CHAPTER 34: MYELODYSPLASTIC SYNDROMES Flashcards
(1) MDSs are most common in which age group?
a. 2 to 10 years
b. 15 to 20 years
c. 25 to 40 years
d. Older than 50 years
d. Older than 50 years
(2) What is a major indication of MDS in the peripheral blood and bone marrow?
a. Dyspoiesis
b. Leukocytosis with left shift
c. Normal bone marrow with abnormal peripheral blood features
d. Thrombocytosis
a. Dyspoiesis
(3) An alert hematologist should recognize all of the following peripheral blood abnormalities as diagnostic clues in MDS except:
a. Oval macrocytes
b. Target cells
c. Agranular neutrophils
d. Circulating micromegakaryocytes
b. Target cells
(4) For an erythroid precursor to be considered a ring sideroblast, the iron laden mitochondria must encircle how much of the nucleus?
a. One quarter
b. One third
c. Two thirds
d. Entire nucleus
b. One third
(5) According to the WHO classification of MDS, what percentage of blasts would constitute transformation to an acute leukemia?
a. 5%
b. 10%
c. 20%
d. 30%
c. 20%
(6) A patient has anemia, oval macrocytes, and hypersegmented neutrophils. Which of the following tests would be most efficient in differential diagnosis of this disorder?
a. Serum iron and ferritin levels
b. Erythropoietin level
c. Vitamin B12 and folate levels
d. Chromosome analysis
c. Vitamin B12 and folate levels
(7) A 60-year-old woman comes to the physician with fatigue and malaise. Her hemoglobin is 8 g/dL, hematocrit is 25%, RBC count is 2.00 3 1012/L, platelet count is 550 x 10^9/L, and WBC count is 3.8 x 10^9/L. Her WBC differential is unremarkable. Bone marrow shows erythroid hypoplasia and hypolobulated megakaryocytes; granulopoiesis appears normal. Ring sideroblasts are rare. Chromosome analysis reveals the deletion of 5q only. Based on the classification of this disorder, what therapy would be most appropriate?
a. Supportive therapy; lenalidomide if the disease progresses
b. Aggressive chemotherapy
c. Bone marrow transplantation
d. Low-dose cytosine arabinoside, accompanied by cis-retinoic acid
a. Supportive therapy; lenalidomide if the disease progresses
(8) Which of the following is least likely to contribute to the death of patients with MDS?
a. Neutropenia
b. Thrombocytopenia
c. Organ failure
d. Neuropathy
d. Neuropathy
(9) Into what other hematologic disease does MDS often convert?
a. Megaloblastic anemia
b. Aplastic anemia
c. AML
d. Myeloproliferative disease
c. AML
(10) Chronic myelomonocytic leukemia is classified in the WHO system as:
a. A myeloproliferative neoplasm
b. Myelodysplastic syndrome, unclassified
c. MDS/MPN
d. Acute leukemia
c. MDS/MPN
