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Hematology Flashcards

1
Q
  1. Expression of which cell surface protein on leukemic cells is considered diagnostic for acute leukemia?A) CD3
    B) CD21
    C) CD34
    D) CD79a
A

C) CD34

Source: Schalm, chapter 143 “Immunophenotyping and Determination of Clonality,” p. 1136

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2
Q

Mott cells and/or flame cells may be seen in this disease.

A) Large granular lymphoma
B) Multiple myeloma
C) Mast cell tumor
D) Myelodysplastic syndrome
A

B) Multiple myeloma

Source: Harvey, chapter 9 “Disorders of Bone Marrow,” p. 303

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3
Q

This receptor found on platelets binds fibrinogen to enable platelet aggregation.

A) GPIb/IX/V
B) Ca1DAG-GEFI
C) Phospholipase C
D) GPIIb/IIIa
A

D) GPIIb/IIIa

Source: Harvey, chapter 7 “Evaluation of hemostasis: Coagulation and platelet disorders,” p. 196

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4
Q

Which of the following feature in a clinical case is not an indication for flow cytometry if hematologic malignancy is suspected:

a. Fluids from a septic process
b. Cytologically abnormal cells noted within the bone marrow
c. Lymphadenopathy
d. Lymphocytosis

A

a. Fluids from a septic process

A. Weiss, D. J., Wardrop, K. J., eds. (2010), Schalm’s Veterinary Hematology. 6th ed. Danvers, MA: Wiley-Blackwell. p. 1134

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5
Q

Which of the following is a not a useful marker for lymphoid leukemia:

a. CD3
b. CD11c
c. CD11d
d. CD21

A

b. CD11c

B. Harvey, J. W. (2012), Veterinary Hematology: A Diagnostic Guide and Color Atlas. St. Louis, MO: Elsevier Saunders, p. 298

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6
Q

Which of the following thrombopathias does not match the reported breed:

a. Mutations in CalDAG-GEFI in Spitz dogs and Simmental cattle
b. Deficiency in the GPIIb subunit of the GPIIb/IIIa in Great Pyrenees
c. AP3B1 mutation in Persian cats
d. Mutation in Kindlin-3 gene in German Shepherd dogs

A

c. AP3B1 mutation in Persian cats

C. Harvey, J. W. (2012), Veterinary Hematology: A Diagnostic Guide and Color Atlas. St. Louis, MO: Elsevier Saunders, p. 217

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7
Q

Which one of the following best describes multiple myeloma?

a. It is a B lymphocyte tumor of bone marrow origin with a monoclonal hyperglobulinemia of either IgG or IgA.
b. It is a T lymphocyte tumor of extra-medullary origin, with a monoclonal hyperglobulinemia of IgM.
c. It is a B lymphocyte tumor of extra-medullary origin with a polyclonal gammopathy.
d. It is a tumor of unknown origin.

A

a. It is a B lymphocyte tumor of bone marrow origin with a monoclonal hyperglobulinemia of either IgG or IgA.

Harvey Chapter 9: Disorders of the Bone Marrow, pg. 302

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8
Q

What intracellular structure do platelets have that erythrocytes do not have to facilitate their high energy demands?

a. Lysosomes
b. Golgi Bodies
c. Mitochondria
d. Endoplasmic Reticulum

A

c. Mitochondria

C. Harvey Chapter 7: Evaluation of Hemostasis: Coagulation and Platelet Disorders, pg. #192

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9
Q

Fibrin Degradation Products (FDPs) are indicative of fibrinolysis. In humans, FDPs have a __________ half-life, indicating ______________________________.

a. short (~ 5 hr.); delayed fibrinolysis or fibrinogenolysis.
b. short (~ 5 hr.); recent or ongoing fibrinolysis or fibrinogenolysis.
c. long (~ 24 hr.); recent or ongoing fibrinolysis or fibrinogenolysis.
d. long (~ 24 hr.); delayed fibrinolysis or fibrinogenolysis.

A

b. short (~ 5 hr.); recent or ongoing fibrinolysis or fibrinogenolysis.

B. Harvey Chapter 7, Evaluation of Hemostasis: Coagulation and Platelet Disorders, pg. #205-206.

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10
Q

Which one of these combinations characterizes neoplastic cells in acute myeloid leukemia ?

a. Impaired differentiation/maturation and impaired proliferation/survival
b. Impaired differentiation/maturation and preserved proliferation/survival
c. Preserved differentiation/maturation and impaired proliferation/survival
d. Preserved differentiation/maturation and increased proliferation/survival

A

b. Impaired differentiation/maturation and preserved proliferation/survival

Veterinary Hematology : a Diagnostic Guide and Color Atlas, Chapter 9 : Disorders of Bone Marrow, p. 306-307

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11
Q

Which one of these conditions may be difficult to differentiate from acute lymphoblastic leukemia, making helpful the measurement of CD34 ?

a. Chronic lymphocytic leukemia
b. Leukemic lymphoma
c. Leukemoid reaction
d. Multiple myeloma

A

b. Leukemic lymphoma

Veterinary Hematology : a Diagnostic Guide and Color Atlas, Chapter 9 : Disorders of Bone Marrow, p. 298

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12
Q

Calcium ions play an important role in primary hemostasis. Which one of the following does NOT involve calcium ?

