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MTAP 2 FINAL SZN > EE HEMA > Flashcards

EE HEMA Flashcards

1
Q

In patients with infectious mononucleosis, which blood cells are infected by the causative agent?
A. Monocytes
B. T lymphocytes
C. B lymphocytes
D. Histiocytes

A

C. B lymphocytes

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2
Q

Which of the following statements about hairy cell leukemia is true?
A. It is an acute disease, primarily
affecting young adults.
B. Splenomegaly is an unusual finding.
C. Hairy cells contain tartrate-resistant
acid phosphatase.
D. Hairy cells are abnormal T lymphocytes

A

C. Hairy cells contain tartrate-resistant
acid phosphatase.

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3
Q

Based on the WHO classification
system, B cell ALL (FAB type L3) and
represent different
clinical presentations of the same
disease entity.
A. Burkitt lymphoma
B. Hodgkin lymphoma
C. Mycosis fungoides
D. Small lymphocytic lymphoma

A

A. Burkitt lymphoma

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4
Q

The presence of both immature neutrophils
and nucleated erythrocytes in the peripheral blood is most accurately called a
A. Neutrophilic left shift
B. Regenerative left shift
C. Neutrophilic leukemoid reaction
D. Leukoerythroblastic reaction

A

D. Leukoerythroblastic reaction

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5
Q

In which anomaly is a failure of granulocytes to divide beyond the band or two-lobed stage observed?
A. Pelger-Huet
B. May-Hegglin
C. Alder-Reilly
D. Chediak-Higashi

A

A. Pelger-Huet

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6
Q

In which of the following are eosinophils
not increased?
A. Gushing syndrome
B. Allergic disorders
C. Skin disorders
D. Parasitic infection

A

A. Gushing syndrome

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7
Q

Which of the following represents the
principal defect in chronic granulomatous
disease (CGD)?
A. Chemotactic migration
B. Phagocytosis
C. Lysosomal formation and function
D. Oxidative respiratory burst

A

D. Oxidative respiratory burst

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8
Q

The blood shown in Color Plate 11 * is from a leukemia patient following treatment. These findings are most suggestive of therapy with
A. Corticosteroids (e.g., prednisone)
B. A folate antagonist (e.g., methotrexate)
C. Recombinant erythropoietin
D. Chloramphenicol

A

B. A folate antagonist (e.g., methotrexate)

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9
Q

A patient with normal hemoglobin and WBC count values, a persistently elevated platelet count (over 1000 X 109/L), increased marrow megakaryocytes, and a history of frequent bleeding and clotting
episodes most likely has
A. Polycythemia vera
B. Chronic myelofibrosis
C. Essential thrombocythemia
D. Chronic myelogenous leukemia

A

C. Essential thrombocythemia

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10
Q

An adult patient with massive
splenomegaly has mild anemia, a slightly elevated WBC count, and an LAP score of 170. The blood smear shows teardrop erythrocytes and leukoerythroblastosis. These findings are most consistent with
A. Chronic myelogenous leukemia
B. Idiopathic myelofibrosis
C. Primary polycythemia
D. Primary thrombocythemia

A

B. Idiopathic myelofibrosis

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11
Q

Which of the following infections does not reveal a blood picture as seen in Color Plate 12B?
A. Epstein-Barr virus (EBV)
B. Bordetellapertussis (whooping cough)
C. Cytomegalovirus (CMV)
D. Toxoplasma gondii (toxoplasmosis)

A

B. Bordetella pertussis (whooping cough)

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12
Q

The most common type of chronic
lymphocytic leukemia (CLL) in the
United States involves the
A. B cell
B. NK cell
C. T cell
D. Plasma cell

A

A. B cell

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13
Q

Which of the following are characteristic findings in Waldenstrom disease?
A. Increased IgA and
hepatosplenomegaly
B. Increased IgE and renal failure
C. Increased IgG and hypercalcemia
D. Increased IgM and blood hyperviscosity

A

D. Increased IgM and blood hyperviscosity

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14
Q

Which of the following would not cause a total WBC count of 62.2 X 10^9/L (62.2 X 10^3/uL) and the blood findings seen in Color Plate 13?
A. Treatment with myeloid growth factors
B. Gram-negative septicemia
C. Human immunodeficiency virus (HIV)
D. Systemic fungal infection

