1st Sem Finals Flashcards
1
Q
Tumor suppressor gene altered in the majority of cancers.
a. PTEN
b. RB
c. P53
d. APC
A
c. P53
2
Q
Laboratory studies of a surgical specimen obtained from a patient with colon cancer demonstrate hypermethylation of the p53 gene. Which of the following best characterizes this biochemical change in the neoplastic cells?
a. Gene amplification
b. Proto Oncogene mutation
c. Epigenetic modification
d. Driver mutation
A
c. Epigenetic modification
3
Q
Most common cancers are effects of ionizing radiation.
a. Myeloid leukemias
b. Thyroid cancer
c. Breast cancers
d. Lung cancers
e. Skin cancers (i.e. melanoma)
A
a. Myeloid leukemias
4
Q
Ms. Iwa Motors, a 75-year old female, a previously heavy smoker, was diagnosed with lung adenocarcinoma. As her physician, you explain that a possible mutation involving the signal transducing protein that caused her cancer is?
a. KRAS
b. LOVE
c. JAK2
d. MHAL
e. FRND/ZNE
A
a. KRAS
5
Q
A critical virulence factor of H. pylori for the development of gastric cancer
a. vacB
b. cagA
c. dupA
d. tupA
e. dobB
A
b. cagA
6
Q
The nomenclature of benign vs malignant neoplasms was explained in the lectures. Which of the following is NOT benign?
a. Fibroma
b. Lymphoma
c. Papilloma
d. Cystadenoma
e. None of the choices
A
b. Lymphoma
7
Q
Environmental carcinogen associated with Hepatic angiosarcoma
a. Asbestos
b. Vinyl chloride
c. Cadmium
d. Benzene
A
b. Vinyl chloride
8
Q
Jovit Sucaldito, a 68 year-old male, was diagnosed with colorectal carcinoma. He came to you asking if cucumbers can help but you explained that there is a bigger picture involved that where cucumbers are insufficient. You explained to him that his cancer maybe due to a defect in the “gatekeeper of colonic neoplasia”, which is..?
a. p53
b. APC
c. p16
d. RB
e. EGFR
A
b. APC
9
Q
HPV Viral oncoprotein that neutralizes growth inhibitory activities of RB and/or p53 gene.
a. E5,E6
b. E6,E7
c. E7,E8
d. E8,E9
A
b. E6,E7
10
Q
Refers to the extent to which neoplastic parenchymal cells resemble the corresponding normal parenchymal cells both morphologically and functionally
a. Metaplasia
b. Differentiation
c. Pleomorphism
d. Anaplasia
A
b. Differentiation
11
Q
Faramir, a 67 year-old male, came for consult to the ER due to chronic abdominal pain. He appears jaundiced with a very protuberant abdomen. On history he admits to having frequent heavy bouts of binge alcohol drinking. He also has a history of cancer in both his mother and father’s side. You requested for some laboratories because you suspect he might have cancer. If he has very elevated CA19-9 and normal level of CEA and AFP, you would suspect him to have?
a. Liver cancer
b. Colon cancer
c. Pancreatic cancer
d. Prostate cancer
e. stomach cancer
A
c. Pancreatic cancer
12
Q
Mutated genes that cause excessive cell growth even in the absence of growth factor and other growth promoting
a. Oncogenes
b. Tumor suppressor genes
c. Oncoprotein
A
a. Oncogenes
13
Q
Mutations of these cause a “loss-of-function”, and behave in a recessive fashion.
a. Oncogenes
b. Oncoproteins
c. Tumor suppressor genes
d. Driver mutation
e. Passenger mutation
A
c. Tumor suppressor genes
14
Q
It is the most reliable feature that differentiates most malignant from benign tumors
a. Metaplasia
b. Dysplasia
c. Invasiveness
d. Increase in mitotic Figures
e. Tumor size
A
c. Invasiveness
15
Q
Eowyn, a G0P0 68-year old woman, came for consultation due to prolonged pelvic pain and a bloated feeling. She previously sought consultation with another physician but was lost to follow-up due to prolonged mourning of her brother, Eomer. You looked at the labs requested and noticed that CA125 was requested. You would remember well from your pathology discussions that this is a marker for..?
a. Colon cancer
b. Endometrial cancer
c. Breast cancer
d. Ovarian cancer
e. Trophoblastic tumors
A
d. Ovarian cancer
16
Q
Which of the following do not belong to the group? a. Xeroderma pigmentosum
b. Fanconi syndrome
c. Bloom syndrome
d. Ataxia telangectasia
e. None of the choices
A
a. Xeroderma pigmentosum
17
Q
Which of the following viruses is NOT associated with carcinogenesis?
a. HSV1
b. HPV
c. HBV
d. HSV2
e. All of the choices are associated with cancer.
