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FRCPath Part 1 written > Analysis and follow-up > Flashcards

Analysis and follow-up Flashcards

1
Q

CML: How many cultures, what stimulation, how long cultured?

A

2
None
1 day and 2 days, can do same day smear if urgent.

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2
Q

CML: How many cells analysed and scored by G-banding if

a) normal
b) abnormal

A

a) 10 + 10

b) 3 + 7

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3
Q

CML: How many FISH Mets and Interphase cells need to be scored to report?

A

Mets - 5

Interphases: 100

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4
Q

CML: If there is no evidence of Ph+ in 20 cells screened yet a clinical diagnosis of CML is still suspected, what should you do?

A

FISH for BCR-ABL fusion; translocation may be cryptic

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5
Q

CML, follow-up testing: How frequently should samples be analysed? When should you switch from BM to PB?

A

3mo, 6mo and every 6mo after until CCgR achieved and confirmed in a second sample. PH+ then screened every 6 months by RQ-PCR
Switch to PB once CCgR achieved.

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6
Q

CML: How many cells analysed and scored AT FOLLOW-UP by G-banding if

a) normal (Ph-)
b) abnormal (Ph+)
b) evidence of relapse

A

a) 20
b) 30
c) 5 + 5

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7
Q

CML: How many FISH Mets and Interphase cells need to be scored AT FOLLOW-UP to report if

a) normal (Ph-)
b) Abnormal (Ph+)
c) insufficient metaphases

A

a) 30 nuclei
b) 20 nuclei
c) 100 nuclei

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8
Q

CML: What should be stated on the report about the type of cells screened? Why?

A

The report should state whether selected or unselected nuclei have been screened.

There are varying proportions of normal lymphocytes; screening neutrophils/granulocytes is more representative of the true count.

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9
Q

CML: what additional clonal abnormalities can be detected in Ph+ cells?

A

+8
abn 7
Sex chromo abn

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10
Q

MPN: what excludes a diagnosis of MPN?

A

Ph+

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11
Q

MPN: What molecular analysis is performed?

A 
PDGFRA
PDGFRB
FGFR1
JAK2 - V617F
CALR
MPL
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12
Q

AML: What are common findings in therapy-related AML?

A

7q-
5q-
MLL translocations
21q22 translocations (RUNX1)

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13
Q

AML: What is the preferred sample for testing?

A

BM

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14
Q

AML: How many cultures, what stimulation, how long cultured?

A

2
none, or IL3/GMCSF can help
1day and 2 days

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15
Q

AML: How many cells analysed and scored by G-banding if

a) normal
b) abnormal

A

a) 10 + 10

b) 5 + 5

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16
Q

How is a ‘clone’ defined by ISCN?

A

2 or more cells with gains/structural abnormalities

3 or more cells with losses

17
Q

AML: What other findings is inv(16) associated with?

A

del9q

+22

18
Q

AML: What should be suspected if the in infant AML?

A

MLL translocations

19
Q

AML: What is the MECOM probe used to screen for?

A

3q duplications

20
Q

Which references are used for classification of CML, adult AML and childhood AML, respectively?

A

Baccarani et al, 2009
Grimwade et al, 1998 or 2010
Harrison et al, 2010

21
Q

What sample is required for MDS analysis?

A

BM - PB is no good

22
Q

ALL:How is high hyperdiploidy defined?

A

51-65 chromosomes

23
Q

ALL: How is low hypodiploidy defined?

A

30-39 chromosomes

24
Q

ALL: How is Near haploidy defined?

A

23-29 chromosomes

25
Q

ALL: How is Near Triploidy defined?

A

66-69 Chromosomes

26
Q

ALL: Where is the TCF3 gene located? Which translocations involving TCF3 are seen in ALL?

A

19p13
t(17;19)(q22;p13) HLF-TCF3
t(1;19) (q23;p13) (PBX1-TCF3)

27
Q

ALL: Where are the TCR loci?

A

7q34

14q11

28
Q

ALL: which sample is preferred for analysis? How many cultures? How long cultured for? How stimulated?

A 
BM
2+
at least one culture <24 hours
For T-ALL - PHA
For B-ALL - GMCSF, IL3, Flt3-lig
29
Q

ALL: How many cells analysed and scored by G-banding if

a) normal
b) abnormal

A

a) 20 (full analysis)

b) 10 (full analysis)

30
Q

ALL: Which FISH test is mandatory for all infant and paed cases of ALL? what will it detect?

A

ETV6-RUNX1
t(12;21)(p13;q22)
iAMP21
Hyperdiploidy

31
Q

ALL: IF the patient is <1 yr old, what whould be screened?

A

MLL 11q23

32
Q

ALL: If the patient is >25, what should be screened?

A

BCR-ALB1

33
Q

ALL: If the patient is 1-25, what should be screened?

A

ETV6-RUNX1
BCR-ABL1
MLL
TCF3

In that order.

34
Q

MDS: How many cells analysed and scored by G-banding if

a) normal
b) abnormal

A

a) 10 + 10

b) 5 + 5

35
Q

MPD: How many cells analysed and scored by G-banding if

a) normal
b) abnormal

A

a) 5 + 15

b) 5 + 5

36
Q

NHL: What sample is needed? How long should NHL cells be cultured? Why?

A

Lymph node biopsy

<1 day ideally, high rate of cell death

37
Q

CLL/MCL: How long should cells be cultured for? Why?

A

3-4 days with PMA

slow growing cells

38
Q

ALL: How many cells analysed and scored by G-banding AT RELAPSE if

a) normal
b) abnormal

A

a) 30 mets scored

b) 10 mets scored

FRCPath Part 1 written (15 decks)

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