A

C. Human immunodeficiency virus (HIV)

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15
Q

The peripheral blood shown in Color Plate 14B is from a 69-year-old female. Her WBC count was 83.0 X 10^9 cells/L (83.0 X 10^3/(uL) and her platelet count was normal. Based on the cell morphology and this information, what is the most likely
diagnosis?
A. Acute lymphoblastic leukemia
B. Chronic lymphocytic leukemia
C. Waldenstrom macroglobulinemia
D. Viral infection

A

B. Chronic lymphocytic leukemia

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16
Q

In which of the following is progression to acute leukemia least likely?
A. Chronic myelogenous leukemia (CML)
B. Refractory anemia with excess blasts (RAEB)
C. Refractory anemia with ringed
sideroblasts (RARS)
D. Chronic lymphocytic leukemia (CLL)

A

D. Chronic lymphocytic leukemia (CLL)

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17
Q

A Gaucher cell is best described as a
macrophage with
A. “Wrinkled” cytoplasm due to an
accumulation of glucocerebroside
B. “Foamy” cytoplasm filled with
unmetabolized sphingomyelin
C. Pronounced vacuolization and
deposits of cholesterol
D. Abundant cytoplasm containing
storage iron and cellular remnants

A

A. “Wrinkled” cytoplasm due to an
accumulation of glucocerebroside

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18
Q

Which of the following suggests a
diagnosis of Hodgkin disease rather than other lymphoproliferative disorders?
A. Presence of a monoclonal population of large lymphoid cells
B. Predominance of immature B cells
with irregular nuclear clefts
C. Circulating T cells with a convoluted, cerebriform nucleus
D. Presence of giant binucleated Reed Sternberg cells with prominent
nucleoli

A

D. Presence of giant binucleated Reed Sternberg cells with prominent
nucleoli

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19
Q

In a patient with fever of unknown origin, which of the following findings is not consistent with an inflammatory process?
A. Increased C-reactive protein
B. Increased albumin level
C. Increased fibrinogen level
D. Increased erythrocyte sedimentation rate

A

B. Increased albumin level

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20
Q

The presence of the chromosomal
abnormality t(15;17) and a high incidence
of disseminated intravascular coagulation
(DIG) is diagnostic of
A. Acute myeloblastic leukemia without
maturation (FAB type Ml)
B. Acute myeloblastic leukemia with
maturation (FAB type M2)
C. Acute promyelocytic leukemia (FAB
type M3)
D. Acute myelomonocytic leukemia
(FAB type M4)

A

C. Acute promyelocytic leukemia (FAB
type M3)

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21
Q

Which of the following is not commonly
found in acute myelogenous leukemias?
A. Neutropenia
B. Thrombocytopenia
C. Hepatosplenomegaly
D. Lymphadenopathy

A

D. Lymphadenopathy

22
Q

The child whose blast cells are shown in
Color Plate 15> has acute lymphoblastic
leukemia that is precursor B cell type
and CALLA positive. Analysis by flow
cytometry would likely show cells that
immunophenotype for
A. CD2,CD7
B. CD10,CD19
C. CD13,CD33
D. CD14,CD34

A

B. CD10,CD19

23
Q

The patient whose bone marrow is shown
in Color Plate 16 * most likely has a(n)
A. Acute leukemia
B. Chronic leukemia
C. Myelodysplastic syndrome
D. Aplastic anemia

A

A. Acute leukemia

24
Q

Multiple myeloma is characterized by the
presence in urine of large amounts of
A. Cryoglobulins
B. IgG heavy chains
C. IgG light chains
D. Beta microglobulins

A

C. IgG light chains

25
Q

Which of the following is not classified as
a myeloproliferative disorder?
A. Polycythemia vera
B. Essential thrombocythemia
C. Multiple myeloma
D. Chronic myelogenous leukemia

A

C. Multiple myeloma

26
Q

Which of the following gene mutations
correlates with the t(9;22) that is present
in Philadelphia chromosome positive
chronic myelogenous leukemia?
A. MYC/IGH
B. BCR/ABL
C. PML/RARA
D. JAK2

A

B. BCR/ABL

27
Q

Which of the following statements does not correctly describe the WHO (World Health Organization) classification of hematopoietic neoplasms?
A. Acute leukemia is defined as the
presence of at least 20% bone marrow blasts.
B. Diagnosis is based on cellular
morphology and cytochemistry.
C. It groups lymphoid disorders into
B cell, T/NK cell, and Hodgkin
lymphoma.
D. Diagnostic criteria include morphologic, cytochemical, immunologic, cytogenetic, and molecular features.

