Chapter 13: Normal hematopoiesis Flashcards
It is the chief site of blood cell formation during the third moth of embryogenesis until shortly before birth
a. yolk sac
b. mesoderm
c. liver
d. bone marrow
C
3rd week - yolk sac
mesoderm
3rd month - liver
4th month - bone marrow
What are the progenitors of red cells
a. granulocytes
b. myeloblasts
c. proerythroblasts
d. megakaryoblasts
C
myeloblasts - progenitor of mature granulocytes
megakaryobasts - progenitor of platelets
What regulates the marrow response to short-term physiologic needs?
a. Hematopoietic stem cells
b. Colony-forming units
c. Colony-stimulating factors (CSFs)
d. Multipotent progenitors
C
Hematopoietic stem cells - pluripotent cells, common origin of red blood cells, granulocytes, monocytes, platelets and lymphocytes
Colony-forming units - produce colonies composed of specific kinds of mature cells when grown in culture
Multipotent progenitors - replenishment of terminally differentiated cells
What is the ultimate source of most cells of the innate and adaptive immune system?
a. yolk sac
b. mesoderm
c. liver
d. bone marrow
D
Which of the following increases the proportion of fat to hematopoietic stem cells?
a. aplastic anemia
b. hemolytic anemia
c. leukemia
A
It provides the best assessment of the morphology of hematopoietic cells.
a. CBC
b. PTT
c. marrow aspirate smears
d. bone marrow biopsies
C
Which of the following is not a cause of neutropenia due to increased destruction or sequestration of neutrophils in the periphery?
a. increased peripheral utilization
b. splenomegaly
c. immunologically mediated injury
d. rare congenital conditions such as Kotsmann syndrome
D
Inadequate granulopoiesis (suppression of hematopoietic stem cells, suppression of committed granulocytic precursors, rare congenital conditions)
What is the most common consequence of agranulocytosis?
a. fever
b. malaise
c. infection
d. chills
C
What is the most severe manifestation of infection in agranulocytosis?
a. Botryomycosis
b. Actinomycosis
c. Mycetoma
d. Pyoderma
A
bacteria grow in colonies resembling those seen on agar plates
What are patches of dilated endoplasmic reticulum that appears as sky-blue cytoplasmic puddles
a. toxic granulations
b. Dohle bodies
c. cytoplasmic vacuoles
d.
B
Which of the following is not a mechanism that causes leukocytosis (increase in the number of white cells in the blood)?
a. chronic infection
b. acute inflammation
c. glucocorticoids
d. exercise
e. none of the options
E
It is a rare type of leukocytosis that often is indicative of myeloproliferative neoplasm.
a. neutrophilic leukocytosis
b. eosinophilic leukocytosis
c. basophilic leukocytosis
d. monocytosis
e. lymphocytosis
C
Chronic non-specific lymphadenitis that is caused by stimuli that activate humoral immune responses
a. follicular hyperplasia
b. nonneoplastic hyperplasia
c. paracortical hyperplasia
d. reticular hyperplasia
A
paracortical hyperplasia - stimuli that trigger T-cell-mediated immune responses
reticular hyperplasia aka sinus histiocytosis- prominent in lymph nodes draining cancers such as carcinoma of the breast
Which of the following is not true about hemophagocytic lymphohistiocytosis?
a. Reactive condition marked by cytopenias and systemic inflammation related to macrophage and CD8+ cells activation
b. Familial forms associated with different mutations
c. Patients present with acute febrile illness associated with splenomegaly and hepatomegaly, anemia, thrombocytopenia, high levels of plasma ferritin and soluble IL-2 receptor
d. It is also referred to as monocyte activation syndrome
D
What is the uncommon proliferative lesions of macrophages and dendritic cells?
a. lymphoid neoplasms
b. myeloid neoplasms
c. histiocytosis
d. lymphocytosis
C
lymphoid neoplasms - Diverse group of tumors of B-cell, T-cell, NK-cell origin
myeloid neoplasms - Acute myeloid leukemias, myelodysplastic syndromes, myeloproliferative neoplasms
What is the most common nonrandom chromosomal abnormality in white cell neoplasms?
a. translocations
b. class switching
c. somatic hypermutation
d. inversions
A
class switching - intragenic recombination event in wc the IgM heavy-chain constant gene segment is replaced with a different constant segment leading to a switch in the class of antibody produced somatic hypermutation - creates point mutations within Ig genes that may increase antibody affinity for antigen
Which of the following is not a disease that increase the risk of having acute leukemia
a. Bloom syndrome
b. Fanconi anemia
c. Ataxia telangiectasia
d. Down syndrome
D
diseases that increase the risk of developing childhood leukemia: down syndrome and type I neurofibromatosis
It is found in a subset of Burkitt lymphoma, 30-40% of Hodgkin lymphoma, B-cell lymphomas from T-cell immunodeficiency, and rare NK-cell lymphomas
a. HTLV-1
b. EBV
c. HHV-8
d. ATLV
B
HTLV-1 - adult T-cell leukemia/lymphoma
HHV-8 - Kaposi sarcoma herpesvirus
Defined as proliferations of white cells, typically lymphocytes
a. lymphoma
b. lymphoid neoplasms
c. leukemia
A
leukemia - neoplasms that present with widespread involvement of the bone marrow and peripheral blood
The following is true about acute lymphoblastic leukemia, except:
a. composed of immature B (pre-B) or T (pre-T) referred to as lymphoblasts
b. most common cancer of children
c. marrow hypocellular and packed with lymphoblasts
d. mediastinal thymic mases in 50-70% of T-ALLs
C
boys > girls
peak: ~3yrs old
Which of the following statements is not true about chronic lymphatic leukemia and small lymphocytic lymphoma
a. most common leukemia of adults in Western world
b. median age is 60, female predominance (2:1)
c. lymph nodes diffusely effaced predominantly by small lymphocytes
d. smudge cells in smears
B
Which of the following is not an immunophenotype of chronic lymphatic leukemia and small lymphocytic lymphoma?
