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HEMA rodak's chapter quizzes Flashcards

1
Q

What is the most common clinical application of flow
cytometry?
a. Diagnosis of platelet disorders
b. Detection of fetomaternal hemorrhage
c. Diagnosis of leukemias and lymphomas
d. Differentiation of anemias

A

c. Diagnosis of leukemias and lymphomas

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2
Q

Which of the following is true of CD45 antigen?
a. It is present on every cell subpopulation in the bone marrow.
b. It is expressed on all hematopoietic cells, with the exception of megakaryocytes and late erythroid precursors.
c. It is not measured routinely in flow cytometry.
d. It may be present on nonhematopoietic cells.

A

b. It is expressed on all hematopoietic cells, with the exception of megakaryocytes and late erythroid precursors.

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3
Q

Erythroid precursors are characterized by the expression of:
a. CD71
b. CD20
c. CD61
d. CD3

A

a. CD71

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4
Q

Antigens expressed by B-LL include:
a. CD3, CD4, and CD8
b. CD19, CD34, and CD10
c. There are no antigens specific for B-LL.
d. Myeloperoxidase

A

b. CD19, CD34, and CD10

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5
Q

Which of the following is true of flow cytometric gating?
a. It is best defined as selection of a target population for flow cytometric analysis.
b. It can be done only at the time of data acquisition.
c. It can be done only at the time of final analysis and interpretation of
flow cytometric data.
d. It is accomplished by adjusting flow rate.

A

a. It is best defined as selection of a target population for flow cytometric analysis.

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6
Q

Collection of ungated events:
a. Facilitates comprehensive analysis of all cells
b. Does not help in detection of unexpected abnormal populations
c. Allows the collection of data on a large number of rare cells
d. Is used for leukemia diagnosis only

A

a. Facilitates comprehensive analysis of all cells

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7
Q

Mycosis fungoides is characterized by:
a. Loss of certain antigens compared with the normal T cell population
b. Polyclonal T cell receptor
c. Immunophenotype indistinguishable from that of normal T cells
d. Expression of CD3 and CD8 antigens

A

a. Loss of certain antigens compared with the normal T cell population

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8
Q

Mature granulocytes show the expression of:
a. CD15, CD33, and CD34
b. CD15, CD33, and CD41
c. CD15, CD33, and CD13
d. CD15, CD33, and CD7

A

c. CD15, CD33, and CD13

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9
Q

During the initial evaluation of flow cytometric data, cell size,
cytoplasmic complexity, and expression of CD45 antigen are used
to define cell subpopulations. Which of the following parameters
defines cytoplasmic complexity/ granularity?
a. SS
b. FS
c. CD45
d. HLA-DR

A

a. SS

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10
Q

The most important feature of the mature neoplastic B cell
population is:
a. The presence of a specific immunophenotype with expression of
CD19 antigen
b. A clonal light chain expression (i.e., exclusively k- or l-positive population)
c. A clonal T cell receptor expression
d. Aberrant expression of CD5 antigen on CD19+ cells

A

b. A clonal light chain expression (i.e., exclusively k- or l-positive population)

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11
Q

Lymphomas differ from leukemia in that they are:
a. Solid tumors
b. Not considered systemic disease
c. Never found in peripheral blood
d. Do not originate from hematopoietic cells

A

a. Solid tumors

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12
Q

Which one of the following viruses is known to cause
lymphoid neoplasms in humans?
a. HIV-1
b. HTLV-1
c. Hepatitis B
d. Parvovirus B

A

b. HTLV-1

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13
Q

Loss-of-function of tumor suppressor genes increases the
risk of hematologic neoplasms by:
a. Suppressing cell division
b. Activating tyrosine kinases which promote proliferation
c. Promoting excessive apoptosis of hematopoietic cells
d. Allowing cells with damaged DNA to progress through the cell cycle

A

d. Allowing cells with damaged DNA to progress through the cell cycle

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14
Q

Oncogenes are said to act in a dominant fashion because:
a. Leukemia is a dominating disease that is systemic
b. The oncogene product is a gain-of-function mutation
c. A mutation in only one allele is sufficient to promote a malignant phenotype
d. They are inherited by autosomal dominant transmission

