CHAPTER 35: ACUTE LEUKEMIAS

Question 1

(1) According to the WHO classification, except in leukemias with specific genetic anomalies, the minimal percentage of blasts necessary for a diagnosis of acute leukemia is:

a. 10%
b. 20%
c. 30%
d. 50%

Answer 1

b. 20%

Question 2

(2) A 20-year-old patient has an elevated WBC count with 70% blasts, 4% neutrophils, 5% lymphocytes, and 21% monocytes in the peripheral blood. Eosinophils with dysplastic changes are seen in the bone marrow. AML with which of the following karyotypes would be most likely to be seen?

a. AML with t(8;21)(q22;q22)
b. AML with t(16;16)(p13;q22)
c. AML with t(15;17)(q22;q12)
d. AML with t(9;11)(p22;q23)

Answer 2

b. AML with t(16;16)(p13;q22)

Question 3

(3) Which of the following would be considered a sign of potentially favorable prognosis in children with ALL?

a. Hyperdiploidy
b. Presence of CD 19 and 20
c. Absence of trisomy 8
d. Presence of BCR/ABL gene

Answer 3

a. Hyperdiploidy

Question 4

(4) Signs and symptoms of cerebral infiltration with blasts are more commonly seen in:

a. AML with recurrent cytogenetic abnormalities
b. Therapy-related myeloid neoplasms
c. AML with myelodysplasia-related changes
d. ALL

Answer 4

d. ALL

Question 5

(5) An oncology patient exhibiting signs of renal failure with seizures after initial chemotherapy may potentially develop:

a. Hyperleukocytosis
b. Tumor lysis syndrome
c. Acute leukemia secondary to chemotherapy
d. Myelodysplasia

Answer 5

b. Tumor lysis syndrome

Question 6

(6) Disseminated intravascular coagulation is more often seen in association with leukemia characterized by which of the following mutations?

a. t(12;21)(p13;q22)
b. t(9;22)(q34;q11.2)
c. inv(16)(p13;q22)
d. t(15;17)(q22;q12)

Answer 6

d. t(15;17)(q22;q12)

Question 7

(7) Which of the following leukemias affects primarily children, is characterized by an increase in monoblasts and monocytes, and often is associated with gingival and skin involvement?

a. Pre-B lymphoblastic leukemia
b. Pure erythroid leukemia
c. AML with t(9;11)(p22;q23)
d. AML with t(15;17)(q22;q12)

Answer 7

c. AML with t(9;11)(p22;q23)

Question 8

(8) A 20-year-old patient presents with fatigue, pallor, easy bruising, and swollen gums. Bone marrow examination reveals 82% cells with delicate chromatin and prominent nucleoli that are CD14+, CD4+, CD11b+, and CD36+. Which of the following acute leukemias is likely?

a. Minimally differentiated leukemia
b. Leukemia of ambiguous lineage
c. Acute monoblastic/monocytic leukemia
d. Acute megakaryoblastic leukemia

Answer 8

c. Acute monoblastic/monocytic leukemia

Question 9

(9) Pure erythroid leukemia is a disorder involving:

a. Pronormoblasts only
b. Pronormoblasts and basophilic normoblasts
c. All forms of developing RBC precursors
d. Equal numbers of pronormoblasts and myeloblasts

Answer 9

b. Pronormoblasts and basophilic normoblasts

Question 10

(10) A patient with normal chromosomes has a WBC count of 3.0 x 10^9/L and dysplasia in all cell lines. There are 60% blasts of varying sizes. The blasts stain positive for CD61. The most likely type of leukemia is:

a. Acute lymphoblastic
b. Acute megakaryoblastic
c. Acute monoblastic
d. AML with t(15;17)

Answer 10

b. Acute megakaryoblastic

Question 11

(11) SBB stains which of the following component of cells?

a. Glycogen
b. Lipids
c. Structural proteins
d. Enzymes

Answer 11

b. Lipids

Question 12

(12) The cytochemical stain a-naphthyl butyrate is a nonspecific esterase stain that shows diffuse positivity in cells of which lineage?

a. Erythroid
b. Monocytic
c. Granulocytic
d. Lymphoid

Answer 12

b. Monocytic