A
a. HSV1
18
Q
Mutated BRCA1 and BRCA 2 genes are implicated in which hereditary tumors:
a. Breast carcinoma
b. Bladder carcinoma
c. Prostate carcinoma
d. Ovarian carcinoma
A
a. Breast carcinoma
19
Q
Most common pathway for the initial dissemination of cancers.
a. Lymphatic spread
b. Seeding of body cavities
c. Hematogenous spread
d. None
A
a. Lymphatic spread
20
Q
A 3-year-old boy presents with intermittent hematuria for 1 week. On examination he appears well developed and well nourished, except a right flank mass is palpable. A biopsy of the mass is performed, which reveals primitive looking small blue cells with glomeruloid and tubuloid structures. What is the diagnosis?
a. Medulloblastoma
b. Wilms tumor
c. Clear cell sarcoma
d. Polycystic kidney disease
A
b. Wilms tumor
21
Q
The hallmark of malignancy:
a. Anaplasia
b. Metaplasia
c. Metastasis
d. Mitosis
A
a. Anaplasia
22
Q
The following are fundamental changes in cell physiology which are considered as hallmarks of cancer except
a. Tumors may not respond to molecules that inhibit the proliferation of normal cells
b. Tumors are resistant to programmed cell death
c. Tumors have unrestricted proliferative capacity
d. Tumor cells undergo a metabolic switch to
anaerobic glycolysis
A
d. Tumor cells undergo a metabolic switch to
anaerobic glycolysis
23
Q
Mr. Robot Jaworski has a 1 year-old child recently diagnosed with retinoblastoma. As the physician on duty upon check-up, you would explain that retinoblastoma is an abnormality in what GENE?
a. Merlin
b. Ankyrin
c. RB
d. PTCH
e. PTEN
A
c. RB
24
Q
A 45-year-old female undergoes a colectomy. The pathologist identifies more than 100 polyps in the resected specimen as well as a focus of invasive adenocarcinoma. What is the functional mechanism for the gene mutation causing this disease process?
a. Increased breakdown of β-catenin
b. Decreased breakdown of β-catenin
c. Decreased activity of β-catenin
d. Lack of production of β-catenin
A
b. Decreased breakdown of β-catenin - answer key ni Doc
25
Cascade of anomalies triggered by one initiating aberration?
a. Sequence
b. Deformations
c. Malformations
d. Disruptions
a. Sequence
26
Which of the following increases the risk of Wilms Tumor?
a. Turner Syndrome
b. Edward Syndrome
c. Klinefelter Syndrome
d. Beckwith-Wiedemann syndrome
e. Alport syndrome
d. Beckwith-Wiedemann syndrome
27
Which of the following is a common malignant neoplasm in 5-9 years
a. Hepatocellular carcinoma
b. Ewing Sarcoma
c. Lymphoma
d. Thyroid carcinoma
a. Hepatocellular carcinoma
28
What is the most common pathogen that colonizes the lower respiratory tract of patients with cystic fibrosis?
a. Staphylococcus aureus
b. Pseudomonas aeruginosa
c. Klebsiella pneumoniae
d. Chlamydophila psittaci
b. Pseudomonas aeruginosa
29
The gold standard for the diagnosis of Cystic Fibrosis. a. trypsinogen
b. sweat chloride test
c. CFTR gene sequencing
d. none of the above
c. CFTR gene sequencing
30
Most common extracranial solid tumor of childhood.
a. Leukemia
b. Retinoblastoma
c. Neuroblastoma
d. Wilm's tumor
c. Neuroblastoma
31
The most common cause of early onset sepsis and early-onset bacterial meningitis.
a. Streptococcus agalactiae
b. Candida albicans
c. Staphylococcus aureus
d. Listeria
a. Streptococcus agalactiae
32
Refers to microscopically normal cells or tissues that are present in abnormal locations.