a. activation of CalDAG-GEFI
b. activation of GPIb
c. activation of protein kinase C
d. binding of coagulation factors

A

b. activation of GPIb

Veterinary Hematology : a Diagnostic Guide and Color Atlas, Chapter 7 : Evaluation of Hemostasis : Coagulation and Platelet Disorders, p. 195-197

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13
Q

Which of the following are correctly paired with the main agonist(s) and the mechanism of hemostasis?

a. Thromboxane A2, high thrombin, collagen and platelet adhesion
b. Thromboxane A2, high thrombin, collagen and platelet activation
c. vWF (main agonist) and platelet aggregation
d. ADP, thromboxane A2, thrombin and PAF and platelet adhesion
e. ADP, thromboxane A2, thrombin and PAF and platelet secretion

A

b. Thromboxane A2, high thrombin, collagen and platelet activation

Page 196-197. vWF is important for platelet aggregation when shear forces are high in blood but ADP, thromboxane A2, thrombin and PAF are important in all situations. vWF is more important for platelet adhesion.
Source: Harvey, JW: Veterinary Hematology: a Diagnostic Guide and Color Atlas, Saunders, 2012.

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14
Q

Which of the following characteristic of CLL is correctly paired with the species?

a. Most common type of CLL in dogs and T cell
b. Most common T cell CLL in cats and CD8
c. Most common T cell CLL In dogs and CD4
d. Abnormally high number of blasts in the peripheral blood in dogs and cats with CLL
e. Most common type of CLL in cats and B cell

A

a. Most common type of CLL in dogs and T cell

Page 300. B and C are switched. The circulating lymphocytes are usually small to medium sized normal looking lymphocytes. The most common type of CLL in dogs and cats is T cell.
Source: Harvey, JW: Veterinary Hematology: a Diagnostic Guide and Color Atlas, Saunders, 2012.

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15
Q

Which of the following criteria can be used to differentiate a neoplastic population from a non-neoplastic population in a lymph node aspirate?

I. Aberrant immunophenotype: T cells without CD21
II. Homogenous phenotype: >80% CD21
III. Homogenous phenotype: >60% CD45 and PARR positive
IV. Aberrant immunophenotype: CD4 and CD8 on the same T cell
V. Aberrant immunophenotype: >50% of CD34 cells

a. I, II, V
b. II, III
c. III, IV, V
d. II, III, IV, V
e. All of the above

A

d. II, III, IV, V
II. Homogenous phenotype: >80% CD21
III. Homogenous phenotype: >60% CD45 and PARR positive
IV. Aberrant immunophenotype: CD4 and CD8 on the same T cell
V. Aberrant immunophenotype: >50% of CD34 cells

Answer: D. Page 1134-1135. T cells normally do not have CD21 (this is a B cell marker) so this is a normal immunophenotype. CD45 is a T cell marker. CD4 is a T helper cell marker and CD8 is a cytotoxic T cell marker and thus both should not be on the same T cell. CD34 is a marker present on hematopoietic stem cells and thus there should not be many cells that stain positive for this marker. It is used as a marker for acute leukemia.
Source: Weiss DJ, Wardrop KJ, eds: Schalm’s Veterinary Hematology, Sixth Edition, Wiley Blackwell 2010.

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16
Q

Which of the following constitutes an indication for performing Flow Cytometry?

A) Highly reactive lymphnodes
B) Reactive mesothelial cells noted in cavitary fluids
C) Monoclonal gammopathy
D) Peripheral lymphocytosis.

A

D) Peripheral lymphocytosis.

pg 1134 (Immune phenotyping and determination of clonality)

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17
Q

Which of the following is true regarding acute leukemia?

A) >20% blasts in peripheral blood is considered supportive of this diagnosis
B) Absence of CD34 expression rules out acute leukemia
C) Staining with CD79a is considered diagnostic for acute leukemia.
D) Cats with acute leukemia are predominantly FeLV negative.

A

A) >20% blasts in peripheral blood is considered supportive of this diagnosis

pg 1136 (Immune Phenotyping and determination of clonality)

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18
Q

Which is true regarding multiple myeloma?

A) A predominantly IgM monoclonal gammopathy characterizes this disease.
B) Biclonality rules out multiple myeloma as a source of hyperglobulinemia.
C) Cats are much more likely than dogs to have metastasis with multiple myeloma.
D) Immunoglobulins are identified using immunodiffusion.

A

C) Cats are much more likely than dogs to have metastasis with multiple myeloma.

pg 303 (Disorders of bone marrow)

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19
Q

A hematopoietic neoplasm that is CD34 positive most likely originated in what location?

a. Spleen
b. Bone Marrow
c. Liver
d. Lymph nodes

A

b. Bone Marrow

Source: Harvey’s Hematology Atlas; Ch. 9, Pg. 299-300

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20
Q

Waldenstrom macroglobulinemia is a lymphoplasmacytic neoplasm that produces a monoclonal population of which antibody?

a. IgE
b. IgA
c. IgG
d. IgM

A

d. IgM

Source: Harvey’s Hematology Atlas; Ch. 9, Pg. 306

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21
Q

All of the following are components of dense granules in platelets, except?

a. P-selectin
b. ADP
c. Serotonin
d. Calcium

A

a. P-selectin

Source: Harvey’s Hematology Atlas; Ch. 7, Pg. 193-194

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22
Q

Fibrinogen degradation products tests provide evidence of ___________ in vivo.