A

B. Diagnosis is based on cellular
morphology and cytochemistry.

28
Q

Which of the following would be least
helpful in distinguishing chronic myelogenous leukemia (CML) from a neutrophilic leukemoid reaction?
A. An extreme leukocytosis with
increased neutrophilic bands,
metamyelocytes, and myelocytes
B. Leukocyte alkaline phosphatase score
C. Presence of marked splenomegaly
D. Neutrophils with Dohle bodies and
toxic granulation

A

A. An extreme leukocytosis with
increased neutrophilic bands,
metamyelocytes, and myelocytes

29
Q

The cytoplasmic inclusion present in the cell shown in Color Plate 17
A. Excludes a diagnosis of acute
myelogenous leukemia
B. Stains positive with leukocyte alkaline phosphatase (LAP)
C. Stains positive with myeloperoxidase (MPO)
D. Identifies the cell as a malignant
lymphoblast

A

C. Stains positive with myeloperoxidase (MPO)

30
Q

Which of the following is a typical finding
in chronic leukemias at onset?
A. Symptoms of infection and bleeding
B. Significant thrombocytopenia
C. Severe anemia
D. Elevated leukocyte count

A

D. Elevated leukocyte count

31
Q

In what condition would an LAP score of
10 most likely be found?
A. Bacterial septicemia
B. Late pregnancy
C. Polycythemia vera
D. Chronic myelogenous leukemia

A

D. Chronic myelogenous leukemia

32
Q

Which of the following is not associated
with neutrophilia?
A. Staphylococcal pneumonia
B. Cm shing inj ury
C. Infectious hepatitis
D. Neoplasms (tumors)

A

D. Neoplasms (tumors)

33
Q

In which of the following would an
absolute monocytosis not be seen?
A. Tuberculosis
B. Recovery stage of acute bacterial
infection
C. Collagen disorders
D. Infectious mononucleosis

A

D. Infectious mononucleosis

34
Q

Coarse PAS positivity may be found in the leukemic cells of
A. Acute myeloblastic leukemia (FAB
type Ml)
B. Acute lymphoblastic leukemia (FAB
type LI)
C. Acute myelomonocytic leukemia
(FAB type M4)
D. Acute monocytic leukemia (FAB
type M5)

A

B. Acute lymphoblastic leukemia (FAB
type LI)

35
Q

Which of the following is not among the diagnostic criteria used for classifying the myelodysplastic syndromes?
A. Unexplained anemia refractory to
treatment
B. Hypogranular and hyposegmented
neutrophils
C. Abnormal platelet size and
granulation
D. Hypocellular bone marrow with 25% blasts

A

D. Hypocellular bone marrow with 25% blasts

36
Q

Naphthol AS-D chloroacetate esterase
(specific) is usually positive in _______ cells, and alphanaphthyl acetate esterase (nonspecific)
is useful for identifying blast cells of ________ lineage.
A. Granulocytic; monocytic
B. Monocytic; granulocytic
C. Granulocytic; lymphocytic
D. Monocytic; lymphocytic

A

A. Granulocytic; monocytic

37
Q

The familial disorder featuring pseudoDohle bodies, thrombocytopenia, and
large platelets is called
A. May-Hegglin anomaly
B. Chediak-Higashi syndrome
C. Pelger-Huet anomaly
D. Alder-Reilly anomaly

A

A. May-Hegglin anomaly

38
Q

Alder-Reilly anomaly is an abnormality of
A. Lysosomal fusion
B. Nuclear maturation
C. Oxidative metabolism
D. Mucopolysaccharide metabolism

A

D. Mucopolysaccharide metabolism

39
Q

What is the initial laboratory technique for the diagnosis of monoclonal gammopathies?
A. Immunologic markers of marrow
biopsy cells
B. Cytochemical staining of marrow and peripheral blood cells
C. Serum and urine protein
electrophoresis
D. Cytogenetic analysis of marrow cells

A

C. Serum and urine protein
electrophoresis

40
Q

Which of the following statements about Hodgkin disease is false?
A. Peak incidence occurs in young adults.
B. Staging determines extent of disease
and treatment course.
C. Stage IV has the best prognosis.
D. Almost a 2:1 male predominance over
females is characteristic.