a. Hamartoma
b. Metastasis
c. Choristoma
d. Teratoma
c. Choristoma
33
A deficiency in this enzyme is the major cause of hyperphenylalaninemia which impairs brain development.
a. Tetrahydrobiopterin reductase
b. Dihydropteridine reductase
c. Phenylalanine hydroxylase
d. Tetrahydrobiopterin oxidase
c. Phenylalanine hydroxylase
34
A 2-week-old infant is evaluated in the emergency room for failure to thrive. The patient has persistent diarrhea, which started at 3 days old. The child’s temperature is 39.5 C, pulse is 145/min, and blood pressure is 66/44. On examination, bilateral corneal opacities are noted. There is mild hepatomegaly. The heart and lungs are clear. Moderate jaundice is observed. The child’s blood glucose is 125 mg/dL, and the urine is positive for reducing substance. What is the most likely underlying condition?
A. Phenylketonuria
B. Galactosemia
C. Homocystinuria
D. Congenital type 1 diabetes
B. Galactosemia
35
An infant born at 39 weeks gestation age via uncomplicated vaginal delivery is noted to have a ring-like constriction of the 3rd digit of the right hand and distal amputation of the 4th digit of the right hand at birth. The child is otherwise normal. What type of morphologic anomaly are these findings an example of?
A. Malformation
B. Sequence
C. Disruption
D. Deformation
C. Disruption
36
Mental retardation in babies born to mothers with PKU is most likely caused by?
A. An enzyme deficiency in the baby
B. PKU in the baby
C. High blood phenylalanine in the mother during pregnancy
D. The father carrying the gene for PKU
E. Too little protein in the mother’s diet during
pregnancy
C. High blood phenylalanine in the mother during pregnancy
37
All of the following statements about arterial calcification in the elderly are true EXCEPT:
a. It involves small- and medium-sized vessels.
b. It can result in ischemic gangrene
c. It is a complication of diabetes
d. It is associated with varicose veins.
d. It is associated with varicose veins
38
These vessels are the principal points of physiologic resistance to blood flow.
a. Arteries
b. Arterioles
c. Veins
d. Capillaries
b. Arterioles
39
A 70-year-old, previously healthy man presents with right upper quadrant pain. Physical examination demonstrates hepatomegaly. A liver biopsy reveals a vascular lesion composed of pleomorphic endothelial cells with hyperchromatic nuclei and numerous mitoses. Laboratory tests for HIV infection are negative. Which of the following is the most likely diagnosis?
a. Angiosarcoma
b. Dermatofibroma
c. Glomus tumor
d. Hemangioma
e. Kaposi sarcoma
a. Angiosarcoma
40
The long term success of angioplasty is limited by which of the following?
a. Vascular dissection
b. Vessel wall spasm
c. Thrombosis
d. Restenosis
d. Restenosis
41
A 60-year-old man presents with dizziness, nausea, and severe shortness of breath of several months’ duration. Physical examination shows hepatomegaly, ascites, and anasarca. His blood pressure is 200/115 mm Hg. An X-ray film of the chest demonstrates cardiomegaly and mild pulmonary edema. Although different mechanisms may have contributed to the pathogenesis of hypertension in this patient, the common end result for all of them is which of the following?
a. Arterial cystic medial necrosis
b. Decreased plasma oncotic pressure
c. Generalized vasodilation
d. Increased peripheral vascular resistance
e. Increased vascular permeability
d. Increased peripheral vascular resistance
42
Which of the following types of vasculitis is mediated by immune complex deposition?
a. Wegener granulomatosis
b. Churg-Strauss angiitis
c. Microscopic polyangiitis
d. Henoch-Schönlein purpura
d. Henoch-Schönlein purpura
43
This refers to an alteration in the endothelial phenotype that Is often proinflammatory and prothrombogenic.
a. Endothelial proliferation
b. Endothelial dysfunction
c. Endothelial injury
d. Endothelial phenotype switching
b. Endothelial dysfunction
44
All of the following conditions can cause aneurysm of the ascending aorta EXCEPT:
a. Mönckeberg medial calcification
b. Syphilitic aortitis
c. Takayasu disease
d. Marfan syndrome
a. Mönckeberg medial calcification
45
Which of the following substances helps prevent the development of atherosclerosis?
