CHAPTER 18: Immunoproliferative Diseases

Question 1

Bence Jones proteins consist of
a. monoclonal IgG.
b. IgG-IgM complexes.
c. free κ or λ light chains.
d. free μ heavy chains.

Answer 1

c. free κ or λ light chains.

Question 2

Which of the following would be the best indicator of a malignant clone of cells?
a. Overall increase in antibody production
b. Increase in IgG and IgM only
c. Increase in antibody directed against a specific epitope
d. Decrease in overall antibody production

Answer 2

c. Increase in antibody directed against a specific epitope

Question 3

All of the following are features of malignancy except
a. excess apoptosis.
b. rapid proliferation.
c. clonal proliferation.
d. chromosomal mutations

Answer 3

a. excess apoptosis.

Question 4

All of the following features are commonly used to classify lymphoid neoplasms except
a. cell of origin.
b. presence of gene translocations.
c. exposure of the patient to carcinogens.
d. morphology or cytology of the malignant cells.

Answer 4

c. exposure of the patient to carcinogens.

Question 5

Hodgkin lymphoma is characterized by
a. proliferation of T cells.
b. excess immunoglobulin production.
c. an incurable, rapidly progressive course.
d. the presence of Reed-Sternberg cells in lymph nodes.

Answer 5

d. the presence of Reed-Sternberg cells in lymph nodes.

Question 6

Chronic leukemias are characterized as
a. usually being of B-cell origin.
b. being curable with chemotherapy.
c. usually occurring in children.
d. following a rapidly progressive course.

Answer 6

a. usually being of B-cell origin.

Question 7

Which of the following is characteristic of heavy-chain diseases?
a. Usually of B-cell origin
b. Rare lymphomas
c. Production of abnormal Ig heavy chains
d. All of the above

Answer 7

d. All of the above

Question 8

Flow cytometry results on a patient reveal a decrease of cells with CD2 and CD3. What does this indicate?
a. Lack of B cells
b. Lack of T cells
c. Lack of monocytes
d. Lack of natural killer cells

Answer 8

b. Lack of T cells

Question 9

Which of the following is true of Waldenström macroglobulinemia but not multiple myeloma?
a. Hyperviscosity syndrome is often present.
b. A single protein-producing clone is elevated.
c. The cancerous cell is a preplasma cell.
d. Bence Jones proteins are present in the urine.

Answer 9

a. Hyperviscosity syndrome is often present.

Question 10

The presence of anemia, bone pain, thrombocytopenia, and lytic bone lesions is suggestive of
a. Hodgkin lymphoma.
b. hairy cell leukemia.
c. chronic lymphocytic leukemia.
d. multiple myeloma.

Answer 10

d. multiple myeloma.

Question 11

The presence of an M protein on immunofixation electrophoresis (IFE) is indicated by
a. broad, diffuse banding.
b. a narrow, discrete band.
c. a few well-defined bands in the IgG lane.
d. a single band at the point of application in all of the lanes.

Answer 11

b. a narrow, discrete band.

Question 12

Surface immunoglobulin on a leukemic cell indicates a(n)
a. B cell.
b. T cell.
c. macrophage.
d. autoimmune disease.

Answer 12

a. B cell.

Question 13

Which of the following is not a requirement for urine testing by IFE?
a. Collection of a 24-hour sample
b. Concentration of the sample
c. Dilution of the sample
d. Removal of sediment

Answer 13

c. Dilution of the sample

Question 14

Multiple myeloma is characteristically preceded by
a. chronic hypogammaglobulinemia.
b. Helicobacter pylori infection.
c. non-Hodgkin lymphoma.
d. monoclonal gammopathy of undetermined significance.

Answer 14

d. monoclonal gammopathy of undetermined significance.

Question 15

Which serum free light chain (sFLC) assay result indicates presence of a malignant plasma cell clone?
a. An abnormal κ:λ ratio
b. A decrease in κ and λ concentrations
c. A decrease in IgG, IgA, and IgM concentrations
d. An increase in immunoglobulin concentrations over a 24-hour period

Answer 15

a. An abnormal κ:λ ratio