A

c. A mutation in only one allele is sufficient to promote a malignant phenotype

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15
Q

Which one of the following is NOT one of the cellular
abnormalities produced by oncogenes:
a. Constitutive activation of a growth factor receptor
b. Constitutive activation of a signaling protein
c. Acceleration of DNA catabolism
d. Dysregulation of apoptosis

A

c. Acceleration of DNA catabolism

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16
Q

Which one of the following is an example of a tumor suppressor gene?
a. ABL1
b. RARA
c. TP53
d. JAK2

A

c. TP53

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17
Q

G-CSF is provided as supportive treatment during leukemia treatment regimens to:
a. Suppress GVHD
b. Overcome anorexia
c. Prevent anemia
d. Reduce the risk of infection

A

d. Reduce the risk of infection

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18
Q

Imatinib is an example of what type of leukemia treatment?
a. Supportive care
b. Chemotherapy
c. Bone marrow conditioning agent
d. Targeted therapy

A

d. Targeted therapy

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19
Q

Which one of the following is FALSE about epigenetic mechanisms?
a. Epigenetic mechanisms control how genes are expressed and silenced
b. Micro RNAs can bind to specific mRNAs and block their translation
c. Hypermethylation of CpG islands in gene promoters result in their overactivation
d. Histone deacetylases keep chromatin of target genes in a closed inactive state.

A

c. Hypermethylation of CpG islands in gene promoters result in their overactivation

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20
Q

Which one of the following is NOT a source of hematopoietic
stem cells for transplantation:
a. Spleen
b. Bone marrow
c. Peripheral blood
d. Umbilical cord blood

A

a. Spleen

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21
Q

MDS 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

A

d. Older than 50 years

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22
Q

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

a. Dyspoiesis

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23
Q

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

A

b. Target cells

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24
Q

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

A

b. One-third

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25
Q

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%

A

c. 20%

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26
Q

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

A

c. Vitamin B12 and folate levels

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27
Q

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 x 1012/L, platelet count is 550 x 109/L, and WBC count is 3.8x 109/L. Her WBC differential is unremarkable. Bone marrown 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 cisretinoic acid

A

a. Supportive therapy; lenalidomide if the disease progresses

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28
Q

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

A

d. Neuropathy

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29
Q

Into what other hematologic disease does MDS often convert?
a. Megaloblastic anemia
b. Aplastic anemia
c. AML
d. Myeloproliferative disease

A

c. AML

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30
Q

Chronic myelomonocytic leukemia is classified in the WHO system as:
a. A myeloproliferative neoplasm
b. Myelodysplastic syndrome, unclassified
c. MDS/MPN
d. Acute leukemia

A

c. MDS/MPN

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31
Q

Non-Hodgkin lymphoma can be best differentiated from reactive disorders by:
a. Genetic testing
b. Immunophenotyping
c. Absolute lymphocyte count
d. Blood film review

A

d. Blood film review

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32
Q

Which laboratory test is most suggestive of autoimmune hemolytic anemia in a patient with CLL?
a. Direct antiglobulin test
b. Hemoglobin
c. Lymphocyte count
d. Platelet count

A

c. Lymphocyte count

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33
Q

What is the best test or method for determining if a clonal population of T cells is present in a specimen?
a. Molecular diagnostic testing
b. Flow cytometry for CD3, CD5, and CD7
c. Immunohistochemical stain
d. Karyotyping

A

d. Karyotyping

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34
Q

A rise in the lymphocyte count from 4.1 x 109/L to 5.5 x 109/L in a patient with monoclonal B lymphocytosis suggests:
a. Acute lymphocyte leukemia
b. Chronic lymphocytic leukemia
c. Acute myelocytic leukemia
d. A reactive condition

A

d. A reactive condition

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35
Q

Which test is often used to differentiate CLL from mantle cell lymphoma?
a. Annexin A staining
b. Lymph node biopsy
c. Immunohistochemistry
d. FISH for BCL2 translocation