a. Homocysteine
b. Fibrinogen
c. Antioxidants
d. C-reactive proteins
c. Antioxidants
46
An 80-year-old woman with a history of smoking experiences acute chest pain and is rushed to the emergency room. Laboratory studies and ECG confirm a diagnosis of myocardial infarction; however, coronary artery angiography 2 hours later does not demonstrate evidence of vessel occlusion. Which of the following proteins mediated fibrinolysis at the site of temporary blockage in this patient’s coronary artery?
a. Bradykinin
b. Collagenase
c. Kallikrein
d. Plasmin
e. Thrombin
d. Plasmin
47
Which of the following shows the correct sequence of the development of atherosclerosis?
a. Endothelial dysfunction, monocyte and platelet adhesion to endothelium, accumulation of lipoproteins in vessel wall, ECM production, extra- and intracellular lipid accumulation
b. Endothelial dysfunction, accumulation of lipoproteins in vessel wall, monocyte and platelet adhesion, ECM production, extra- and intracellular lipid accumulation
c. Extra- and intracellular lipid accumulation, endothelial dysfunction, accumulation of lipoproteins in vessel wall, monocyte and platelet adhesion, ECM production, calcification
d. Extra- and intracellular lipid accumulation, endothelial dysfunction, accumulation of lipoproteins in vessel wall, monocyte and platelet adhesion ECM production
b. Endothelial dysfunction, accumulation of lipoproteins in vessel wall, monocyte and platelet adhesion, ECM production, extra- and intracellular lipid accumulation
48
A previously healthy 67-year-old man presents to the emergency room with numbness of his left leg. Temperature and blood pressure are normal. Physical examination shows pallor and a cool left leg with absence of distal pulse. An ECG reveals no abnormalities. An arteriogram demonstrates a markedly dilated abdominal aorta and occlusion of the left popliteal artery. The blockage is removed surgically, and the patient recovers. Which of the following is the most likely source of the arterial thromboembolism in this patient?
a. Deep venous thrombosis
b. Left ventricular mural thrombus
c. Nonbacterial endocarditis
d. Paradoxical emboli
e. Thrombus from an atheromatous aorta
e. Thrombus from an atheromatous aorta
49
What region of the heart is most susceptible to ischemia?
a. Endocardium
b. Subendocardium
c. Pericardium
d. Sub Pericardium
b. Subendocardium
50
A 40-year-old female with an unrepaired ventricular septal defect develops dyspnea and cyanosis. An echocardiogram reveals dilation and hypertrophy of the right ventricle. Which condition has she developed?
a. Eisenmenger’s syndrome
b. Trousseau’s syndrome
c. Osler-Weber-Rendu syndrome
d. Superior vena cava syndrome
a. Eisenmenger’s syndrome
51
A 30-year-old woman presents with a heart murmur. There is a history of recurrent episodes of arthritis, skin rash, and glomerulonephritis. Blood cultures are negative. Laboratory tests for antinuclear antibodies (ANA) and anti–double-stranded DNA are positive. Which of the following is the most likely cause of heart murmur in this patient?
a. Libman-Sacks endocarditis
b. Mitral valve prolapse
c. Myocardial infarct
d. Rheumatic fever
a. Libman-Sacks endocarditis
52
A 60-year-old man presents with increasing girth and fatigue.Physical examination reveals peripheral edema, ascites, and hepatomegaly. Liver function tests are normal. An echocardiogram shows a remarkably enlarged right heart and no signs of valvular heart disease. Endomyocardial biopsy discloses interstitial, pink amorphous deposits between cardiac myocytes. Which of the following is the appropriate diagnosis?
a. Carcinoid disease
b. Cardiac amyloidosis
c. Dilated cardiomyopathy
d. Hypertrophic cardiomyopathy
e. Rheumatic heart disease
b. Cardiac amyloidosis
53
A 40-year-old woman with a history of rheumatic fever presents with shortness of breath, weight loss, fatigue, and abdominal distension. Physical examination shows rales in the lungs, hepatosplenomegaly, and 2+ pitting edema of the legs. A chest X-ray reveals only left atrial enlargement and pulmonary edema. What is the most likely cause of pulmonary edema in this patient?