A

C. Stage IV has the best prognosis.

41
Q

The blast cells shown in Color Plate 18
are CD14 and CD33 positive, Sudan black B positive, specific esterase positive, and nonspecific esterase positive. Which type of acute leukemia is most consistent with
the immunophenotyping and cytochemical staining results?
A. Acute lymphoblastic leukemia, T cell type
B. Acute erythroleukemia
C. Acute myelomonocytic leukemia
D. Acute monocytic leukemia

A

C. Acute myelomonocytic leukemia

42
Q

Which type of leukemia is associated with the best prognosis for a cure?
A. Chronic lymphocytic leukemia in the elderly
B. Acute lymphoblastic leukemia in
children
C. Acute myelogenous leukemia in
children
D. Chronic myelogenous leukemia in
young adults

A

B. Acute lymphoblastic leukemia in
children

43
Q

What is the key diagnostic test for
Hodgkin lymphoma?
A. Bone marrow biopsy
B. Lymph node biopsy
C. Spinal tap
D. Skin biopsy

A

B. Lymph node biopsy

44
Q

A bone marrow with 90% cellularity and myeloid:erythroid (M:E) ratio of 10:1 is most characteristic of
A. Chronic myelogenous leukemia
B. Primary polycythemia
C. Beta-thalassemia major
D. Aplastic anemia

A

A. Chronic myelogenous leukemia

45
Q

A 60-year-old patient presents with
extreme fatigue. Her blood and bone
marrow findings are as follows: severe anemia with a dual RBC population, 3% marrow blasts, and numerous ringed sideroblasts. This information is most consistent with
A. Refractory anemia (RA)
B. Refractory anemia with ringed
sideroblasts (RARS)
C. Refractory anemia with excess blasts (RAEB)
D. Chronic myelomonocytic leukemia
(CMML)

A

B. Refractory anemia with ringed
sideroblasts (RARS)

46
Q

Which of the following is not a
mechanism by which neutropenia
may be produced?
A. Hypersplenism
B. Marrow injury or replacement
C. Recent strenuous exercise
D. Drug-induced antibodies

A

C. Recent strenuous exercise

47
Q

Which of the following is not a characteristic finding in polycythemia vera?
A. Blood pancytosis
B. Increased red cell mass
C. Increased erythropoietin level
D. Increased blood viscosity

A

C. Increased erythropoietin level

48
Q

In what disorder is significant basophilia
most commonly seen?
A. Hairy cell leukemia
B. Plasma cell leukemia
C. Acute lymphoblastic leukemia
D. Chronic myelogenous leukemia

A

D. Chronic myelogenous leukemia

49
Q

Acute erythroleukemia (FAB type M6) is characterized by increased
A. Promyelocytes and lysozyme activity
B. Marrow megakaryocytes and
thrombocytosis
C. Marrow erythroblasts and multinucleated red cells
D. Marrow monoblasts and immature
monocytes

A

C. Marrow erythroblasts and multinucleated red cells

50
Q

The blood findings present in Color Plate 20 are from a patient with complaints of fatigue and severe lower back pain. Which of the following would not be typical of
this disease?
A. Bone tumors of plasma cells
B. Hypercalcemia
C. Progressive renal impairment
D. Normal sedimentation rate

A

D. Normal sedimentation rate

51
Q

Myeloid metaplasia refers to
A. Displacement of normal marrow cells
by fibrous tissue
B. Hematopoietic failure
C. Extramedullary hematopoiesis
D. Tumors (neoplasms) of the bone marrow

A

C. Extramedullary hematopoiesis

52
Q

Which of the following statements about non-Hodgkin types of lymphoma is true?
A. Lymphadenopathy is the most
common presenting symptom.
B. Initially, they present as a systemic
disease rather than a localized tumor.
C. They are often associated with
multiple bone lesions.
D. They are characterized by proliferation
of malignant cells primarily involving
the bone marrow.

A

A. Lymphadenopathy is the most
common presenting symptom.

MTAP 2 FINAL SZN (7 decks)

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