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Hematology > Chapter 19 > Flashcards

Chapter 19 Flashcards

1
Q

The fundamental characteristic of MDS is:
A) Peripheral blood cytopenia and bone marrow hypocellularity
B) Peripheral blood cytopenia and bone marrow hypercellularity
C) Peripheral blood cytosis and bone marrow hypocellularity
D) Peripheral blood cytosis and bone marrow hypercellularity
E) None of the above

A

B) Peripheral blood cytopenia and bone marrow hypercellularity

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2
Q 
The myeloid-to-erythroid ratio in MDS:
A) Is increased
B) Is decreased
C) Represents normal hematopoiesis
D) Represents decreased erythropoiesis
E) None of the above
A

B) Is decreased

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3
Q 
The following morphologies are characteristic of dyserythropoiesis in MDS:
A) Basophilic stippling
B) Normochromic, normocytic red cells
C) Multinuclearity
D) A and C
E) A, B, and C
A

D) A and C

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4
Q 
Which specific features are characteristic of dysgranulopoiesis morphology in MDS?
A) Hypergranulation
B) Pure Pelger–Huët anomaly
C) Auer rods
D) Hypersegmentation in bone marrow
E) None of the above
A

D) Hypersegmentation in bone marrow

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5
Q 
What specific features are characteristic of dysmegakaryocytopoiesis morphology in MDS (myelodysplastic syndrome)?
A) Macromegakaryocytes
B) Small platelets
C) Micromegakaryocytes
D) Normal segmentation
E) None of the above
A

C) Micromegakaryocytes

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6
Q 
The French–American–British (FAB) classification system separates the myelodysplastic syndromes into \_\_\_\_\_\_\_\_\_\_ different types.
A) One
B) Three
C) Five
D) Six
E) None of the above
A

C) Five

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7
Q

Which type of MDS demonstrates a mild decreased white blood cell (WBC) count (3.9 x 10^9/L), increased erythropoiesis and normal numbers of blast cells in the marrow, and <15% sideroblasts?
A) Refractory anemia with ringed sideroblasts (RARS)
B) Refractory anemia (RA)
C) Refractory anemia with excess blasts (RAEB)
D) Chronic myelomonocytic leukemia (CMML)
E) None of the above

A

B) Refractory anemia (RA)

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8
Q 
Which factor(s) differentiate(s) RARS (refractory anemia with ringed sideroblasts) from refractory anemia?
A) Erythroid dimorphism
B) > 15% sideroblasts
C) Normal WBC
D) All of the above
E) None of the above
A

D) All of the above

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9
Q 
RAEB contains a maximum of \_\_\_\_\_\_\_\_\_\_ blasts in the bone marrow.
A) 30%
B) 20%
C) 10%
D) 5%
E) None of the above
A

B) 20%

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10
Q 
MDS occurs more often in which age group?
A) Pediatric
B) Child
C) Adult
D) Elderly
E) None of the above
A

D) Elderly

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11
Q 
The most common and consistent nonrandom chromosomal aberration in the MDS, refractory anemia is deletion of the long arm of \_\_\_\_\_\_\_\_\_\_.
A) Chromosome 16
B) Chromosome 5
C) Chromosome 6
D) Chromosome 9
E) None of the above
A

B) Chromosome 5

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12
Q 
Chromosomal abnormalities are directly correlated with the presence of the \_\_\_\_\_\_\_\_\_\_ population in patients with MDS.
A) Promyelocyte
B) Blast
C) Megakaryocyte
D) Erythrocyte
E) None of the above
A

B) Blast

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13
Q

Which of the following is the most significant prognostic indicator in MDS?
A) Degree of cytopenia
B) Degree of dysplasia in peripheral blood
C) Percentage of bone marrow blasts
D) Degree of dysplasia in bone marrow
E) None of the above