a. Aortic insufficiency
b. Aortic stenosis
c. Mitral stenosis
d. Pulmonic stenosis
c. Mitral stenosis
54
The most common cause of right-sided heart failure.
a. Primary pulmonary hypertension
b. Pulmonary embolism
c. Cardiac amyloidosis
d. Left-sided heart failure
d. Left-sided heart failure
55
66-year-old man presents with recurrent chest pain that develops whenever he attempts to mow his yard. He relates that the pain goes away after a couple of minutes if he stops and rests. He also states that the pain has not increased in frequency or duration in the last several months. Which of the following is the most likely diagnosis?
a. Stable angina
b. Unstable angina
c. Atypical angina
d. Prinzmetal angina
a. Stable angina
56
A 62-year-old man with a history of hypertension is brought to the emergency room with severe left chest and back pain. His blood pressure is 80/50 mm Hg. Physical examination shows pallor, diaphoresis, and a murmur of aortic regurgitation. An ECG does not show myocardial infarction. An X-ray film of the chest reveals mediastinal widening. Which of the following is the most likely diagnosis?
a. Bacterial endocarditis
b. Dissecting aneurysm
c. Pericarditis
d. Pulmonary thromboembolism
e. Ruptured myocardial wall
b. Dissecting aneurysm
57
The most common chromosomal abnormality associated with congenital heart disease:
a. Deletions in chromosomal region 22q11.2
b. 45 XO chromosomal karyotype
c. Trisomy 21
d. Trisomy 18
c. Trisomy 21
58
Which of the following is TRUE of physiologic cardiac hypertrophy?
a. Static exercise is associated with volume-load hypertrophy
b. Aerobic exercise increases resting heart rate
c. Recurrent Valsalva maneuvers during weight lifting results in more beneficial cardiac remodeling
d. Aerobic exercise results in hypertrophy with accompanying increase in capillary density
d. Aerobic exercise results in hypertrophy with accompanying increase in capillary density
59
Themostcommonmechanismofsuddencardiacdeath.
a. Lethal arrhythmia
b. Ventricular free wall rupture
c. Myocardial infarction
d. Dressler syndrome
a. Lethal arrhythmia
60
A 7-year-old boy presents with the acute onset of fever, pain in several joints, and a skin rash. Physical examination finds an enlarged heart, several subcutaneous nodules, and a skin rash on his back with a raised,erythematous margin. Laboratory tests find an elevated erythrocyte sedimentation rate and an elevated antistreptolysin O titers. Which one of the following is most likely to be present in the heart of this child?
a. Beta hemolytic streptococci
b. Anitschkow cells
c. Langhans giant cells
d. Psammoma bodies
b. Anitschkow cells
61
A 45-year-old man had a mediastinal mass and bilateral pleural effusion. Diagnosis was acute lymphoblastic lymphoma. Unfavorable prognosis is expected in this patient because of presence of all of the following factors EXCEPT:
a. Male gender
b. High white cell count
c. Polyploid tumor cells/ hyperdiploidy
d. Translocation t(1;19)(q21;q23)
c. Polyploid tumor cells/ hyperdiploidy
A kay doc
62
The most important prognostic parameter in Hodgkin disease is:
a. Age
b. Clinical stage
c. Location
d. Histologic type
b. Clinical stage
63
A 50-year-old man presents with fever and diffuse lymphadenopathy. A lymph node biopsy reveals non-Hodgkin follicular lymphoma. Immunohistochemical staining of neoplastic lymphoid cells within the nodular areas of the lymph node would be expected to stain positively for which of the following protein markers?
a. Abl
b. Bax
c. Bcl-2
d. Myc
e. Retinoic acid receptor
c. Bcl-2
64
What is the most common lymphoma seen in children?
