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BOC study (harr book) > heme externship 1.5-1.6 > Flashcards

heme externship 1.5-1.6 Flashcards

1
Q

which of the following is an unusual complication that may occur in infectious mononucleosis
A. splenic infarctions
B. dactylitis
C. hemolytic anemia
D. giant platelets

A

C. hemolytic anemia
- anti-I development

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2
Q

in a patient with HIV infection, one should expect to see:
A. shift to the left in WBCs
B. target cells
C. reactive lymphocytes
D. pelgeroid cells

A

C. reactive lymphocytes

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3
Q

which inclusions may be seen in leukocytes
A. dohle bodies
B. basophilic stippling
C. malrial parasites
D. howell jolly bodies

A

A. dohle bodies
- remnant RNA

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4
Q

which of the following is contained in the primary granules of the neutrophil
A. lactoferrin
B. myeloperoxidase
C. histamine
D. alkaline phosphatase

A

B. myeloperoxidase

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5
Q

what is the typical refernce range for relative lymphocyte percentage in PS in a 1 yr old
A. 1-6%
B. 27-33%
C. 35-58%
D. 50-70%

A

D. 50-70%
- lymphs are higher in children while PMNs are higher in adults

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6
Q

qualitative and quantitative neutrophil changes noted in response to infection include all of the following except
A. neutrophilia
B. pelgeroid hyposegmentation
C. toxic granulation
D. vacuolization

A

B. pelgeroid hyposegmentation
- seen in a congenital pelger huet anomaly

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7
Q

neutropenia is present in patients with which an absolute neutrophil count:
A. <1.510^9/L
B. <5.010^9/L
C. <10.010^9/L
D. <15.010^9/L

A

A. <1.5*10^9
- neutropenia = absolute decrease in neutrophils

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8
Q

the morphological characteristic(s) associated with Chediak-Higashi syndrome is (are):
A. pale blue cytoplasmic inclusions
B. giant lysosomal granules
C. small, dark-staining granules and condensed nuclei
D. nuclear hyposegmentation

A

B. giant lysosomal granules

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9
Q

the familial condition of pelger-huet anomaly is important to recognize because this disorder must be differentiated from:
A. infectious mono
B. may-hegglin
C. shift to the left
D. G6PD deficiency

A

C. shift to the left

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10
Q

SITUATION: a diff shows reactive lymphs, the physician suspected that a viral infection is the cause. What is the expected lab finding in a patient with a CMV infection
A. heterophile antibody pos
B. Epstein Barr virus IgM pos
C. DAT pos
D. CMV - IgM pos

A

D. CMV-IgM pos
- if heterophile Ab test and EBV -IgM are negative serum is checked for CMV - IgM

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11
Q

neutrophil phagocytosis and partical ingestion are associated with an increase in O2 utilization called respiratory burst. what are the two most important products of the biochemical reaction
A. H2O2 and superoxide anion
B. lactoferrin and NADPH oxidase
C. cytochrome b and collagenase
D. alkaline phosphatase and ascorbic acid

A

A. H2O2 and superoxide anion

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12
Q

which of the morphological findings are characteristic of reactive lymphocytes:
A. high N:C ratio
B. prominent nucleoli
C. basophilic cytoplasm
D. all of these options

A

D. all of these

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13
Q

Auer rods may be seen in all of the following except
A. AML M4
B. ALL
C. AML M1
D. APML M3

A

B. ALL
- auer rods are seen in myeloblasts, not lymphoblasts

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14
Q

which type of anemia is usually present in a patient with acute leukemia
A. microcytic hyperchromic
B. microcytic hypochromic
C. normocytic normochromic
D. macrocytic normochromic

A

C. normocytic normochromic

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15
Q

in leukemia which term describes the PS finding of leukocytosis with a shift to the left and nRBCs
A. myelophtisis
B. dysplasia
C. leukoerythroblastosis
D. megaloblastosis

A

C. leukoerythroblastosis

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16
Q

the basic pahtophysiological mechanisms responsible for producing signs and symptoms in leukemia include all of the following except
A. replacement of normal marrow precursors by leukemic cells causing anemia
B. decrease in functional leukocytes causing infection
C. hemorrhage secondary to thrombocytopenia
D. decreased eytrhoporitin production

A

D. decreased EPO production
- would see increase to compensate for anemia

17
Q

which type of acute myeloid leukemia is called the true monocytic leukemia which follows an acute or subacute course characterized by monoblasts, promonos and monos
A. acute myeloid leukemia, minimally differentiated
B. acute myeloid leukemia, without maturation
C. acute meylomonocytic leukemia
D. acute monocyti leukemia

A

D. acute monocytic leukemia

18
Q

in which age group does ALL occur with the highest frequency
A. 1-15 yrs
B. 20-35 yrs
C. 45-60 yrs
D. 60-75 yrs