A

b. Lymph node biopsy

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36
Q

If not treated, which of the following would generally be associated with the best outcome?
a. Peripheral T cell lymphoma
b. Burkitt lymphoma
c. Splenic marginal zone lymphoma
d. Sézary syndrome

A

b. Burkitt lymphoma

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37
Q

What do CLL and myeloma have in common?
a. Osteolytic lesions
b. Light chain restriction
c. Cell of origin
d. Immunophenotype

A

b. Light chain restriction

38
Q

In Hodgkin lymphoma the Reed-Sternberg cell and _________ are malignant.
a. Popcorn cells
b. T cells
c. B cells
d. Histiocytes

A

a. Popcorn cells

39
Q

In most cases the diagnosis of lymphoma relies on all of the following except:
a. Microscopic examination of affected lymph nodes
b. Immunophenotyping
c. Molecular analysis
d. Peripheral blood examination and complete blood count

A

c. Molecular analysis

40
Q

Which of the following is present in monoclonal gammopathy of underdetermined significance?
a. Hypercalcemia
b. Serum monoclonal protein
c. Anemia
d. Bone lesion

A

a. Hypercalcemia

41
Q

A definition of a leukemia could include
a. an overproduction of leukocytes
b. solid, malignant tumors of the lymph nodes
c. malignant cells trespassing the blood-brain barrier
d. both A and C

A

d. both A and C

42
Q

Descriptive terms for most lymphomas can include
a. a nonneoplastic proliferative disease
b. a solid malignant tumor of the lymph nodes
c. a lymphocytopenia
d. freely trespassing the blood-brain barrier

A

b. a solid malignant tumor of the lymph nodes

43
Q

An acute leukemia can be described as being
a. of short duration with many mature leukocyte forms in the peripheral blood
b. of short duration with many immature leukocyte forms in the peripheral blood
c. of short duration with little alteration of the leukocytes of the peripheral blood
d. of long duration with many mature leukocyte forms in the peripheral
blood

A

b. of short duration with many immature leukocyte forms in the peripheral blood

44
Q

A difference between the FAB and WHO staging systems is that
a. FAB uses molecular information
b. WHO uses molecular information
c. FAB only classifies myelogenous leukemias
d. WHO only classifies lymphoid leukemias

A

b. WHO uses molecular information

45
Q

The etiological agents of leukemias can include
a. ionizing radiation
b. certain infectious agents
c. chemical exposure to benzene
d. all of the above

A

d. all of the above

46
Q

Cancer-predisposing genes may act by
a. affecting the rate at which exogenous precarcinogens are metabolized to actively carcinogenic forms
b. affecting the host’s ability to repair resulting damage to DNA
c. altering the immune system’s ability to recognize and wipe out incipient tumors
d. all of the above

A

d. all of the above

47
Q

Which of the following are typical characteristics of an acute leukemia?
a. Replacement of normal marrow elements by leukocytic blasts and bleeding episodes
b. Blasts and immature leukocytes in the peripheral blood and anemia
c. Leukocytosis
d. All of the above

A

d. All of the above

48
Q

Myeloid and monocytic acute leukemias are classified as FAB
a. M1
b. M4
c. M5
d. L1

49
Q

Monocytic acute leukemia is classified as FAB
a. M1
b. M4
c. M5
d. L1

50
Q

Myeloid without maturation acute leukemias is classified as FAB
a. M1
b. M4
c. M5
d. L1

51
Q

Lymphoblastic (one cell population) acute leukemias are classified as FAB
a. M1
b. M4
c. M5
d. L1

52
Q

Characteristics of FAB M1 include
a. leukocytosis with maturation of the myeloid cell line in the peripheral blood
b. leukocytosis with maturation of the lymphocytic cell line in the peripheral blood
c. leukocytosis without maturation of the myeloid cell line in the peripheral blood
d. leukocytosis with many mature leukocytes in the peripheral blood

A

c. leukocytosis without maturation of the myeloid cell line in the peripheral blood

53
Q

The incidence of FAB M1 is
a. high in children younger than 18 months of age
b. high in children between 1.5 and 12 years of age
c. high in middle-aged adults
d. both A and C