a. Lymphoblastic lymphoma
b. Classical Hodgkin lymphoma
c. Nodular lymphocyte predominant Hodgkin lymphoma
d. Diffuse large B-cell lymphoma
a. Lymphoblastic lymphoma
65
Under what category of myeloid neoplasm where there is Increased production of one or more terminally differentiated myeloid element, usually leading to elevated counts
a. Acute Myeloid Leukemia
b. Myeloid Dysplastic syndrome
c. Chronic myeloproliferative disorders
c. Chronic myeloproliferative disorders
66
This is neoplasm of B cell with (11;14) translocation a. Burkitt lymphoma
b. DLBCL
c. Follicular lymphoma
d. Mantle cell lymphoma
d. Mantle cell lymphoma
67
This subtype of Hodgkin lymphoma is usually stage III or IV and 70% is associated with EBV
a. Nodular sclerosis
b. Mixed Cellularity
c. Lymphocyte rich
d. Lymphocyte depletion
e. Lymphocyte predominance
b. Mixed Cellularity
68
A 60-year-old man complains of night sweats, weight loss, easy fatigability, and discomfort in the left upper abdominal quadrant. Physical examination reveals splenomegaly. Laboratory studies show leukocytosis (40,000/mL). A peripheral blood smear demonstrates mature and maturing granulocytes, myelocytes, basophils, and occasional myeloblasts. The bone marrow is hypercellular and dominated by WBC precursors. Megakaryocytes are numerous, and RBC precursors are less prominent. A smear of the bone marrow aspirate is shown in the image. Cytogenetic studies disclose a monoclonal population of abnormal cells with a t(9;22)(q34;q11) chromosomal translocation. What is the appropriate diagnosis?
a. Acute lymphoblastic leukemia
b. Acute myeloid leukemia
c. Chronic lymphocytic leukemia
d. Chronic myelogenous leukemia
e. Myelodysplastic syndrome
d. Chronic myelogenous leukemia
69
This virus has been implicated as causative agent of Burkitt Lymphoma
a. HTLV1
b. EBV
c. KSHV
d. HHV8
b. EBV
70
A 49-year old man complains of back pain, fatigue and occasional confusion with polyuria and polydipsia. An X-ray was requested revealing numerous lytic lesions in the lumbar vertebral bodies. Laboratory studies disclose hypoalbuminemia, mild anemia and thrombocytopenia. A monoclonal IgK peak is demonstrated by serum electrophoresis. Urinalysis shows 4+ proteinuria. Bone marrow biopsy shows foci of plasma cells which account for 18% of all hematopoietic cells. What is the appropriate diagnosis?
a. Multiple myeloma
b. Waldenstrom macroglobulinemia
c. Chronic lymphocytic leukemia
d. Acute lymphoblastic lymphoma
a. Multiple myeloma
71
Physical examination reveals marked pallor. Palpation of his sternum demonstrates diffuse tenderness. Laboratory studies disclose anemia, thrombocytopenia, and leukocytosis. The WBC differential count shows that 90% blasts. A bone marrow biopsy stained immunohistochemically for terminal deoxynucleotidyl transferase (TdT) is shown in the image. Which of the following is the appropriate diagnosis?
a. Acute lymphoblastic leukemia
b. Acute myelogenous leukemia
c. Acute promyelocytic leukemia
d. Chronic lymphocytic leukemia
e. Chronic myelogenous leukemia
a. Acute lymphoblastic leukemia
72
What condition would increase the osmotic fragility test?
a. Sickle cell anemia
b. Thalassemia
c. Hereditary spherocytosis
d. Megaloblastic anemia
c. Hereditary spherocytosis
73
What is the most abundant hemoglobin in adults?
a. HbA
b. HbS
c. HbF
d. HbA2
a. HbA
74
The most common location for thymomas?
a. Thyroid
b. Anterior superior mediastinum
c. Neck
d. Posterior mediastinum
b. Anterior superior mediastinum
75
Which is the most aggressive among these B cell neoplasm
a. Burkitt lymphoma
b. DLBCL
c. Follicular lymphoma
d. Mantle cell lymphoma
b. DLBCL - sagot ni Doc
a. Burkitt lymphoma - agsa
76
A 62-year-old man presents with a history of several months of vague abdominal pain and fatigue. Physical examination reveals marked splenomegaly but no evidence of lymphadenopathy. The patient subsequently develops bacterial sepsis and expires. A bone marrow biopsy at autopsy shows numerous atypical megakaryocytes and marked marrow fibrosis (results shown in the image). Which of the following is the most likely diagnosis?