a. fibrinolysis
b. thrombocytosis
c. thromboembolism
d. hypercoagulability

A

a. fibrinolysis

Reference: Evaluation of Hemostasis: Coagulation and Platelet Disorders. Chapter 7. Pg 205-206

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23
Q

Disseminated intravascular coagulation is generally initiated by the disseminated presentation of _____________ in the blood. Thrombin that is generated by the _______ pathway activates platelets, resulting in further changes.

a. tissue factor
b. factor VII
c. plasmin
d. fibrinogen

A

a. tissue factor

Reference: Evaluation of Hemostasis: Coagulation and Platelet Disorders. Chapter 7. Pg 220

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24
Q

An 11mo MC pitbull presented with acute signs of dyspnea. Initial triage revealed epistaxis and evidence of pleural effusion on TFAST. Lab work revealed a normal platelet count, prolonged PT, and normal PTT. What is the most likely cause of his clinical signs and lab work abnormalities?

a. Thrombocytopathy
b. Von Willebrand disease
c. Anti-coagulant rodenticide toxicity
d. Early disseminated intravascular coagulopathy

A

c. Anti-coagulant rodenticide toxicity

Reference: Evaluation of Hemostasis: Coagulation and Platelet Disorders. Chapter 7. Pg 224

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25
Q

An increase in the cytosolic concentration of this ion within the platelet help stimulate platelets in various ways, resulting in TxA2 synthesis, shape change, integrin activation, secretion, aggregation, and platelet procoagulant activity:

A.  Hydrogen
B.  Potassium
C.  Calcium 
D.  Sodium
A

C. Calcium

pg. 195-6; Veterinary Hematology: a Diagnostic Guide and Color Atlas, Harvey, 2012

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26
Q

Which of the following von Willebrand Factor deficiencies is characterized by a complete lack of vWF monomers?

A.  vWF type 1
B.  vWF type 2A
C.  vWF type 2B
D.  vWF type 3
A

D. vWF type 3

pg 613-614; Schalm’s Veterinary Hematology,6th ed. Weiss & Wardrop, 2010

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27
Q

Where is von Willebrand Factor stored?

A.  mature neutrophils 
B.  endothelial Weibel-Palade bodies
C.  respiratory epithelial cells
D.  bone marrow
A

B. endothelial Weibel-Palade bodies

pg 207; Veterinary Hematology: a Diagnostic Guide and Color Atlas, Harvey, 2012

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28
Q

The normal mean life span for canine platelets is ___________.

A. 24-48 hours
B. 4-8 days
C. 10-14 days
D. 120 days

A

B. 4-8 days

Harvey, Ch. 7 Coagulation and Platelet Disorders, pg. 191

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29
Q

Platelet adhesion requires the binding of the GPIb/IX/V complex to ______________, which is primarily stimulated by ______________.

A. von Willebrand Factor; activation of Tissue Factor
B. fibrinogen; activation of Tissue Factor
C. von Willebrand Factor; shear force
D. fibrinogen; shear force

A

C. von Willebrand Factor; shear force

Harvey, Ch. 7 Coagulation and Platelet Disorders, pg. 194-196

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30
Q
  1. Which of the following is not contained within primary granules of neutrophils?A) Defensin
    B) Myeloperoxidase
    C) Lysozyme
    D) Lactoferrin
A

D) Lactoferrin

Source: Schalm’s “Neutrophil Structure and Biochemistry,” Chapter 40, p. 265

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31
Q

Which of the following cytokines stimulates a second wave of migration of eosinophils following initial mast cell and/or parasite-derived attractants?

A) IL-3
B) GM-CSF
C) IL-5
D) IL-1
A

C) IL-5

Source: Harvey “Evaluation of Leukocytic Disorders,” Chapter 5, p. 128

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32
Q

This inherited neutrophil defect is characterized by enlarged membrane-bound granules in blood leukocytes and melanocytes, which are thought to arise from abnormal fusion of lysosomes during cell development.

A) Chediak-Higashi syndrome
B) Kindlin-3 deficiency
C) Cyclic hematopoiesis
D) B2 integrin deficiency
A

A) Chediak-Higashi syndrome

Source: Harvey “Evaluation of Leukocytic Disorders,” Chapter 5, p. 147

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33
Q

Which of the following is characterized by the triad of leukocyte inclusions, thrombocytopenia and macroplatelets:

a. Chediak-Higashi Syndrome
b. May-Hegglin Anomaly
c. Pelger-Huet Anomaly
d. Mucoplysaccharidosis Type VII

A

b. May-Hegglin Anomaly

Harvey, J. W. (2012), Veterinary Hematology: A Diagnostic Guide and Color Atlas. St. Louis, MO: Elsevier Saunders, pgs. 134, 137, 140.

