Mod. 1 Disease of WBC Flashcards
A 45-year-old patient receiving chemotherapy for breast cancer has a neutrophil count of 900 cells/mL. The nurse notes oral ulcerations and a temperature of 38.3°C (100.9°F). Which intervention is the highest priority?
A) Administer acetaminophen as prescribed to reduce fever
B) Initiate neutropenic precautions and notify the provider
C) Perform an oral swab to assess the extent of ulcerations
D) Encourage oral hydration and provide warm saline rinses
B) Initiate neutropenic precautions and notify the provider
Rationale: A neutrophil count below 1,500 cells/mL indicates neutropenia, and this patient is at high risk for infection. A temperature of 38.3°C (100.9°F) is concerning for neutropenic fever, which can be life-threatening. Immediate protective precautions and provider notification are the priority to prevent sepsis.
A 17-year-old patient diagnosed with infectious mononucleosis presents with severe left upper quadrant pain and dizziness. The nurse suspects which of the following complications?
A) Hepatic failure
B) Splenic rupture
C) Acute renal failure
D) Guillain-Barré syndrome
B) Splenic rupture
Rationale: Infectious mononucleosis, caused by Epstein-Barr virus, often leads to splenomegaly. A sudden increase in left upper quadrant pain with dizziness suggests splenic rupture, a medical emergency requiring immediate evaluation.
A 62-year-old male diagnosed with lymphoma undergoes a biopsy, which reveals the presence of Reed-Sternberg cells. Based on this finding, which statement is correct?
A) The patient has a poor prognosis due to rapid systemic spread
B) The lymphoma likely originates from T cells
C) The disease is highly curable with chemotherapy and radiation
D) The patient’s cancer does not involve lymph node structures
C) The disease is highly curable with chemotherapy and radiation
Rationale: Reed-Sternberg cells are a hallmark of Hodgkin’s lymphoma, which is highly curable, especially in early stages. Unlike non-Hodgkin’s lymphoma, Hodgkin’s lymphoma primarily affects B cells and originates in lymph nodes of the upper body.
A 6-year-old child is diagnosed with acute lymphoblastic leukemia (ALL). The child’s parents ask about the prognosis. The nurse provides which most appropriate response?
A) “ALL is the least treatable form of leukemia in children.”
B) “ALL has a high response rate to treatment, and many children achieve remission.”
C) “ALL typically progresses slowly, and most children live for many years without treatment.”
D) “ALL originates from myeloid stem cells, making treatment options limited.”
B) “ALL has a high response rate to treatment, and many children achieve remission.”
Rationale: Acute lymphoblastic leukemia (ALL) is the most common type of leukemia in children and has a high survival rate with aggressive treatment. It originates from lymphoid precursors, not myeloid stem cells.
A 70-year-old patient with multiple myeloma is experiencing severe lower back pain and newly diagnosed hypercalcemia. What is the primary cause of this finding?
A) Excessive Bence Jones protein in the urine
B) Infiltration of abnormal plasma cells in the liver
C) Overproduction of erythrocytes leading to vascular congestion
D) Increased osteoclast activity leading to bone resorption
D) Increased osteoclast activity leading to bone resorption
Rationale: Multiple myeloma causes bone destruction due to osteoclast activation, leading to hypercalcemia and pathologic fractures. Bence Jones protein affects renal function but does not directly cause hypercalcemia.
What is the normal range for neutrophil concentration in the blood?
A) 500–1,000 cells/mL
B) 1,500–8,000 cells/mL
C) 9,000–12,000 cells/mL
D) 100–500 cells/mL
B) 1,500–8,000 cells/mL
Rationale: The normal range for neutrophils in the blood is approximately 1,500–8,000 cells/mL. Neutropenia is diagnosed when neutrophil levels drop below 1,500 cells/mL, increasing the risk of infections.
What is the primary cause of infectious mononucleosis?
A) Cytomegalovirus (CMV)
B) Epstein-Barr virus (EBV)
C) Human papillomavirus (HPV)
D) Human immunodeficiency virus (HIV)
B) Epstein-Barr virus (EBV)
Rationale: Infectious mononucleosis, also known as the “kissing disease,” is caused by the Epstein-Barr virus (EBV). EBV infects B cells and can incorporate into their genome, leading to the production of heterophile antibodies.
Which of the following is a key diagnostic marker for Hodgkin’s lymphoma?
A) Presence of Reed-Sternberg cells
B) Increased neutrophil count
C) Philadelphia chromosome
D) Bence Jones protein in urine
A) Presence of Reed-Sternberg cells
Rationale: Hodgkin’s lymphoma is characterized by the presence of Reed-Sternberg cells in affected lymph nodes. These cells are absent in Non-Hodgkin’s lymphoma, which differentiates the two diseases.
What is the primary treatment for acute lymphoblastic leukemia (ALL)?
A) Radiation therapy
B) Chemotherapy
C) Bone marrow transplant
D) Immunosuppressants
B) Chemotherapy
Rationale: Acute lymphoblastic leukemia (ALL) is primarily treated with chemotherapy, which has a high success rate, especially in children. In some cases, bone marrow transplants may be necessary.