a. Acute myelogenous leukemia
b. Acute promyelocytic leukemia
c. Chronic idiopathic myelofibrosis
d. Chronic lymphocytic leukemia
e. Chronic myelogenous leukemia
c. Chronic idiopathic myelofibrosis
77
What WBC neoplasm is related to cigarette smoking
a. ALL
b. AML
c. CML
d. CLL
b. AML
78
A 38-year old man complains of fatigue and nausea for 3 months. Physical examination reveals numerous pustules on the face with splenomegaly and hepatomegaly. Laboratory studies show hemoglobin of 6.3 g/dl and platelets of 50,000/uL. A peripheral smear shows malignant cells with Auer rods. The patient develops diffuse purpura, bleeding from the gums and laboratory features of disseminated intravascular coagulation (DIC). Which is the appropriate diagnosis?
a. Chronic myelogenous leukemia
b. Acute lymphoblastic leukemia
c. Acute megakaryocytic leukemia
d. Acute promyelocytic leukemia
d. Acute promyelocytic leukemia
79
What condition will have macrocytic RBCs in the PBS?
a. IDA
b. Pernicious anemia
c. Thalassemia
d. sideroblastic anemia
b. Pernicious anemia
80
Which of the following is associated with a poor prognosis of ALL?
a. Age between 2-10
b. Low WBC count
c. Hyperdiploidy
d. MLL gene translocation
d. MLL gene translocation
81
A 27-year-old female presents with an earache of 5 days duration. She also reports increased urine production, a skin rash and bone pain on her scalp. Physical examination reveals otitis media, dermatitis and exophthalmos. An X-ray of the scalp show calvarial bone defects. A fine needle aspirate displays numerous eosinophils. Which is the most likely diagnosis?
a. Hodgkin lymphoma
b. Malignant melanoma
c. Multiple myeloma
d. Langerhans cell Histidinemia
d. Langerhans cell histiocytosis
82
A 58-year-old man presents with a 2-month history of erythematous, scaly plaques over his trunk and upper extremities. Biopsy of these lesions reveals an atypical lymphocytic infiltrate in the dermis, which extends into the overlying epidermis. Immunohistochemical staining demonstrates positive staining for CD4. Which of the following is the most likely diagnosis?
a. Acute lymphoblastic lymphoma
b. Chronic lymphoid leukemia
c. Extramedullary plasmacytoma
d. Hairy cell leukemia
e. Mycosis fungoides
e. Mycosis fungoides
83
All of the following cell types are found in increased numbers in cases of viral lymphadenitis EXCEPT:
a. Atypical lymphocytes
b. Reed-Sternberg like cells
c. Langerhans cells
d. B-lymphocytes
c. Langerhans cells - kay doc
b. Reed-Sternberg like cells - agsa
84
A 57-year-old man is admitted to the hospital with inguinal and cervical lymphadenopathy. He had noticed the first palpable nodule about 6 months ago. Upon physical examination, more palpable lymph nodes are found in the axillary and supraclavicular regions. Laboratory data show the serum proteins to be within normal limits, whereas the WBC count is 25,000/mL with many small abnormal lymphocytes. A cervical lymph node biopsy is shown in the image. The histologic features are most consistent with which of the following hematologic disorders?
a. Burkitt lymphoma
b. Hodgkin lymphoma
c. Plasmacytoma
d. Reactive follicular hyperplasia
e. Small lymphocytic lymphoma
e. Small lymphocytic lymphoma
85
These are the following factors that will result to worse prognosis in CLL and SLL except:
a. Lack of somatic hypermutation
b. Deletion in 11q
c. Trisomy 21
d. Presence of Notch 1 mutation
c. Trisomy 21
86
Which of the following diseases is considered a disorder of T-helper lymphocytes?
a. Mycosis fungoides
b. Anaplastic large cell lymphoma
c. Subcutaneous panniculitis-like lymphoma
d. Large granular lymphocyte leukemia
a. Mycosis fungoides - kay doc
d. Large granular lymphocyte leukemia -agsa
87
What hemoglobin is increased in cases of beta thalassemia ?
a. HbA
b. HbS
c. HbF
d. HbA2
c. HbF
88
This is neoplasm of B cell with (14;18) translocation a. Burkitt lymphoma
b. DLBCL
c. Follicular lymphoma
d. Mantle cell lymphoma
c. Follicular lymphoma
89
A 4-year-old boy from Kenya presents with a 3-week history of a rapidly expanding jaw. A biopsy of an enlarged cervical lymph node is shown in the image. Histologic examination reveals numerous mitotic figures and many macrophages containing nuclear and cytoplasmic debris. The cells express surface IgM and are positive for common B-cell antigens. Which of the following is the appropriate diagnosis?