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34
Q

Decreased neutrophil adhesion, impaired chemotaxis and aggregation and minimal bactericidal activity in Irish Setter dogs is associated with a deficiency in:

a. LAD-I
b. LAD-II
c. LAD-III
d. LAD-IV

A

a. LAD-I

Harvey, J. W. (2012), Veterinary Hematology: A Diagnostic Guide and Color Atlas. St. Louis, MO: Elsevier Saunders, p. 148

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35
Q

Which of the following is not a product utilized or formed during the respiratory burst in neutrophils?

a. Hydrogen peroxide (H2O2)
b. Superoxide (O2-)
c. NADPH
d. Hypochlorite (HOCl)

A

d. Hypochlorite (HOCl)

Harvey, J. W. (2012), Veterinary Hematology: A Diagnostic Guide and Color Atlas. St. Louis, MO: Elsevier Saunders, pgs. 126-127

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36
Q

Once outside the vessel, which receptor on the surface of activated neutrophils is the most important for migration ?

a. β1 integrin
b. β2 integrin
c. C3b receptor
d. P-selectin glycoprotein ligand-1

A

a. β1 integrin

Schalm’s Veterinary Hematology, Chapter 5 : Evaluation of Leukocytic Disorders, p. 126.

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37
Q

Which one of these morphologic abnormalities is NOT seen in neutrophil toxicity ?

a. foamy basophilia
b. giant neutrophils
c. hyposegmentation
d. Russell bodies

A

d. Russell bodies

Schalm’s Veterinary Hematology, Chapter 5 : Evaluation of Leukocytic Disorders, p. 137.

38
Q

Which one of the following best describes Pelger-Huët anomaly ?

a. blue granules and vacuoles in neutrophils and lymphocytes
b. hyposegmentation in neutrophils, eosinophils and basophils
c. large pink-to-purple granules in neutrophils
d. large blue inclusions in neutrophils and thrombocytopenia

A

b. hyposegmentation in neutrophils, eosinophils and basophils

Schalm’s Veterinary Hematology, Chapter 5 : Evaluation of Leukocytic Disorders, p. 134

39
Q

When a neutrophil is stimulated, which granules are the first to be released?

a. Primary granules
b. Secondary granules
c. Tertiary granules
d. Secretory vesicles

A

d. Secretory vesicles

Source: Schalm Ch. 40, Pg. 265

40
Q

What is the primary role of defensins?

a. Alter the membrane permeability of bacteria
b. Chelate iron required for bacterial growth
c. Phagocytize invading microorganisms
d. Help stimulate the respiratory burst

A

a. Alter the membrane permeability of bacteria

Source: Schalm Ch. 5, Pg. 127

41
Q

An increase in IL-5 production most commonly results in stimulation of what cell?

a. Neutrophil
b. Eosinophil
c. Basophil
d. Lymphocyte

A

b. Eosinophil

Source: Schalm Ch. 5, Pg. 150

42
Q

Which of the following causes of neutropenia is correctly paired?

a. Cyclic hematopoiesis and mortality by 6 months of age or systemic amyloidosis as adults
b. Beta 2 integrin deficiency and gray collies
c. Chediak-Higashi syndrome and Australian Shepherds
d. FeLV/FIV and reduced granulopoiesis
e. Hypertension and pseudoneutropenia

A

a. Cyclic hematopoiesis and mortality by 6 months of age or systemic amyloidosis as adults

Page 147-148. Beta 2 integrin deficiency is most commonly associated with an autosomal recessive gene in Irish Setters and Holsteins. Hypotension and shock shift neutrophils from the CNP to the MNP. FeLV/FIV cause dysgranulopoiesis with normal or increased precursors in the BM but decreased release of mature forms. Chediak-Higashi syndrome is associated with Persian cats and Puelger Huet is associated with Australian Shepherds.
Source: Harvey, JW: Veterinary Hematology: a Diagnostic Guide and Color Atlas, Saunders, 2012.

43
Q

Which of the following is/are consistent with neutrophil toxicity?

I.	Foamy cytoplasm 
II.	Bone marrow dysplasia 
III.	Binucleation 
IV.	Ring forms 
V.	Bluish angular cytoplasmic inclusions

a. I, IV
b. I, III, IV, V
c. I, II, III, IV
d. I, III, IV
e. I-V

A 
e.	I-V 
   I.	Foamy cytoplasm 
   II.	Bone marrow dysplasia 
   III.	Binucleation 
   IV.	Ring forms 
   V.	Bluish angular cytoplasmic inclusions

Page 137.
Source: Harvey, JW: Veterinary Hematology: a Diagnostic Guide and Color Atlas, Saunders, 2012.

44
Q

What is the main function of B1 integrins in the immune system?

a. Degranulation of mast cells
b. Firm adhesion of granulocytes to endothelial cells
c. Presenting antigens to lymphocytes for adaptive immunity
d. High affinity for proteins in the extracellular matrix and thus are crucial for extravascular neutrophil migration
e. Haptotaxis

A

d. High affinity for proteins in the extracellular matrix and thus are crucial for extravascular neutrophil migration

Page 126. IgE is important for mast cell degranulation. B2 receptors are for firm adhesion. MHC2 are for antigen presentation. Immobilized chemoattractants include IL-8, C5a, leukotriene B4, etc.
Source: Harvey, JW: Veterinary Hematology: a Diagnostic Guide and Color Atlas, Saunders, 2012.

