic origin that inhibits ferroportin from transporting iron out of the enterocyte.
A. Hephaestin D. Transferrin
B. Dcytb E. Ferritin
C. Hepcidin
61. These are RBC inclusions primarily composed of precipitated RNA which appear as dark blue-purple, fine or
coarse punctate granules distributed throughout cytoplasm when using a supravital stain:
a) Basophilic Stippling d) Heinz Bodies
b) Cabot Ring e) None of These
c) Diffuse Basophilia
62. An anomaly of the RBC where slightly larger RBCs with bluish tinge are observed indicating reticulocytosis.
a) Anisochromia d) Polychromasia
b) Anisocytosis e) None of these
c) Poikilocytosis

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63. Anisochromia reflects the following, except:
a) MCV d) hemoglobin content of RBC
b) MCH e) None of these
c) MCHC
64. Hemoglobin iron may become oxidized to Fe3+ by several pathologic mechanisms. What pathway reduces iron to
Fe2+?
A. Hexose Monophosphate Pathway D. Both A and C
B. Embden Meyerhof Pathway E. Methemoglobin reductase pathway
C. Pentose Phosphate Pathway
65. 18. What hexose-monophosphate shunt products participate in the detoxification of peroxides?
a) 2,3-BPG & Pyruvic Acid d) Pyruvic & Lactic Acid
b) ATP & Lactic Acid e) None of These
c) NADPH & Reduced Glutathione
66. Which of the following is rare group of genetic diseases characterized by low neutrophil count, increased risk of
infection, organ dysfunction, and a high rate of leukemic transformation?
A. Chediak-Higashi syndrome D. Myeloperoxidase Deficiency
B. May-Hegglin Anomaly E. Gaucher Disease
C. Congenital Neutropenia
67. Hereditary hyposegmentation is:
A. Pelger Huet Anomaly D. Myeloperoxidase Deficiency
B. Reilly Anomaly E. Macropolytosis
C. Gaucher's Disease
68. Monocytopenia is observed in ____ except:
A. Steroid therapy D. Epstein- Barr infection
B. Hemodialysis E. Aplastic anemia
C. Overwhelming infections
69. Which of the following is true about agranulocytosis?
A. seen in response to amidopyrine
B. absolute neutrophil count is < 0.5 x 10 to the 9th per liter of blood.
C. Contagious and occurs mainly in children
D. Both A & B
E. Both B & C
70. Which of the following is B-cell deficiency that affects usually males and all immunoglobulin classes are either
absent or extremely low?
A. Di George's syndrome D. Bruton agammaglobulinemia
B. Nezelof's syndrome E. None of the these
C. Common variable hypogammaglobulinemia
71. Which of the following is a type of histiocytosis with accumulated sphingomyelin in its cytoplasm?
A. Tay-Sachs D. Macropolytosis
B. Niemann-Pick E. None of these
C. Gaucher's
72. Which is true in toxoplasmosis?
A. similar to infectious mononucleosis
B. caused by Toxoplasma gondii
C. only a small number of immunocompetent patients are symptomatic
D. All choices are correct
E. None of the choices is correct
73. Which of the following is true in chronic lymphocytosis?
A. rare condition primarily affecting males D. rare condition primarily affecting children
B. rare condition primarily affecting females E. All choices are correct
C. affects post-splenectomy individuals
74. The following are functional disorders of neutrophils except:
A. Chronic Granulomatous Disease D. Specific Granule Deficiency
B. Wiskott-Aldrich syndrome E. None of the choices is correct
C. Myeloperoxidase Deficiency
75. Neutropenia is seen in _____ except:
A. Bacterial infections D. Toxins
B. Drugs, radiation E. None of the choices is correct
C. Immune-mediated
76. Basophilia is seen in______ except:
A. Ulcerative colitis D. Hypothyoidism
B. Immediate hypersensitivity E. None of the choices is correct
C. Hyperthyroidism
77. Neutrophilia can be seen in ____ except
A. Severe hemolysis D. Bacterial infections
B. Aplastic anemia E. None of the choices is correct
C. Myelogenous leukemia
78. Which of the following is true in monocytosis?
A. non-resolution of Mycobacterium tuberculosis D. resolution of Mycoplasma pnuemoniae
B. resolution of Mycobacterium tuberculosis E. All choices are correct
C. resolution of staphylococcal/streptococcal infection