a. CD19
b. CD20
c. CD10
d. CD23
e. CD5
C
It is strongly associated with chromosomal translocations involving BCL2
a. chronic lymphatic leukemia
b. small lymphocytic lymphoma
c. acute lymphoblastic leukemia
d. follicular lymphoma
D
Hallmark of Follicular Lymphoma
a. t(14;18)
b. t(18;14)
c. t(11;14)
d. t(14;11)
A
It is the most common form of NHL
a. follicular lymphoma
b. diffuse large b-cell lymphoma
c. Burkitt lymphoma
d. mantle cell lymphoma
B
All forms are associated with translocations of the MYC gene on chromosome 8
a. follicular lymphoma
b. diffuse large b-cell lymphoma
c. Burkitt lymphoma
d. mantle cell lymphoma
C
Which of the following is not an immunophenotype of Burkitt Lymphoma?
a. surface IgM
b. CD19
c. CD20
d. CD10
e. CD23
E
BCL6
It is the pattern of phagocytes with abundant clear cytoplasm in Burkitt Lymphoma
a. Starry night pattern
b. Starry sky pattern
c. Night sky pattern
d. Sky and stars pattern
B
It almost always fails to express antiapoptotic protein BCL2
a. follicular lymphoma
b. diffuse large b-cell lymphoma
c. Burkitt lymphoma
d. mantle cell lymphoma
C
Which of the following is not an immunophenotype of mantle cell lymphoma?
a. CD19
b. CD20
c. surface Ig
d. CD10
e. Cyclin D1
D
Group of B-cell tumors that arise in lymph nodes, spleen, extranodal tissues
a. mantle cell lymphoma
b. marginal zone lymphoma
c. hairy cell leukemia
d. peripheral T-cell lymphoma
B
These resemble normal mature T or NK cells
a. mantle cell lymphoma
b. marginal zone lymphoma
c. hairy cell leukemia
d. peripheral T-cell lymphoma
D
Rare, distinctive B-cell neoplasm that occurs in middle-aged white males; with activating point mutations in serine/threonine kinase BRAF
a. mantle cell lymphoma
b. marginal zone lymphoma
c. hairy cell leukemia
d. peripheral T-cell lymphoma
C
The following are true about peripheral T-Cell Lymphoma, except:
a. not easily categorized
b. “wastebasket” diagnosis
c. no morphologic feature pathognomonic
d. usually express CD2, CD3, CD5
e. most patient present with generalized lymphdenopathy
no answer
Which of the following is not true about Anaplastic Large-Cell Lymphoma (ALK+)
a. it is uncommon and is defined by presence of rearrangements in ALK gene on chromosome 2p23
b. with round, oblong, or reniform nuclei
c. tend to occur in children or young adults
d. with good prognosis
B
should be composed of large anaplastic cells, some containing horseshoe-shaped nuclei and voluminous cytoplasm (hallmark cells)
Which of the following is not a manifestation of Adult T-cell Leukemia
a. skin lesions
b. generalized lymphadenopathy
c. hepatosplenomegaly
d. peripheral blood lymphocytosis
e. hypocalcemia
E
hypercalcemia
The following statements are true about Adult T-cell Leukemia, except:
a. neoplasm of CD4+ cells in adults infected by HTLV-1
b. occurs in regions where HTLV-1 is endemic
c. rapidly progressive disease
d. cells with horseshoe-shaped nuclei frequently observed
D
Cells with multilobated nuclei frequently observed (“cloverleaf” or “flower” cells)
Cutaneous lesions of mycosis fungoides typically progress through three somewhat distinct stages, which of the following is an exception?
a. inflammatory premycotic phase
b. plaque phase
c. pustular phase
d. tumor phase
C
It presents as destructive nasopharyngeal mass and is highly associated with EBV.
a. Extranodal NK/T-Cell Lymphoma
b. Large Granular Lymphocytic Leukemia
c. Mycosis Fungoides
d. Multiple Myeloma
A
It usually present with mild to moderate lymphocytosis and splenomegaly and express CD3on their surfaces
a. NK-cell disease
b. T-cell disease
c. B-cell disease
d. NK/T-cell disease
B