45
Q

A 12 week old male intact Australian Shepherd dog presented for an exam and booster vaccinations. His physical exam was unremarkable for all body systems. Blood work was performed revealing a moderate eosinophilia. What is the most likely cause for this change?

a. Clinically insignificant
b. Pelger-Huet anomaly
c. Intestinal parasitism
d. May-hegglin anomaly

A

c. Intestinal parasitism

Reference: Chapter 5 “Evaluation of Leukocytic Disorders” Pg 127 – 128

46
Q

May-Hegglin Anomaly is characterized by the following change, in addition to thrombocytopenia and macrothrombocytes

a. Hemosiderin
b. Dohle bodies
c. Hyposegmentation of neutrophils
d. Leukocyte inclusions

A

d. Leukocyte inclusions

Reference: Chapter 5 “evaluation of Leukocytic Disorders” Pg 140

47
Q

The ________ oxidase enzyme is normally inactive in resting or unstimulated phagocytes of neutrophils. Once activated, this enzyme is important in initiation of the respiratory burst mechanism in killing bacteria.

a. NADPH
b. Myeloperoxidase
c. Defensins
d. Lactoferrin

A

a. NADPH

Reference: Chapter 5 “evaluation of leukocytic disorders” pg 126

48
Q

Which of the following statements is true?

A. Primary neutrophil granules are formed during the metamyelocyte stage of maturation.
B. Secondary neutrophil granules are formed during the promyelocyte stated of maturation.
C. Tertiary neutrophil granules are formed during the metamyelocyte stage of maturation.
D. Primary neutrophil granules are formed during the promyelocyte stage of maturation.

A

D. Primary neutrophil granules are formed during the promyelocyte stage of maturation.

Ch. 40 of Schalm, Neutrophil Structure & Biochemistry, Nabity & Ramaiah, pg. #264.

49
Q

After phagocytosis, two cellular events are thought to be the primary initiators of bacterial killing in neutrophils. What are these two events?

A. Exocytosis and opsonization
B. Respiratory burst & degranulation
C. Release of histamine and β2 integrins

A

B. Respiratory burst & degranulation

Ch. 5 of Harvey, Evaluation of Leukocytic Disorders, pg. #126.

50
Q

Which inherited neutrophil disease can have large/giant pink to purple granules that are suspected to arise from unregulated fusion of primary lysosomes during cell development and has been reported in multiple species?

A. Chédiak - Higashi Syndrome
B. Lysosomal Storage Disease
C. May - Hegglin Anomaly
D. Pelger - Huët Anomaly

A

A. Chédiak - Higashi Syndrome

Ch. 5 of Harvey, Evaluation of Leukocytic Disorders, pg. # 173 & 147.

51
Q

Which one of the following is released into the phagosome?

A. Primary granules
B. Secondary granules
C. Tertiary granules
D. Secretory vesicles

A

A. Primary granules

Nabity , Ch. 40 Neutrophil Structure and Biochemistry, pg. 265

52
Q

Which of the following is true regarding lactoferrin?

A. It is primarily found in tertiary granules.
B. It is an important antimicrobial protein.
C. It is only found in cattle.
D. It is a strong anti-inflammatory protein.

A

B. It is an important antimicrobial protein.

Nabity , Ch. 40 Neutrophil Structure and Biochemistry, pg. 265

53
Q

Which of the following is true regarding neutrophil pools?

A. More than 50% of the total neutrophils are always in the circulating pool.
B. The predominant organ of the marginating neutrophil pool is the spleen.
C. Neutrophil margination increases in the lungs when blood flow is reduced.
D. The majority of marginated neutrophils are retained in main arteries.

A

C. Neutrophil margination increases in the lungs when blood flow is reduced.

(Ch. 5 – Evaluation of Leukocytic Disorders, pg. 123)

54
Q

Which one of the following species are giant neutrophils most commonly seen in?

a. Cat
b. Dog
c. Cow
d. Horse

A

a. Cat

Pg 137 Chapter 5 Evaluation of Leukocytic Disorders

55
Q

Which breed of dog does cyclic hematopoiesis occur in?

a. Cocker Spaniels
b. Grey Collies
c. Irish Setters
d. German Shepherds

A

b. Grey Collies

Pg 148 Chapter 5 Evaluation of Leukocytic Disorders

56
Q

Eosinophilia could be seen in each of the following diseases EXCEPT:

a. Helminth infection
b. Feline asthma
c. B cell lymphoma
d. Mast cell tumor

A

c. B cell lymphoma

Pg 150 Chapter 5 Evaluation of Leukocytic Disorders

57
Q

Which of the following is NOT currently considered an organ contributing to the marginating neutrophil pool (MNP)?

A. GI tract
B. lung
C. spleen
D. bone marrow

A

A. GI tract

pg. 123; Harvey Veterinary Hematology: a Diagnostic Guide and Color Atlas, Saunders, 2012

58
Q

Which of the following white blood cell is NOT paired with one of its primary target:

A. Neutrophils – bacteria
B. Eosinophils – helminth infections
C. Basophils – ectoparasites
D. Basophils - bacteria

A

D. Basophils - bacteria

pg 125-128; Harvey Veterinary Hematology: a Diagnostic Guide and Color Atlas, Saunders, 2012

59
Q

Which of the following are NOT found in neutrophils:

A. myeloperoxidase
B. sucrose
C. lysozyme
D. alkaline phosphatase

A

B. sucrose

pg. 265 Ch 40; Schalm’s Veterinary Hematology, 6th ed. Weiss & Wardrop, 2010

60
Q

Which of the following describe hematopoietic stem cells ((HSC)?

a) Proliferate at a higher frequency than hematopoietic progenitor cells
b) Most are CD43+
c) The daughter cells of HSC are the common lymphoid progenitor and the common myeloid progenitor
d) HSC are located in the intravascular spaces in the bone marrow
e) HSC replicate once a month

A

c) The daughter cells of HSC are the common lymphoid progenitor and the common myeloid progenitor

Answer C. Pages 34-35. HSC replicate once every 8-10 weeks. Most are CD34+. HPC proliferate more often than HSC although HSC have unlimited replication potential. HSC are located in the extravascular sinuses in the bone marrow.