A

C) Percentage of bone marrow blasts

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14
Q

Which is the most current system used for scoring MDS?
A) FAB score
B) International Prognostic Scoring System (IPSS)
C) Sanz
D) Bournemouth
E) None of the above

A

B) International Prognostic Scoring System (IPSS)

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15
Q

Which MDS classification has the worst prognosis?
A) Refractory anemia with excess blasts in transformation (RAEB-T)
B) Refractory anemia (RA)
C) Chronic myelomonocytic leukemia (CMML)
D) Refractory anemia with excess blasts (RAEB)
E) None of the above

A

A) Refractory anemia with excess blasts in transformation (RAEB-T)

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16
Q 
Which MDS classification has the best prognosis?
A) RAEB-T
B) RAEB
C) RA
D) CMML
E) None of the above
A

C) RA

17
Q 
Which of the following represents the “cornerstone” of myelodysplastic-syndrome treatment?
A) Component therapy
B) Antibiotic therapy
C) Autologous bone marrow transplant
D) Interferon
E) A and B
A

E) A and B

18
Q 
What is the purpose of transfusing granulocytes to a patient with RA?
A) Prevent hemorrhages
B) Prophylaxis to infection
C) Increase blood volume
D) Decrease plasma viscosity
E) None of the above
A

B) Prophylaxis to infection

19
Q 
The most promising course of therapy for MDS is \_\_\_\_\_\_\_\_\_\_.
A) Bone marrow transplant
B) Androgens
C) Blood transfusion
D) Myelostimulants
E) None of the above
A

A) Bone marrow transplant

20
Q 
In calculating the percentage of myeloblasts in the bone marrow, the following data are given. Erythroid nuclear precursors (E) = 65%, myeloblasts = 14%, other cells = 21%. Based on these numbers, what is the percentage of myeloblasts by the FAB classification?
A) 14%
B) 30%
C) 40%
D) 60%
E) None of the above
A

C) 40%

21
Q 
What characterizes the cytogenetic analysis of patients with MDS?
A) Translocations
B) Inversions
C) Deletions
D) Reciprocal translocations
E) All of the above
A

B) Inversions

22
Q

A type III sideroblast in dyserythropoiesis is demonstrated by:
A) 1–5 granules
B) Blue ring around the nucleus with Prussian blue
C) 5–10 granules
D) No granules
E) None of the above

A

B) Blue ring around the nucleus with Prussian blue

23
Q 
Ringed sideroblasts (type III) are seen in what MDS classification?
A) RA
B) RAEB
C) RAEB-T
D) RARS
E) None of the above
A

D) RARS

24
Q 
Which of the following agents may lead to secondary myelodysplastic syndrome (sMDS)?
A) Hydrocortisone
B) Alkylating agents
C) Irradiated blood components
D) Folic acid
E) Pyridoxal phosphate
A

B) Alkylating agents

25
Q 
Which of the following is most likely to affect prognosis in MDS?
A) Leukopenia
B) Increased bone marrow myeloblasts
C) Erythroid hyperplasia
D) Thrombocytosis
E) None of the above
A

B) Increased bone marrow myeloblasts

26
Q 
In female patients with RA and elevated platelet counts, which chromosome abnormality is
most often found?
A) (5q–)
B) t(8;21)
C) (7q–)
D) t(15;17)
E) t(9;22)
A

A) (5q–)

27
Q 
Which of the following biological and/or genetic anomalies are important in the pathogenesis
of MDS?
A) Chromosomal translocations
B) Chromosomal deletions
C) Hemolysis
D) Increased intramedullary apoptosis
E) B and D
A

E) B and D

28
Q 
Which of the MDS subtypes is more closely related to the chronic myeloproliferative
disorders?
A) RAEB
B) CMML with WBC > 13 x 10^9/L
C) CMML with WBC < 13 x 10^9/L
D) RARS
E) None of the above
A

B) CMML with WBC > 13 x 10^9/L

Hematology (16 decks)

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