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HEMATOLOGY > MALIGNANT LEUKOCYTE DISORDERS > Flashcards

MALIGNANT LEUKOCYTE DISORDERS Flashcards

1
Q

What acute leukemia cellular morphology is most often associated with Disseminated Intravascular Coagulation (DIC)?

A

Blast-like cells with butterfly, reniform nuclear shapes and abundant auer rod

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2
Q

According to the WHO classification, what is the minimal percentage of blasts required in bone marrow to confirm a diagnosis of acute leukemia?

A

20%

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3
Q

Which cell line will demonstrate a diffuse positive reaction for a non-specific esterase α-Naphthyl acetate stain?

A

Monocytic

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4
Q

According to the FAB classification, which leukemia demonstrates end-stage maturation at the promyelocyte stage with Faggot Cells?

A

M3

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5
Q

Which of the following bone marrow disorders is best characterized by a peripheral blood smear showing immature granulocytes, nucleated NRBCs, tear drop RBCs and large and giant platelets?

A

Myelofibrosis

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6
Q

What unique chimeric gene is found in Chronic Myeloid Leukemia?

A

BCR-ABL1

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7
Q

Which cytochemical stains are useful in differentiating AML from ALL?

A

SBB

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8
Q

Which leukemia accounts for up to 75% of childhood leukemia?

A

Acute lymphocytic leukemia

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9
Q

What is the greatest transformational risk associated with the Myelodysplastic Syndromes?

A

Acute Leukemia

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10
Q

How much of the nucleus must iron granules circle in order to be considered a ringed sideroblast?

A

At least 1/3 of the nucleus

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11
Q

Why is it important to perform Pearl’s Prussian blue stain on a bone marrow aspirate smear?

A

To differentiate Iron Deficiency from Sideroblastic anemia

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12
Q

What special stain would be used to differentiate CML from a leukemoid reaction?

A

LAP

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13
Q

What genetic mutation is associated with Polycythemia Vera?

A

JAK2 gene

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14
Q

Which of the following will demonstrate a negative MPO staining reaction?

A

M0

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15
Q

Why is a bone marrow biopsy of the utmost importance in the diagnosis of Hairy Cell Leukemia?

A

The aspirate is a dry tap

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16
Q

What best describes the morphology of typical CLL lymphocytes?

A

Small round lymphocytes with a soccer ball pattern

17
Q

What is present in patients with Multiple Myeloma?

A

Hypercalcemia, increased plasma cells, increased Monoclonal Immunoglobulin

18
Q

What is a distinct morphological difference between Lymphoblasts and Myeloblasts?

A

Auer Rods

19
Q

What is the definition of M/E ratio?

A

Myeloid:Erythroid ratio

20
Q

In flow-cytometry, what does CD stand for?

A

Cluster of Differentiation

21
Q

What auxiliary tests are routinely collected during a bone marrow aspiration?

A

Cytogenetics, Immunology (Flow) & Molecular

22
Q

What does cytogenetics testing do?

A

Identifies the type of AML, and gives specific gene translocation.

23
Q

What does immunology (flow) testing do?

A

Identifies the type of blasts – Myeloid vs.Lymphoid, Type of lymphocytes (B-Cell, T-Cell, can differentiate CLL from NHL)

24
Q

What does molecular testing test for?

A

Bcr/Abl1(Philadelphia Chromosome)

25
Q

What is the significance of Auer rods and what cells are they found in?

A

Auer rods indicate an AML and are found in Myeloblasts and abnormal promyelocytes

26
Q

What is the name of a mature red cell that contains iron?

A

Siderocyte

27
Q

What is a nucleated red cell that contains iron called?

A

Sideroblast

28
Q
  1. What genetic translocation is found in M3?
A

t(15;17)

29
Q
  1. What is the genetic translocation found in CML?
A

t(9;22)

30
Q

Name 3 abnormal features of cells seen in Myelodysplastic syndrome.

A
  • Hypogranulation
  • Hypolobation
  • Nuclear-cytoplasmic dissociation
31
Q

What is the principle of LAP stain?

A
  • Substrate naphthol AS-B1 phosphate is hydrolyzed by the LAP enzyme found in secondary neutrophil granules at an alkaline PH which combines w red dye to produce a color precipitate proportional to the amount of enzyme present.
32
Q

What is the principle of PAS?

A

Periodic acid oxidizes glycogen, mucoproteins, and HMW carbohydrates to aldehydes which react with colorless Schiff reagent to stain bright pink. Intensity and pattern depend on the aldehyde groups present.

33
Q

What does PAS differentiate?

A

Differentiate certain Lymphoid and abnormal erythroid cells(as in AML M6)

34
Q

What are the results for Sudan Black B?

A

AML(+) vs ALL(-)
AML M0 and pure monocytic AML may also be(-)

35
Q

What does SBB stain?

A

stains lipids, the intensity of the staining is dependent on the amount of lipids present and the maturity of the cell.

36
Q

What is the principle of the Tartrate Resistant Acid Phosphatase (TRAP) stain?

A

Acid phosphatase hydrolyzes the substrate naphthol AS-B1 phosphoric acid and couples with a dye to produce a red precipitate.
Hairy cells produce an abundance of isoenzyme 5.

37
Q

What do esterases – SE (Specific) & NSE(Nonspecific) differentiate?

A

Used to differentiate myeloblast and neutrophils from monocytic.

HEMATOLOGY (8 decks)

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