61
Q

Which of the following are correctly paired?

a) Neutrophil develop around macrophages in the bone marrow
b) Macrophages develop around stromal cells located away from the vascular sinuses
c) Red blood cells develop adjacent to sinusoidal endothelial cells in the bone marrow
d) Eosinophils develop adjacent to sinusoidal endothelial cells in the bone marrow
e) Megakaryocytes develop around stromal cells located away from the vascular sinuses in the bone marrow

A

b) Macrophages develop around stromal cells located away from the vascular sinuses

Answer: B. Page 38. Erythroid cells develop around macrophages and megakaryocytes form adjacent to sinusoidal endothelial cells; granulocyte develop¬ment is associated with stromal cells located away from the vascular sinuses.

62
Q

On which cells does erythropoietin exert it’s greatest effect?

a) Erythroid precursors (EP)
b) Burst-forming unit erythrocyte (BFU-E)
c) Colony-forming-unit erythrocyte (CFU-E)
d) Rubriblast
e) Rubricytes

A

c) Colony-forming-unit erythrocyte (CFU-E)

Answer C. Page 38. The production of EPs is stimulated by SCF, IL-3, GM-CSF, and TPO.

63
Q

In an inflammatory state, elevation in IL-6 can result in which of the following changes?

a. Neutrophil production
b. RBC production
c. Mast cell production
d. Basophil production

A

a. Neutrophil production

Answer: A; Reference: Veterinary Hematology. Chapter 3. Pg 33 – 45
IL-6 results in granulopoiesis and thrombopoiesis. IL 6 is an inhibitor of erythropoiesis. Erythropoiesis is stimulated by CMP, which gives rise to MkEP, which can differentiate into Eps. The production of EP is stimulated by SCF, IL3, GM-CSF, and TPO. EPO is the primary growth factor involved in the proliferation and differentiation of CFU-E into rubriblasts. Mast cell progenitors mature into mast cells in the tissues. SCF is a major growth and differentiation factor for mast cells. Mast cell production is also stimulated by IL3, IL4, IL9, IL10, and IL13. Basophils mature in the bone marrow; GMP produces BMaP (basophil-mast cell progenitor) which may be stimulated by IL-3, GM-CSF,IL5, TGF-beta and nerve growth factor.

64
Q

Which of the following are necessary for erythropoiesis?

  1. Iron
  2. Copper
  3. Pyridoxine
  4. Terahydrofolic acid

a. 1
b. 1 and 2
c. 1, 2 and 3
d. 1, 2, 3, and 4

A

d. 1, 2, 3, and 4
1. Iron
2. Copper
3. Pyridoxine
4. Terahydrofolic acid

Answer: D; Reference: Veterinary Hematology. Chapter 3. Pg 39

In addition to amino acids and essential fatty acids, iron, copper, B6, and folic acid are needed. Iron is needed for the synthesis of heme. Copper is needed for the release of iron from tissue plasma for transport to developing erythroid cells. Pyridoxine (B6) is needed as a cofactor in the first enzymatic step in heme synthesis. Folic acid is needed for the transfer of single carbon containing molecules in DNA and RNA. Cobalt is needed for synthesis of B12 by ruminants.

65
Q

Which of the following is true regarding PFK deficiency?

a. Uncompensated hemolytic anemia
b. Mild to severe regenerative hemolytic anemia
c. Decreased life span associated with hepatic failure or myelofibrosis
d. Decreased 2,3 DPG concentration results in RBCs that are fragile in alkalemia

A

d. Decreased 2,3 DPG concentration results in RBCs that are fragile in alkalemia

Answer: D; Reference: Erythrocyte Biochemistry. Chapter 21. Page 132
Other statements are associated with PK deficiency

66
Q

At the duodenal apical membrane, ____________ reduces iron from its ferric form (Fe3+) to its ferrous form (Fe2+). Following this, the ferrous form moves to the basolateral membrane, where _________ re-oxidizes it to its ferric state, after which it is transported into plasma.

A. Hepcidin; Duodenal cytochrome B
B. Duodenal cytochrome B; haephestin
C. Hepcidin; haephestin
D. Duodenal cytochrome B; apotransferrin

A

B. Duodenal cytochrome B; haephestin

Answer: B (Olver et al, Ch. 20 Erythrocyte Structure and Function, pg. 127-128)

67
Q

Cats have __________ sulfydryl groups per molecule of hemoglobin than other species, making them more susceptible to __________ toxicity.

A. Less; acetaminophen
B. Less; carbon monoxide
C. More; acetaminophen
D. More; carbon monoxide

A

C. More; acetaminophen

Answer: C (Olver et al, Ch. 20 Erythrocyte Structure and Function, pg. 126)

68
Q

____________ amounts of 2,3-diphosphoglycerate may be produced in anemic dogs and cats, resulting in ___________ oxygen affinity to hemoglobin.

