31. White Blood Cells Disorder-4

Question 1

A pregnant woman has a chromosome testing done on baby to prepare for any illnesses the child might be predisposed to. Testing comes back showing a t(15;17) what is related to this condition?

A. Punched out skeletal bone
B. Auer Rods
C. Positive for CD15 and CD30
D. Bite Cells 
E. Bence Jones Protein 

RFA

Answer 1

Ans. B. (t15;17)- is AML which is associated with Auer Rods

A & D, Punched out skeletal bone and Bence Jones Protein- are both characteristic of multiple myeloma

C. Positive for CD15 and CD30- is characteristic of HL

D. Bite Cells- G6PD

Question 2

A 64 year old woman comes to the doctor for a routine check up. She has been have no complaints about her recent health. A blood examination is done as a normal investigation and the exam find Smudge cells. What else would exam likely yield?

A.  Low LAP 
B. Increased basophils 
C.CD5 B cells 
D. MPO staining 
E. CD 103+ cells 

RFA

Answer 2

Ans. C CD5 B cells- the patient has CLL ( Smudge cells, asymptomatic, age (60s). This is a chronic Leukemia of naive lymphocytes that is usually asymptomatic but increases risk of bacterial infection due to aggammabluemnai

A. Low LAP- CML

B. Increased Basophils-CML

D. MPO staining- AML

E. CD 103+ cells- Hairy cell Leukemia

Question 3

A 55 year old male presents with acute fatigue, fever, sepsis, and evidence of thrombocytopenia. Peripheral blood smear shows Auer rods. Which of the following causal chromosomal translocations has the best prognosis for her condition? (MG)

A. 8;14
B. 9;22
C. 8;21
D. 15;17

Answer 3

C. 8;21

D is also for AML but not as good prognosis. 16;16 is also for AML but not listed as an option in the question

Question 4

A 55 year old female was diagnosed with Stage 2 breast cancer 5 years ago which has completed remissed with the use of chemotherapy and radiation. However, she ends up dying from a bacterial infection that normally would not kill a patient. What disease did she have that triggered the infection and resultant death from sepsis? (MG)

A. TB
B. Acute Lymphoblastic Leukemia
C. Myelodysplastic Syndrome
D. CMV
E. Hairy cell leukemia

Answer 4

C. Myelodysplastic Syndrome

Chemo and radiation can cause clonal maturational defects in stem cells leading to cytopenias that eventually transform to acute myeloid leukemia in 10-40% of cases.