1.6 Acute Leukemias Flashcards
Auer rods may be seen in all of the following except:
A. Acute myelomonocytic leukemia (M4)
B. Acute lymphoblastic leukemia (ALL)
C. Acute myeloid leukemia without maturation (AML:M1)
D. Acute promyelocytic leukemia (PML; M3)
B. Acute lymphoblastic leukemia (ALL)
Which type of anemia is usually present in a patient with acute leukemia?
A. Microcytic, hyperchromic
B. Microcytic, hypochromic
C. Normocytic, normochromic
D. Macrocytic, normochromic
C. Normocytic, normochromic
In leukemia, which term describes the peripheral blood finding of leukocytosis with a shift to the left, accompanied by NRBCs?
A. Myelophthisis
B. Dysplasia
C. Leukoerythroblastosis
D. Megaloblastosis
C. Leukoerythroblastosis
The basic pathophysiological mechanisms responsible for producing signs and symptoms in leukemia include all of the following except:
A. Replacement of normal marrow precursors by leukemic cells causing anemia
B. Decrease in functional leukocytes causing infection
C. Hemorrhage secondary to thrombocytopenia
D. Decreased erythropoietin production
D. Decreased erythropoietin production
Which type of acute myeloid leukemia is called the true monocytic leukemia and follows an acute or subacute course characterized by monoblasts, promonocytes, and monocytes?
A. Acute myeloid leukemia, minimally differentiated
B. Acute myeloid leukemia, without maturation
C. Acute myelomonocytic leukemia
D. Acute monocytic leukemia
D. Acute monocytic leukemia
In which age group does ALL occur with the highest frequency?
A. 1–15 years
B. 20–35 years
C. 45–60 years
D. 60–75 years
A. 1–15 years
Disseminated intravascular coagulation (DIC) is most often associated with which of the following types of acute leukemia?
A. Acute myeloid leukemia, without maturation
B. Acute promyelocytic leukemia (PML)
C. Acute myelomonocytic leukemia
D. Acute monocytic leukemia
B. Acute promyelocytic leukemia (PML)
An M:E ratio of 10:1 is most often seen in:
A. Thalassemia
B. Leukemia
C. Polycythemia vera (PV)
D. Myelofibrosis
B. Leukemia
Which of the following is a characteristic of Auer rods?
A. They are composed of azurophilic granules
B. They stain positive on periodic acid–Schiff (PAS) staining
C. They are predominantly seen in chronic myelogenous leukemia (CML)
D. They are nonspecific esterase positive
A. They are composed of azurophilic granules
SITUATION: The following laboratory values are seen:
WBC = 6.0 × 109/L Hgb = 6.0 g/dL
RBC = 1.90 × 1012/L Hct = 18.5%
PLT = 130 × 109/L
Serum vitamin B12 and folic acid: normal
WBC Differential Bone Marrow
6% PMNs 40% myeloblasts
40% lymphocytes 60% promegaloblasts
4% monocytes 40 megaloblastoid
NRBCs/100 WBCs 50% blasts
These results are most characteristic of:
A. Pernicious anemia
B. Acute myeloid leukemia, without maturation
C. Acute erythroid leukemia
D. Acute myelomonocytic leukemia
C. Acute erythroid leukemia
A 24-year-old man with Down syndrome presents with fever, pallor, lymphadenopathy, and hepatosplenomegaly. His CBC results are as follows:
WBC = 10.8 × 109/L RBC = 1.56 × 1012/L
8% PMNs Hgb = 3.3 g/dL
25% lymphocytes Hct = 11%
67% PAS-positive blasts PLT = 2.5 × 109/L
These findings are suggestive of:
A. Hodgkin lymphoma
B. Myeloproliferative disorder
C. Leukemoid reaction
D. Acute lymphocytic leukemia
D. Acute lymphocytic leukemia
SITUATION: A peripheral blood smear shows 75% blasts. These stain positive for both Sudan Black B (SBB) and peroxidase. Given these values, which of the following disorders is most likely?
A. Acute myelocytic leukemia (AML)
B. CML
C. Acute undifferentiated leukemia (AUL)
D. ALL
A. Acute myelocytic leukemia (AML)
In myeloid cells, the stain that selectively identifies phospholipid in the membranes of both primary and secondary granules is:
A. PAS
B. Myeloperoxidase
C. SBB
D. Terminal deoxynucleotidyl transferase (TdT)
C. SBB
Sodium fluoride may be added to the naphthyl ASD acetate (NASDA) esterase reaction. The fluoride is added to inhibit a positive reaction with:
A. Megakaryocytes
B. Monocytes
C. Erythrocytes
D. Granulocytes
B. Monocytes
Leukemic lymphoblasts reacting with anti–common acute lymphoblastic leukemia antigen (anti-CALLA) are characteristically seen in:
A. B-cell ALL
B. T-cell ALL
C. Null-cell ALL
D. Common ALL
D. Common ALL
Which of the following reactions are often positive in ALL but are negative in AML?
A. TdT and PAS
B. Chloroacetate esterase and nonspecific esterase
C. SBB and peroxidase
D. New methylene blue and acid phosphatase
A. TdT and PAS
A patient’s peripheral blood smear and bone marrow both show 70% blasts. These cells are negative on SBB staining. Given these data, which of the following is the most likely diagnosis?
A. AML
B. Chronic lymphocytic leukemia (CLL)
C. Acute PML
D. ALL
D. ALL
Which of the following leukemias are included in the 2008 World Health Organization classification of myeloproliferative neoplasms (MPN)?
A. CML
B. Chronic neutrophilic leukemia (CNL)
C. Chronic eosinophilic leukemia (CEL)
D. All of these options are classified as MPN
D. All of these options are classified as MPN
In addition to morphology, cytochemistry, and immunophenotyping, the WHO classification of myelo- and lymphoproliferative disorders is based on which characteristic?
A. Proteomics
B. Cytogenetic abnormalities
C. Carbohydrate-associated tumor antigen production
D. Cell signaling and adhesion markers
B. Cytogenetic abnormalities
The WHO classification requires what percentage for the blast count in blood or bone marrow for the diagnosis of AML?
A. At least 30%
B. At least 20%
C. At least 10%
D. Any percentage
D. Any percentage
What would be the most likely designation by the WHO for AML M2 by the FAB classification?
A. AML with t(15;17)
B. AML with mixed lineage
C. AML with t(8;21)
D. AML with inv(16)
C. AML with t(8;21)
What would be the most likely designation by the WHO for AML M3 by the FAB classification?
A. AML with t(15;17)
B. AML with mixed lineage
C. AML with t(8;21)
D. AML with inv(16)
A. AML with t(15;17)
Which AML cytogenetic abnormality is associated with AML M4 with marrow eosinophilia under the WHO classification of AML with recurrent genetic abnormalities?
A. AML with t(15;17)
B. AML with mixed lineage
C. AML with t(8;21)
D. AML with inv(16)
D. AML with inv(16)
What would be the most likely classification by the WHO for AML M7 by the FAB classification?
A. Acute myeloid leukemias with recurrent genetic abnormalities
B. Acute myeloid leukemia with multilineage dysplasia
C. Acute megakaryoblastic leukemia classified under AML (not otherwise categorized)
D. Acute leukemias of ambiguous lineage
C. Acute megakaryoblastic leukemia classified under AML (not otherwise categorized)