a. Acute myelogenous leukemia
b. Burkitt lymphoma
c. Plasmacytoma
d. Reactive follicular hyperplasia
e. Small lymphocytic lymphoma
b. Burkitt lymphoma
90
A 55-year-old man complains of pain in his back, fatigue and occasional confusion. He admits to polyuria and polydipsia. An X-ray examination reveals numerous lytic lesions in the lumbar vertebral bodies. Laboratory studies disclose hypoalbuminemia, mild anemia, and thrombocytopenia. A monoclonal Igk peak is demonstrated by serum electrophoresis. Urinalysis shows 4+ proteinuria. A bone marrow biopsy discloses foci of plasma cells, which account for 18% of all hematopoietic cells. What is the appropriate diagnosis?
a. Acute lymphoblastic lymphoma
b. Chronic lymphocytic leukemia
c. Extramedullary plasmacytoma
d. Multiple myeloma
e. Waldenström macroglobulinemia
d. Multiple myeloma
91
A 40-year-old woman complains of fatigue and nausea of 3 months in duration. Physical examination reveals numerous pustules on the face, as well as splenomegaly and hepatomegaly. Laboratory studies show hemoglobin of 6.3 g/dL and platelets of 50,000/mL. A peripheral smear shows malignant cells with Auer rods (arrow). The patient develops diffuse purpura, bleeding from the gums, and laboratory features of disseminated intravascular coagulation (DIC). Which of the following is the appropriate diagnosis?
a. Acute lymphoblastic leukemia
b. Acute megakaryocytic leukemia
c. Acute promyelocytic leukemia
d. Chronic myelogenous leukemia
e. Monocytic leukemia
c. Acute promyelocytic leukemia
92
Most common trigger of hemolysis in glucose-6-phosphate dehydrogenase deficiency?
a. Fava beans
b. Infection
c. Moth balls
d. Antimalarial drugs
b. Infection
93
Acute hemolytic reactions are usually caused by preformed _____ antibodies against donor red cells that fix complement.
a. IgG
b. IgA
c. IgM
d. IgD
c. IgM
94
A 58-year-old man presents with headaches and pruritus. Physical examination reveals splenomegaly but no lymphadenopathy. A CBC demonstrates elevated hemoglobin of 19.6 g/dL. WBC of 12, 600/uL and platelets of 600,000/uL. The bone marrow displays hypercellularity of all lineages and depletion of marrow iron stores. Which of the following is the most likely diagnosis?
a. Essential thrombocythemia
b. Idiopathic myelofibrosis
c. Polycythemia vera
d. Acute myelogenous leukemia
c. Polycythemia vera
95
Which of the following phenotypes represents a silent carrier?
a. α/α α/-
b. α/α -/-
c. α/- α/-
d. α/α α/α
a. α/α α/-
96
Precipitates of denatured globin.
a. Siderotic granules
b. Howell-Jolly bodies
c. Heinz bodies
d. Cabot rings
c. Heinz bodies
97
A 60-year old man presents with a 6-month history of increasing fatigue . Physical examination reveals marked pallor and CBC shows a macrocytic anemia. Which of the following is the most likely cause of anemia in this patient?
a. Iron deficiency
b. Alcoholism
c. Thalassemia
d. Renal disease
b. Alcoholism
98
A patient with a history of chronic alcoholism presents with macrocytic anemia and thrombocytopenia. Peripheral blood smear shows numerous oval macrocytes and hypersegmented neutrophils. Which of the following is the most likely diagnosis?
a. Anemia of chronic disease
b. Folic acid deficiency
c. Sickle cell anemia
d. G6PD deficiency
b. Folic acid deficiency
99
A 30-year old woman complains of recent easy fatigability, bruising and recurrent throat infections. Physical examination reveals numerous petechiae over her body and mouth. Abnormal laboratory findings include hgb of 6g/dl, WBC of 1500/ul, platelets of 20,000/ul. The bone marrow is hypocellular and displays increased fat. What is the appropriate diagnosis?
a. Pure red cell aplasia
b. Megaloblastic anemia
c. Iron deficiency anemia
d. Aplastic anemia
d. Aplastic anemia