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79. Which of the following is true in lymphadenitis?
A. Enlargement of lymph nodes D. None of the choices is correct
B. May be found in bacterial infection E. All choices are correct
C. If severe as in HIV may be referred to as lymphadenopathy
80. Which of the following is/are found in acute conditions like infections?
A. Dohle bodies B. Toxic granules C. None of these D. All choices are correct
81. Monocytosis is seen in____ except:
A. Syphilis C. Typhoid fever
B. Subacute Bacterial Endocarditis D. Aplastic anemia
82. Hereditary, large inclusion bodies which are RNA particles are found in ____.
A. Dohle bodies C. May Hegglin Anomaly
B. Chediak-Higashi anomaly D. Wiskott-Aldrich syndrome
83. Which of the following is the condition wherein inability of leukocytes to degrade mucopolysaccharides?
A. Lipidosis C. Hurler Syndrome
B. Mucopolyssacharidoses D. Turner Syndrome
84. Neutrophils and monocytes are direct descendants of a common progenitor known as:
A. CLP B. GMP C. MEP D. HSC
85. Which one of the following is a function of neutrophils?
A. Presentation of antigen to T and B lymphocytes C. Nonspecific destruction of foreign organisms
B. Protection against re-exposure by same antigen D. Initiation of delayed hypersensitivity response
86. The following is unique to both B and T lymphocytes and occurs during their early development:
A. Expression of surface antigens CD4 and CD8 C. Synthesis of immunoglobulins
B. Maturation in the thymus D. Rearrangement of antigen receptor g
87. Which of the following is the final stage of B cell maturation after activation by antigen?
A. Large, granular lymphocyte C. Reactive lymphocyte
B. Plasma cell D. Immunoblast
88. Which of the following cell types is capable of differentiating into osteoclasts, macrophages, or dendritic cells?
A. Neutrophils B. Lymphocytes C. Monocytes D. Eosinophils
89. Basophils and mast cells have high-affinity surface receptors for which immunoglobulin?
A. A B. D C. E D. G
90. Which of the following cells are important in immune regulation, allergic inflammation, and destruction of tissue
invading helminths?
A. Neutrophils and monocytes C. T and B lymphocytes
B. Eosinophils and basophils D. Macrophages and dendritic cells
91. The stage in neutrophilic development in which the nucleus is indented in a kidney bean shape and the cytoplasm
has secondary granules that are lavender in color is the:
A. Band B. Myelocyte C. Promyelocyte D. Metamyelocyte
92. The large granular lymphocytes function for ____ except
A. Antibody-dependent cell mediated cytolysis C. Killing virally-infected cells and tumor cells
B. Humoral Immunity D. All
93. Normally, there are more stab cells in the bone marrow than in the blood
A. True B. False
94. These cells migrate to and from the blood from the tissues except:
A. Eosinophil B. Basophil C. Lymphocyte D. Monocytes
95. Cells not considered as leukocytes but are tissue effector cells of allergy and inflammatory reactions:
A. Mast cells B. Kupffer Cells C. Basophils D. Eosinophils
96. The largest lymphopoietic organ:
A. Spleen B. Lymph nodes C. Bone marrow D. Gut-associated lymphoid tissues
97. Which of these cells is also called an immunocyte?
A. Monocyte B. Basophil C. Lymphocyte D. neutrophil
98. The type of white blood cell which increases during bacterial infection by phagocytosis:
A. Monocyte B. basophil C. lymphocyte D. neutrophil
99. Which of the following cells does not originate from myeloid stem cells?
A. Thymocytes B. Thrombocyte C. Macrophage D. Granulocytes
100. Stage of neutrophil development where mitosis stops:
A. Stab B. metamyelocyte C. promyelocyte D. myelocyte

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--END OF EXAM--
Prepared by: Hematology 1 CSG 1st Sem SY 2023-2024

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