Hematology Reviewer for MTLE Philippines 2026

By LisensyaPrep Team | Last Updated: April 2026 | 11-minute read

Hematology is one of the most consistently tested subjects in the Medical Technologist Licensure Examination. It covers the study of blood, its components, their formation, and the disorders that arise when any part of that system breaks down.

The good news is that hematology rewards structured review more than almost any other MTLE subject. The concepts build on each other logically. Once you understand normal blood cell development, the abnormal findings in disease states become much easier to recognize and remember.

This reviewer covers the core areas of hematology tested in the MTLE, from blood cell morphology and CBC interpretation through coagulation and hemoglobin disorders.

Blood Cell Formation: Hematopoiesis

All blood cells originate from a single pluripotent stem cell in the bone marrow. The process by which these stem cells develop into the various mature blood cell types is called hematopoiesis.

Understanding the normal developmental sequence is essential because many MTLE questions ask you to identify which stage a cell is at based on its morphological description, or to explain why a certain disorder produces a particular type of abnormal cell.

Red Blood Cells: Normal Values and Morphology

Normal RBC Reference Values

The complete blood count is the most commonly performed laboratory test and one of the most tested topics in MTLE hematology. Know these normal values by heart.

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RBC Morphology Terms You Must Know

Anisocytosis refers to variation in red blood cell size. It is reflected in an elevated RDW.

Poikilocytosis refers to variation in red blood cell shape. It is a non-specific finding that appears in many different disorders.

Microcytosis means RBCs are smaller than normal. MCV below 80 fL. Seen in iron deficiency anemia, thalassemia, and anemia of chronic disease.

Macrocytosis means RBCs are larger than normal. MCV above 100 fL. Seen in megaloblastic anemia from vitamin B12 or folate deficiency.

Target cells (codocytes) are RBCs with a bull's-eye appearance. Seen in thalassemia, liver disease, and hemoglobin C disease.

Sickle cells (drepanocytes) are crescent-shaped RBCs seen in sickle cell disease caused by the HbS mutation.

Schistocytes are RBC fragments seen in microangiopathic hemolytic anemia, DIC, and thrombotic thrombocytopenic purpura.

Spherocytes are small, round, densely staining RBCs without central pallor. Seen in hereditary spherocytosis and autoimmune hemolytic anemia.

Teardrop cells (dacrocytes) are RBCs shaped like teardrops. Classically seen in myelofibrosis.

White Blood Cell Differential

Normal WBC Values and Differential

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Left Shift and Right Shift

Left shift means immature neutrophils (bands, metamyelocytes) are released into circulation before they fully mature. It indicates the bone marrow is under demand, usually from severe bacterial infection or inflammation.

Right shift means neutrophils have more than the normal 5 lobes in their nucleus. Also called hypersegmentation. Classic finding in megaloblastic anemia from B12 or folate deficiency.

Coagulation: The Clotting Cascade

Key Coagulation Tests

Prothrombin Time (PT/INR) tests the extrinsic and common pathways. Prolonged in warfarin therapy, liver disease, and factor VII deficiency.

Activated Partial Thromboplastin Time (aPTT) tests the intrinsic and common pathways. Prolonged in heparin therapy, hemophilia A (factor VIII deficiency), and hemophilia B (factor IX deficiency).

Thrombin Time (TT) tests fibrinogen to fibrin conversion. Prolonged in hypofibrinogenemia, dysfibrinogenemia, and heparin contamination.

D-dimer is a fibrin degradation product elevated in DIC, pulmonary embolism, and deep vein thrombosis.

Common Anemias: Classification and Recognition

Microcytic Anemias (MCV below 80 fL)

Iron deficiency anemia is the most common anemia worldwide. Key findings: low serum iron, low ferritin, high TIBC, high RDW, microcytic hypochromic RBCs. Pencil cells (elliptocytes) may be seen on peripheral smear.

Thalassemia results from defective globin chain synthesis. Key finding: target cells on peripheral smear, normal or low RDW (unlike iron deficiency where RDW is high), elevated HbA2 in beta thalassemia trait.

Anemia of chronic disease shows low serum iron but also low TIBC, with normal or elevated ferritin. This distinguishes it from iron deficiency where TIBC is elevated.

Macrocytic Anemias (MCV above 100 fL)

Megaloblastic anemia from B12 or folate deficiency shows hypersegmented neutrophils on peripheral smear, oval macrocytes, and pancytopenia in severe cases. B12 deficiency additionally causes neurological symptoms which folate deficiency does not.

Normocytic Anemias (MCV 80 to 100 fL)

Hemolytic anemias including sickle cell disease, hereditary spherocytosis, and autoimmune hemolytic anemia. Key findings: elevated reticulocyte count, elevated indirect bilirubin, elevated LDH, decreased haptoglobin.

Aplastic anemia results from bone marrow failure. Shows pancytopenia with a hypocellular bone marrow biopsy.

How to Study Hematology for the MTLE

Hematology questions in the MTLE come in two forms. The first type gives you lab values and asks you to identify the disorder. The second type describes a clinical scenario and asks what laboratory finding you would expect.

For both types, build a habit of thinking in patterns. Iron deficiency has a pattern: low iron, low ferritin, high TIBC, microcytic, high RDW. Megaloblastic anemia has a pattern: macrocytic, hypersegmented neutrophils, low B12 or folate. Learn the patterns, not isolated facts.

Practice questions for MTLE Hematology are available at LisensyaPrep. No account needed.

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