A

d. both A and C

54
Q

A mixture of myeloid and monocytic blasts predominate in
a. FAB M2
b. FAB M3
c. FAB M4
d. FAB M6

55
Q

Blasts of the monocytic type predominate in
a. FAB M2
b. FAB M3
c. FAB M4
d. FAB M5

56
Q

Many coarsely granular promyelocytes with dumbbell-shaped or bilobed nuclei predominate in
a. FAB M2
b. FAB M3
c. FAB M4
d. FAB M6

57
Q

Myeloblasts, promyelocytes, and myelocytes predominate in
a. FAB M2
b. FAB M3
c. FAB M4
d. FAB M6

58
Q

Immature leukocytic and erythrocytic cell types predominate in
a. FAB M2
b. FAB M3
c. FAB M4
d. FAB M6

59
Q

Which cytochemical stain will demonstrate lysosomal enzyme activity in primary azurophilic granules?
a. Prussian Blue
b. Sudan Black B
c. Periodic acid–Schiff (PAS)
d. Myeloperoxidase

A

d. Myeloperoxidase

60
Q

Multinucleated (3–5) erythroid precursors are usually seen in
a. acute myeloblastic leukemia without maturation
b. chronic myeloid leukemia
c. myelofibrosis
d. acute lymphoblastic leukemia

A

a. acute myeloblastic leukemia without maturation

61
Q

The M:E ratio in acute erythroid leukemia is usually
a. high
b. normal
c. variable
d. low

62
Q

Auer rods are
a. an aggregation of lysosomes or primary granules
b. peroxidase negative
c. LAP positive
d. associated with lymphoblasts

A

a. an aggregation of lysosomes or primary granules

63
Q

One cytochemical stain that can differentiate most cases of precursor lymphoblastic leukemia from other foms of leukemia is
a. peroxidase
b. alkaline phosphatase
c. nonspecific esterease
d. TdT terminal deoxynucleotidyl transferase

A

d. TdT terminal deoxynucleotidyl transferase

64
Q

Which cellular series can be identified by a positive Sudan Black B reaction?
a. Lymphocytic
b. Monocytic
c. Myelocytic
d. Erythrocytic

A

c. Myelocytic

65
Q

Which type of cell demonstrates the most intense peroxidase reaction?
a. neutrophil, expect blast forms
b. Basophil
c. Lymphocyte
d. Monocyte

A

a. neutrophil, expect blast forms

66
Q

Which cytochemical stain is associated with selectively identifying lipoproteins in the cellular membranes of myelogenous cells and mitochrondria?
a. Sudan Black B
b. LAP
c. Nonspecific esterease
d. Acid phosphatase

A

a. Sudan Black B

67
Q

Which cytochemical stain is associated with staining glycogen and related mucopolysaccharides?
a. Sudan Black B
b. LAP
c. Periodic acid Schiff stain (PAS)
d. Acid phosphatase

A

c. Periodic acid Schiff stain (PAS)

68
Q

Leukemia secondary to Burkitt’s lymphoma is classified as
a. FAB M1
b. FAB L1
c. FAB L2
d. FAB L3

69
Q

) Childhood lymphoblastic leukemia is classified as
a. FAB M1
b. FAB L1
c. FAB L2
d. FAB L3

70
Q

Older children and adults are typically classified with
a. FAB M1
b. FAB L1
c. FAB L2
d. FAB L3

71
Q

Chloromas are associated with
a. FAB M1
b. FAB M3
c. FAB M4
d. FAB M5

72
Q

A common characteristic of ALL is
a. bone and joint pain
b. many blast cells with Auer rods
c. leukocytopenia
d. a leukemia of older persons

A

a. bone and joint pain

73
Q

Specific nature B-cell surface marker(s) membrane is
a. CD 79a
b. CD19
c. CD 20
d. all of the above

74
Q

Patients with AML have a good prognosis if
a. < 45 years of age
b. Auer rods are present in blast cells
c. Ph chromosome
d. all of the above

A

a. < 45 years of age

75
Q

Which of the following classification systems delineates each
subtype of acute leukemia on immunophenotyping and
cytogenetic analysis as well as morphology?
a. REAL
b. WHO
c. FAB
d. RYE

