Heme Test

Question 1

Malignant disease of normal bone marrow. Replacement of normal bone marrow with abnormal (neoplastic) blood cells.

Answer 1

Leukemia

Question 2

2 Most common adult leukemias

Answer 2

acute myeloid leukemia and chronic lymphoid leukemia

Question 3

Ratio of adult to child with leukemia

Answer 3

10:1

Question 4

Most common leukemia in children

Answer 4

acute lymphoblastic leukemia

Question 5

WBC is generally increased in this type of leukemia

Answer 5

Chronic leukemia

Question 6

This gene regulates cell proliferation and tumor suppressor genes and its mutation is related to leukemia.

Answer 6

Oncogene

Question 7

Leukemia is classified according to?

Answer 7

Cell type, its maturity and cell lineage.

Question 8

Smudge cells are seen in what leukemia?

Answer 8

chronic lymphoid leukemia

Question 9

Auer rod is indicative of this leukemia?

Answer 9

acute myeloid leukemia

Question 10

According to WHO For acute leukemias __% of blasts must be found in peripheral blood for diagnosis confirmation.

Answer 10

20%

FAB requires 30%

Question 11

Blasts are larger in AML or ALL?

Answer 11

AML

Question 12

This test is useful in differentiating AML(+ blasts) from ALL(- blasts) and is more specific than the Sudan black B stain.

Answer 12

Myeloperoxidase stain

Question 13

Phospholipids, neutral fats, and sterols are stained by this. Differentiates AML from ALL, used when specimen is not fresh.

Answer 13

Sudan black B stain (SBB)

Question 14

This stain, not as sensitive as others, tests positive in neutrophils, basophils, mast cells and their precursors only. Main use is demonstrating myeloid differentiation in paraffin-embeded tissue.

Answer 14

Specific esterase stain

Question 15

Stain used to identify monocytic cells. Positive in these cells while negative in granulocytic cells. Seperates mono (+) from myelo(-) blasts.

Answer 15

Nonspecific esterase test

Question 16

Stains for glycogen and related compounds. Strong positivity may be present in eryhtroblasts in erythroleukemia. Helps differentiate from pernicious anemia.

Answer 16

Periodic Acid-Schiff

Question 17

A unique nuclear enzyme found in the majority of lymphoblastic leukemias, allowing the distinction of ALL from AML.

Answer 17

TDT terminal deoxynucleotidyl transferase

Question 18

What stain is used to identify Hairy Cell Leukemia?

Answer 18

TRAP- Tartrate Resistant Acid Phosphatase Stain

Question 19

Myeloid CD markers

Answer 19

CD 14
CD33
CD13
CD 117

Question 20

Lymphoid CD markers

Answer 20

CD 19
CD 10
Common ALL antigen (CALLA)
CD 20
HLA-DR

Question 21

CD markers used to identify AML

Answer 21

CD 33
CD13
CD14
CD11b
CD 117

Question 22

Most common translocation in precursor B-cell ALL in children with peak incidence 2-5 years

Answer 22

ALL with t(12;21): TEL-AML1

Question 23

ALL with Results in the formation of an abnormal fusion protein

Answer 23

t(1:19): PBX1-E2A

Question 24

Seen in the most common form of ALL infancy

Answer 24

t(4;11): AF4-MLL

Question 25

most useful marker for distinguishing HCL from other B-cell leukemias

Answer 25

CD103

Question 26

``` System widely in use to predict prognosis of CML Criteria is based upon: Age Splenomegaly Platelet count (platelets > 700,000) Blast count ```

Answer 26

Sokol Score

Question 27

Trisomy 12 | Deletions/translocations 13q14

Answer 27

B-CLL

Question 28

In DNA, Each nucleotide is composed of one of four different types of nitrogenous bases

Answer 28

Adenine Guanine Thymine Cytosine

Question 29

is a chromosome abnormality caused by rearrangement of parts between nonhomologous chromosomes

Answer 29

translocation

Question 30

Purpose to detect and localize specific DNA sequences in G-banded metaphase chromosomes using a labeled probe Advantages Permits visualization of target DNA in the (karyotypic visualization of metaphase chromosomes Aids in the diagnosis of DiGeorge Syndrome Disadvantages Metaphase analysis requires live cells capable of entering mitosis Visualization of fluorochromes requires an input light source (fluorochromes fades with time)

Answer 30

Fluorescent In-situ Hybridization (FISH)

Question 31

Purpose is to localize DNA or RNA to particular cells in a tissue section Clinical Applications Localize foreign organisms in relation to lesion cells Important for pathogens that might also exist as normal flora Detect and localize gene expression by targeting RNA transcripts Advantages Permits visualization of target nucleic acid in the context of cytologic and morphological features Sensitive to low numbers of affected cells Disadvantage Difficult to obtain adequate sensitivity for detecting single copy targets.

Answer 31

In-Situ Hybridization

Question 32

Used to amplify target DNA a billion fold so that it may be easily detected Works by enzymatically replicating one particular segment of DNA in a patient’s sample 1st amplification method be introduced into clinical laboratories Clinical Applications Measure tumor burden to monitor efficacy of anticancer therapy Measure the viral load to monitor the efficacy of antiviral therapy Selectively amplify DNA that has a particular disease associated defect such as JAK2 point mutation or PML/RARA translocation Advantages Extremely sensitive to low numbers of target sequences Small sample size requirement Relatively fast and inexpensive unless extensive post-amplification is required Disadvantages Extreme precautions are require to avoid cross contamination of samples or reagents by extraneous DNA

Answer 32

Polymerase Chain Reaction (PCR)

Question 33

Purpose is to detect RNA: Advantages Sensitive to low numbers of target sequences Small sample size requirement Disadvantages RNA is labile, RNA-based testing requires meticulous care to avoid degradation by RNases Avoiding cross contamination of samples or reagents

Answer 33

RT-PCR

Question 34

Analyzes the molecular structure of DNA to identify disease specific genetic alterations Most accurate method of detecting clonal gene rearrangement in lymphoid neoplasms Advantages Most accurate method of detecting clonal gene rearrangement in lymphoid neoplasms Disadvantages Sensitivity is relatively low Labor-intensive and costly Relatively long turnaround time Requires fresh or frozen tissue and not amenable to formalin-fixed tissue

Answer 34

Southern Blot

Question 35

Determine the nucleotide order in a given gene and compare it to that of health individuals Screen for mutations (deletions or insertion events) associated with disease Clinical Applications Detect mutation of the HBB(beta globin)gene in a patient with beta thal Predict drug responsiveness or resistance in patients with CML treated with tyrosine kinase inhibitors Perform HIV genotyping to predict which drugs will be effective Advantages Sequencing considered the gold standard assay for detecting mutations Disadvantages Expensive and relatively insensitive to acquired mutations affecting fewer than 20% of cells in the sample

Answer 35

DNA Sequencing

Question 36

Trisomy 8 AML-

Answer 36

Acute Myelocytic Leukemia

Question 37

t(15;17)

Answer 37

AML-M3

Question 38

inv(16)

Answer 38

AML-M4

Question 39

t(9:22)

Answer 39

CML (or ALL)- acquired mutation

Question 40

del(5q)

Answer 40

MDS