A

A. 1-15 yrs

19
Q

DIC is most often associated wiht which of the following type of acute leukemia
A. acute myeloid leukemia without maturation
B. actue promyelocytic leukemia (PML)
C. acute myelomonocytic leukemia
D. acute monocytic leukemia

A

B. acute promyelocytic leukemia
- due to dumping of granules with thromboplastin substances

20
Q

an M:E ratio of 10:1 is most often seen in:
A. thalassemia
B. leukemia
C. polycythemia vera
D. myelofibrosis

A

B. leukemia

21
Q

which of the following is a characteristic of auer rods
A. they are composed of azurophilic granules
B. they stain pos on PAS stain
C. they are predominantly seen in CML
D. they are nonspecific esterase pos

A

A. they are composed of azurophilic granules
- auer rods are linear projections of primary granules

22
Q

a 24 yr old with Down syndrome presents with fever, pallor, lymphadenopathy, and hepatosplenomegaly. his CBC results are as follows
WBC: 10.8
RBC: 1.56
hgb: 3.3
hct 11%
8% PMNs, 25% lymphs, 67% PAS - pos blasts

these findings are suggestive for:
A. hodgkin lymphoma
B. myeloproliferative disorder
C. leukemoid reaction
D. acute lymphocytic leukemia

A

D. ALL
- lymphoblasts are PAS pos

23
Q

SITUATION: a PS shows 75% blasts. these stain pos for both SBB and peroxidase. given these values, which of the following disorders is most likely
A. AML
B. CML
C. AUL
D. ALL

A

A. AML

24
Q

in myeloid cells, the stain that selectively identifies phospholipid in the membranes of both primary and secondary granules is:
A. PAS
B. myeloperoxidase
C. SBB
D. TdT

A

C. SBB
- sudan stains = lipids

25
Q

sodium fluoride may be added to the napthyl ASD esterase rxn. the fluoride is added to inhibit pos reaction with
A. megakaryocytes
B. monocytes
C. eytrhocytes
D. granulocytes

A

B. monocytes

26
Q

leukemic lymphoblasts reacitng with anti-common acute lymphoblastic leukemic agent are characteristically seen in:
A. B cell ALL
B. T cell ALL
C. null cell ALL
D. common ALL

A

D. common ALL

27
Q

which of the following reactions are often positive in ALL but negative in AML
A. TdT and PAS
B. chloroacetate esterase and nonspecific esterase
C. SBB and peroxidase
D. new methylene blue and acid phosphatase

A

A. TdT and PAS
- pos in 1 and 2 but neg in 3

28
Q

a patients PS and BM show 70% blasts. These cells are negative on SBB staining. Given these data, which of the following is the most likely diagnosis
A. AML
B. CLL
C. acute PML
D. ALL

A

D. ALL

29
Q

which of the following leukemias are included in 2008 WHO classification of myeloproliferative neoplasms (MPN)
A. CML
B. CNL
C. CEL
D. all

A

D. all

30
Q

in addition to morphology, cytochemistry, and immunophenotyping, the WHO classification of meylo and lymphoproliferative disorders is based on which characteristic?
A. proteomics
B. cytogenetic abnormalities
C. carbohydrate associated tumor antigen production
D. cell signaling and adhesion markers

A

B. cytogenetic abnormalities
- think chromosomal abnormalities

31
Q

the WHO classification requires what percentatge for the last count in blood or bone marrow for a diagnosis of AML
A. at least 30%
B. at leat 20%
C. at leat 10%
D. any

A

B. at least 20%

32
Q

what would be the most likely designation by the WHO for AML M2 by the FAB classification
A. AML with t(15;17)
B. AML with mixed lineage
C. AML with t(8;21)
D. AML with inv(16)

A

C. AML with t(8;21)

33
Q

what would be the most likely designatino by the WHO for AML M3 by the FAB classification
A. AML with t(15;17)
B. AML with mixed lineage
C. AML with t(8;21)
D. AML with inv(16)

A

A. AML t(15;17)

34
Q

which AML cytogenetic abnormality is assocaited with AML M4 with marrow eosinophilia under the WHO classification of AML with recurrent genetic abnormalities?
A. AML with t(15;17)
B. AML with mixed lineage
C. AML with t(8;21)
D. AML with inv(16)

A

D. AML with inv(16)

35
Q

what would be the most likely classification by the WHO for AML M7 by the FAB classification
A. acute meyloid leue ias with recurrent genetic abnormalities
B. acute myeloid leukemia with multilineage dysplasia
C. acute megakaryoblastic leukemia classified under AML
D. acute leukemias of ambiguous lineage

A

C. acute megakeryoblastic leukemia

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