Which blood cancer is associated with excessive Bence Jones protein in urine?
A) Hodgkin’s lymphoma
B) Multiple myeloma
C) Chronic myeloid leukemia (CML)
D) Acute myeloid leukemia (AML)
B) Multiple myeloma
Rationale: Multiple myeloma is a plasma cell cancer that leads to the production of Bence Jones proteins, which are filtered into the urine. This contributes to renal impairment commonly seen in affected patients.
Which of the following conditions is defined as a neutrophil count below 1,500 cells/mL?
A) Neutropenia
B) Neutrophilia
C) Leukocytosis
D) Lymphopenia
A) Neutropenia
Rationale: Neutropenia is a condition in which neutrophil levels drop below 1,500 cells/mL, leading to an increased risk of infections. It can be caused by congenital disorders, infections, medications, or bone marrow suppression.
Which leukemia is most commonly seen in children and responds well to therapy?
A) Acute myeloid leukemia (AML)
B) Chronic lymphoid leukemia (CLL)
C) Acute lymphoblastic leukemia (ALL)
D) Chronic myeloid leukemia (CML)
C) Acute lymphoblastic leukemia (ALL)
Rationale: ALL is the most common leukemia in children. It originates in the lymphoid cell line and has a high response rate to chemotherapy, leading to a good prognosis in many cases.
What is the primary method used to diagnose infectious mononucleosis?
A) Blood cultures
B) Complete blood count (CBC)
C) Monospot test
D) Bone marrow biopsy
C) Monospot test
Rationale: The Monospot test detects heterophile antibodies produced in response to Epstein-Barr virus (EBV) infection, which is the causative agent of infectious mononucleosis.
Which lymphoma is more common and has a poorer prognosis due to multiple subtypes?
A) Hodgkin’s lymphoma
B) Non-Hodgkin’s lymphoma
C) Burkitt lymphoma
D) Mycosis fungoides
B) Non-Hodgkin’s lymphoma
Rationale: Non-Hodgkin’s lymphoma is more common than Hodgkin’s lymphoma and has a poorer prognosis due to its multiple subtypes, variable progression, and lack of a single defining cellular marker like Reed-Sternberg cells.
Which of the following symptoms is most commonly associated with multiple myeloma?
A) Painless enlarged lymph nodes
B) Pathologic fractures and hypercalcemia
C) Leukocytosis and fever
D) Petechiae and purpura
B) Pathologic fractures and hypercalcemia
Rationale: Multiple myeloma is characterized by the destruction of bone tissue, leading to fractures and hypercalcemia. This is due to excessive plasma cell proliferation in the bone marrow.
Which leukemia is associated with the Philadelphia chromosome (t9;22 translocation)?
A) Acute lymphoblastic leukemia (ALL)
B) Chronic myeloid leukemia (CML)
C) Acute myeloid leukemia (AML)
D) Chronic lymphoid leukemia (CLL)
B) Chronic myeloid leukemia (CML)
Rationale: The Philadelphia chromosome (t9;22 translocation) is a hallmark of chronic myeloid leukemia (CML). It results in the formation of the BCR-ABL fusion protein, which drives uncontrolled cell proliferation.
Which white blood cell disorder is characterized by an increase in the number of immature leukocytes in the bone marrow?
A) Infectious mononucleosis
B) Neutropenia
C) Leukemia
D) Lymphoma
C) Leukemia
Rationale: Leukemia is a cancer of the bone marrow characterized by the uncontrolled proliferation of immature leukocytes, which crowd out normal blood cell production, leading to anemia, thrombocytopenia, and neutropenia.
Which of the following is NOT a typical symptom of Hodgkin’s lymphoma?
A) Night sweats
B) Pruritus (itching)
C) Bence Jones protein in urine
D) Painless lymphadenopathy
C) Bence Jones protein in urine
Rationale: Bence Jones protein in urine is characteristic of multiple myeloma, not Hodgkin’s lymphoma. Hodgkin’s lymphoma typically presents with painless lymph node enlargement, night sweats, and pruritus.
A patient diagnosed with neutropenia is at the highest risk for which of the following complications?
A) Opportunistic infections
B) Excessive clot formation
C) Autoimmune disorders
D) Severe allergic reactions
A) Opportunistic infections
Rationale: Neutropenia is a condition of reduced neutrophil count, which weakens the immune system and increases susceptibility to infections, particularly opportunistic infections.
Which of the following is a common symptom of acute leukemia but NOT chronic leukemia?
A) Slow disease progression
B) Presence of Reed-Sternberg cells
C) Sudden onset of fatigue and bone pain
D) Philadelphia chromosome
C) Sudden onset of fatigue and bone pain
Rationale: Acute leukemias (ALL and AML) have a rapid onset and often present with fatigue, bone pain, and severe symptoms due to the sudden proliferation of immature leukocytes. Chronic leukemias (CLL and CML) progress more slowly.