A. Larger; decreased
B. Larger; increased
C. Smaller; decreased
D. Smaller; increased

A

A. Larger; decreased

Answer: A (Harvey, Ch. 21 Erythrocyte Biochemistry, pg. 133)

69
Q

Which molecule is the iron exporter from cells to the circulation ?

a. Divalent metal iron transporter-1
b. Ferroportin
c. Hepcidin
d. Hephaestin

A

b. Ferroportin

Answer : b. Schalm’s Veterinary Hematology, Chapter 20 : Erythrocytes Structure and Function, p. 128.

70
Q

Phagocytosis of senescent red blood cells is mediated by band 3 clustering, IgG binding and

a. complement.
b. Heinz bodies.
c. methemoglobin.
d. zinc.

A

a. complement.

Answer : a. Schalm’s Veterinary Hematology, Chapter 22 : Erythrokinetics and Erythrocyte Destruction, p. 141.

71
Q

The formation of 2,3-diphosphoglycerate is stimulated by

a. decreased glycolysis.
b. decreased phosphate concentration.
c. increased oxidative damage.
d. increased pH.

A

d. increased pH.

Answer : d. Schalm’s Veterinary Hematology, Chapter 21 : Erythrocyte Biochemistry, p. 133

72
Q

Which of the following regarding the maturing reticulocyte is true?

a. Early reticuloctyres have comparable stability and deformability to mature RBCs
b. Maturation of canine reticulocytes is complete 24hrs after being released from the bone marrow.
c. Cats release large numbers of aggregate reticulocytes compared to dogs.
d. Circulating punctate reticulocytes have a short circulating maturation time 12hrs.

A

b. Maturation of canine reticulocytes is complete 24hrs after being released from the bone marrow.

Answer: B (Erythrokinetics and erythrocyte destruction: pg 137)

73
Q

Which of the following regarding anemia of inflammation is true?

a. Anemia of inflammation is classified as a microcytic anemia due to decreased iron stores
b. Hepcidin is a negative acute phase protein associated with chronic inflammation
c. Anemia of inflammation is characterized by hypoferremia and deceases total iron binding capacity.
d. The degree of anemia is mediated by inflammatory cytokines such as IL10.

A

c. Anemia of inflammation is characterized by hypoferremia and deceases total iron binding capacity.

Answer: C (Anemia of inflammatory, neoplastic, renal and endocrine disease: page 246)

74
Q

Which is true regarding the erythrocyte membrane structure

a. Fluidity is increased by saturation of membrane phospholipids.
b. Phosphatidylcholine (PC) is the predominant phospholipid in camellids and sheep
c. Membrane asymmetry is maintained by flippase and floppase
d. Esterified fatty acids decrease membrane fluidity due to their size

A

c. Membrane asymmetry is maintained by flippase and floppase

Answer: C ( Erythrocyte structure and function: pg 124)

75
Q

The expression of hepcidin is _____________ by inflammatory processes which binds to ferroportin causing _______________ release of iron into the plasma.

a. increased, increased
b. increased, decreased
c. decreased, increased
d. decreased, decreased

A

b. increased, decreased

Chapter 37: Anemia of inflammatory, neoplastic, renal and endocrine diseases p 247

76
Q

A decreased expression of hepcidin would be expected in which of the following patients?

a. Bulldog with severe dermatitis
b. Labrador retriever with an Ehrlichia infection
c. Poodle with a chronic gastrointestinal bleed
d. Domestic short hair cat with gastrointestinal lymphoma

A

c. Poodle with a chronic gastrointestinal bleed

Hepcidin is decreased in cases of iron deficiency and hemorrhage
Chapter 37: Anemia of inflammatory, neoplastic, renal and endocrine diseases p 247

77
Q

The average lifespan of a dog’s erythrocyte is

a. 70-85 days
b. 80-95 days
c. 100-115 days
d. 130-145 days

A

c. 100-115 days

Erythrokinetics and erythrocyte destruction chapter 22 p 138

78
Q

Which of the following cell surface markers is used in the identification of Hematopoietic Stem Cells (HSCs):

a. CD3
b. CD11c
c. CD34
d. CD79a

A

c. CD34

Weiss, D. J., Wardrop, K. J., eds. (2010), Schalm’s Veterinary Hematology. 6th ed. Danvers, MA: Wiley-Blackwell. p. 15

79
Q

The switch to HgbC from HgbA during anemia occurs in which of the following species:

a. Horses
b. Sheep
c. Dogs
d. Rats

A

b. Sheep

Weiss, D. J., Wardrop, K. J., eds. (2010), Schalm’s Veterinary Hematology. 6th ed. Danvers, MA: Wiley-Blackwell. p. 126

80
Q

Select the correct pathway of iron absorption, transport and storage from the following:

a. Fe2+ to Fe3+ via dCytb → through DMT-1 into enterocyte → Fe3+ to Fe2+ via Hepcidin → through Ferroportin into plasma → transported bound to transferrin → stored as Ferritin
b. Fe3+ to Fe2+ via dCytb → through DMT-1 into enterocyte → Fe2+ to Fe3+ via Haephestin → through Ferroportin into plasma → transported bound to transferrin → stored as Ferritin
c. Fe3+ to Fe2+ via dCytb → through Ferroportin into enterocyte → Fe2+ to Fe3+ via Hepcidin → through Ferroportin into plasma → transported bound to transferrin → stored as Ferritin
d. Fe3+ to Fe2+ via dCytb → through Ferroportin into enterocyte → Fe2+ to Fe3+ via Haephestin → through Ferroportin into plasma → transported bound to transferrin → stored as Ferritin