76
Q

A diagnosis of an acute leukemia according to the World Health Organization is defined by:
a. a high WBC count
b. blasts in the peripheral blood
c. >20% non-erythroid blasts in the bone marrow
d. Hepatosplenomegaly

A

c. >20% non-erythroid blasts in the bone marrow

77
Q

ALL Prognosis is NOT dependent on which of the following?
a. tumor burden
b. immunophenotype
c. genetic abnormalities
d. morphology of the blasts

A

d. morphology of the blasts

78
Q

Patients with Down Syndrome are predisposed to developing ALL due to what genetic alteration?
a. Philadelphia chromosome
b. GATA1 mutation
c. deletion of 5q
d. no genetic alterations have been seen

A

b. GATA1 mutation

79
Q

What intimal cell synthesizes and stores von Willebrand factor (VWF)?
a. Smooth muscle cell
b. Endothelial cell
c. Fibroblast
d. Platelet

A

b. Endothelial cell

80
Q

What subendothelial structural protein triggers coagulation through activation of factor VII?
a. Thrombomodulin
b. Nitric oxide
c. Tissue factor
d. Thrombin

A

c. Tissue factor

81
Q

What coagulation plasma protein should be assayed when platelets fail to aggregate properly?
a. Factor VIII
b. Fibrinogen
c. Thrombin
d. Factor X

A

b. Fibrinogen

82
Q

What is the primary role of vitamin K for the prothrombin group factors?
a. Provides a surface on which the proteolytic reactions of the factors occur
b. Protects them from inappropriate activation by compounds such as thrombin
c. Accelerates the binding of the serine proteases and their cofactors
d. Carboxylates the factors to allow calcium binding

A

d. Carboxylates the factors to allow calcium binding

83
Q

What is the source of prothrombin fragment F1.2?
a. Plasmin proteolysis of fibrin polymer
b. Thrombin proteolysis of fibrinogen
c. Proteolysis of prothrombin by factor Xa
d. Plasmin proteolysis of cross-linked fibrin

A

b. Thrombin proteolysis of fibrinogen

84
Q

What serine protease forms a complex with factor VIIIa, and what is the substrate of this complex?
a. Factor VIIa, factor X
b. Factor Va, prothrombin
c. Factor Xa, prothrombin
d. Factor IXa, factor X

A

d. Factor IXa, factor X

85
Q

What protein secreted by endothelial cells activates fibrinolysis?
a. Plasminogen
b. TPA
c. PAI-1
d. TAFI

86
Q

What two regulatory proteins form a complex that digests activated factors V and VIII?
a. TFPI and Xa
b. Antithrombin and protein C
c. APC and protein S
d. Thrombomodulin and plasmin

A

c. APC and protein S

87
Q

What are the primary roles of VWF?
a. Inhibit excess coagulation and activate protein C
b. Activate plasmin and promote lysis of fibrinogen
c. Mediate platelet adhesion and serve as a carrier molecule for factor VIII
d. Mediate platelet aggregation via the GP IIb/IIIa receptor

A

c. Mediate platelet adhesion and serve as a carrier molecule for factor VIII

88
Q

Most coagulation factors are synthesized in:
a. The liver
b. Monocytes
c. Endothelial cells
d. Megakaryocytes

A

a. The liver

89
Q

The events involved in secondary hemostasis:
a. Lead to the formation of a stable fibrin clot
b. Usually occur independently of primary hemostasis
c. Occur in a random fashion
d. Are the first line of defense against blood loss

A

a. Lead to the formation of a stable fibrin clot

90
Q

Which of the following coagulation factors is activated by thrombin and mediates the stabilization of the fibrin clot?
a. Tissue factor
b. Factor VII
c. Factor IX
d. Factor XIII

A

d. Factor XIII

91
Q

Which of the following endogenous plasma inhibitors is (are) important for the control of excessive thrombin
generation?
a. AT, TFPI
b. Platelet factor 4
c. TAT, F1.2
d. a and b

A

a. AT, TFPI

MTAP 2 (23 decks)

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