A

b. Fe3+ to Fe2+ via dCytb → through DMT-1 into enterocyte → Fe2+ to Fe3+ via Haephestin → through Ferroportin into plasma → transported bound to transferrin → stored as Ferritin

Weiss, D. J., Wardrop, K. J., eds. (2010), Schalm’s Veterinary Hematology. 6th ed. Danvers, MA: Wiley-Blackwell. p. 127-

81
Q

What is considered the key mediator of anemia of inflammation by inhibiting an efflux of iron into the plasma?

A.  Haptoglobin
B.  CXCL12
C.  Hepcidin
D.  Thrombopoietin
A

C. Hepcidin

Answer C. (pg. 246-247; Schalm’s Veterinary Hematology, 6th ed. Weiss & Wardrop, 2010)

82
Q

All of the following are sources of iron for cells of the body except:

A.  recycling from senescent RBCs
B.  liver storage iron
C.  absorption from the gut
D.  respiratory tract
A

D. respiratory tract

Answer D. (pg 126; Schalm’s Veterinary Hematology, 6th ed. Weiss & Wardrop, 2010)

83
Q

Match the correct hormone/cytokine to the process it can INHIBIT:

A.  mature neutrophils - granulopoiesis 
B.  EPO – erythropoiesis
C.  IL-3 – eosinophil production
D.  IL-6 – thrombopoiesis
A

A. mature neutrophils - granulopoiesis

Answer A. (pg. 42, 43, & 45; Veterinary Hematology: a Diagnostic Guide and Color Atlas, Harvey, 2012)

84
Q

Which of the following increases hepcidin expression?

a. Anemia
b. Inflammation
c. Hypoxia
d. Erythropoietin administration

A

b. Inflammation

Answer: b. Source: Schalm Ch. 20, pg. 128

85
Q

Which of the following species produces fetal hemoglobin?

a. Dog
b. Cat
c. Cow
d. Horse

A

c. Cow

Answer: c. Source: Schalm Ch. 20, pg. 126

86
Q

What cell extrudes its nucleus to become a reticulocyte?

a. Rubricyte
b. Metarubricyte
c. Prorubricyte
d. Rubriblast

A

b. Metarubricyte

Answer: b. Source: Schalm Ch. 3, pg. 39

87
Q

This extrinsic factor signaling pathway stimulates self-renewal of hematopoietic stem cells and concurrently inhibits hematopoietic stem cell differentiation.

	A) LIF
	B) Wnt
	C) BMP4
	D) FGF
	E) IGF-2
A

B) Wnt

Answer: B; Source: “Stem Cell Biology” (Chapter 3) in Schalm’s, p. 16

88
Q

Which pathway is primarily utilized by red blood cells to meet their energy requirements?

	A) Krebs cycle
	B) Oxidative phosphorylation
	C) Pentose phosphate pathway
	D) Embden-Meyerhof pathway
	E) Citric acid cycle
A

D) Embden-Meyerhof pathway

Answer: D; Source: “Erythrocyte Biochemistry” (Chapter 21) in Schalm’s, p.131

89
Q

Which of the following does not stimulate hepcidin production?

	A) Anemia of inflammation
	B) High dietary iron concentration
	C) Iron-deficiency anemia
	D) IL-6
	E) IL-1
A

C) Iron-deficiency anemia

Answer: C; Source: “Anemia of Inflammatory, Neoplastic, Renal, and Endocrine Diseases” (Chapter 37) in Schalm’s, p. 246-247

90
Q

What are the two functional characteristics of stem cells?

a. ) The ability of long term self renewal and capacity to form differentiated or specialized cell types.
b. ) The ability of long term self renewal and formation of undifferentiated or non specific cell types.
c. ) The ability to up or down regulate hematopoiesis and have an average life span of 110 days in most species.

A

a.) The ability of long term self renewal and capacity to form differentiated or specialized cell types.

Answer: A; Overman et al, Stem Cell Biology, pg. 14

91
Q

This molecule, ___________________, is normally in a high concentration in dogs, horses, pigs, and humans and low in cat and ruminants. The function of the molecule is to (increase/decrease) oxygen affinity of hemoglobin.

a. Glutathione (GSH), decrease
b. Methemoglobin (MetHb), increase
c. 2,3-diphosphoglycerate (2,3 DPG), decrease
d. Glyceraldehyde phosphate dehydrogenase (GAPD), increase

A

c. 2,3-diphosphoglycerate (2,3 DPG), decrease

Answer: C; Harvey, J. Erythrocyte Biochemistry pg 133.

92
Q

The over-expression of hepcidin results in _________________.

a. intravascular hemolysis
b. iron deficiency anemia
c. myelosuppression
d. polycythemia

A

b. iron deficiency anemia

Answer: B; Fry, MM. Anemia of Inflammatory, Neoplastic, Renal, & Endocrine Disease. pg. 247

Advanced Clinical Pathology (8 decks)

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