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Hematology II > TEST 1 > Flashcards

TEST 1 Flashcards

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1
Q

What virus causes lymphoid malignancies in humans

A

Epstein-Bar virus

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2
Q

Tumor suppresor genes causes cancers such as leukemia when mutations result in

A

Failure to prevent malignant process

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3
Q

Oncogenes are said to act in a dominant fashion because

A

A mutation in a single allele is sufficient for malignancy to develop

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3
Q

what is a cellular abnormality produced by oncogenes

A

Acceleration of DNA catabolism

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3
Q

Compared with autologous bone marrow transplantation, allogeneic transplantation has

A

better long term succes

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3
Q

Chemotherapeutic agents are divided into which two major subgroups

A
  1. phase specific
  2. phase non specific
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4
Q

Qualitative and quantitative neutrophil hanges noted in response to infection include

A
  1. neutropenia
  2. toxic granulation
  3. vacuolization
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4
Q

The WHO classification requires what percentage for the blast count in the blood or bone

A

At least 20%

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4
Q

In addition to morphology, cytochemistry, and immunophenotyping, the WHO
classification of
Myelo- and lymphoproliferative disorders is based upon which characteristic?

A

Cytogenetic abnormalities

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4
Q

Which AML cytogenetic abnormality is associated with acute myelomonocytic leukemia
with marrow eosinophilia under the WHO classification of AML with recurrent genetic
abnormalities?

A

AML with inv

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4
Q

neutropenia is present in patients with which absolute count

A

<1.5*10^9/L

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4
Q

A m:e (myeloid:erythroid ration) of 10:1 is mostly seen in

A

Leukemia

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5
Q

Which of the following leukemias are included in the 2008 World Health Organization
classification of myeloproliferative neoplasms?

A

Chronic myelogenous leukemia (CML)
Chronic neutrophilic leukemia (CNL)
Chronio eosinophilic leukemia (CEL)

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6
Q

Repeated phlebotomy in patients with polycythemia vera (PV) may lead to the
development of:

A

Iron deficiency anaemia

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7
Q

in essential thrombocytopenia the platelets are

A

increased in number and fuctionality abnormal

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8
Q

Which of the following cells is considered pathognomonic for Hodgkin’s disease?

A

Reed- sternberg cells

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9
Q

Which of the morphological findings are characteristics of reactive lymphocytes

A
  1. high nuclear: cytoplsmic ration
  2. prominent nucleoli
  3. basophilic cytoplasm
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10
Q

Auer rods may be seen in all of the following

A
  1. acute myelomonocytic leukemia (M4)
  2. acute myeloid leukemia leukemia without maturation (M1)
  3. acute promyelocytic leukemia (M3)
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11
Q

Which type of anaemia is ussually present in a patient with acute leukemia

A

Normocytic, Normochromic

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12
Q

In leukemia which term decribes a peripheral blood finding of leukocytosis with a shift to the left, accompanied by nucleated red cells

A

Leukoerythroblastosis

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13
Q

The basic pathophysiological mechanisms responsible for producing signs and symptoms in leukemia include all of the following except

A

Decreased erythropoietin production

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14
Q

Which type of acute myeloid leukemia is called the true monocytic leukemia and follows an acute or sub acute course charcterized by monoblasts, promonocytes and monocytes

A

Acute monocytic anaemia

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15
Q

In which age group does acute lymphoblastic leukemia occur with the highest frequency

A

1-15 years

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16
Q

Disseminated intravascular coagulation (DIC) is mostly often associated with which of the following types of acute leukemia

A

Acute promyelocytic leukemia

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17
Q

In Myelofibrosis, the characteristic abnormal red blood cell morphology is that of

A

Tear drop cell

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18
Q

PV is characterized by

A

Absolute increase in total red cell mass

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19
Q

Features of secondary polycynthemia incude all of the foloowing except

A

splenomegaly

20
Q

The erythrocytosis seen in relative polycythemia occurs because of

A

Decreased plasma volume of circulating blood

21
Q

In PV, what is characteristically seen in the peripheral blood?

A

Pancytosis

22
Q

The leukocyte alkaline phosphatase (LAP) stain on a patient gives the following results:
10(0) 48(1+) 38(2+) 3(3+) 1(4+). Calculate the LAP score.
The LAP score is calculated as: (the number of 1+ cells x 1) + (2+ cells x 2) + (3+ cells>
3) + (4+ cells x 4).

A

137

23
Q

CML is distinguished from leukemoid reaction by which of the following?

A

CML: low LAP; leukemoid: high LAP

24
Q

Which of the following occurs in idiopathic Myelofibrosis (IMF)?

A

All of these options

25
Q

What influence does the Philadelphia (Ph1) chromosome have on the prognosis of
patients with chronic myelogenous leukemia?

A

The prognosis is better if Ph1 is present

26
Q

Which of the following is (are) commonly found in CML?

A

An increase in basophils

27
Q

In which of the following conditions does LAP show the least activity?

A

In leukomoid reactions

28
Q

A striking feature of the peripheral blood of a patient with CML is a:

A

Presence of granulocytes at different stages of development

29
Q

Which of the following is often associated with CML but not with AML?

A

Splenomegaly

30
Q

The JAK2(V617F) mutation may be positive in all of the following chronic
myeloproliferative disorders Except

A

CML

31
Q

All of the following are major criteria for the 2008 WHO diagnostic criteria for essential
thrombocythemia Except:

A

Sustained platelet count >600 x 109/L

32
Q

A patient in whom CML has previously been diagnosed has circulating blasts and
promyelocytes that total 30% of leukocytes. The disease is considered to be in what
phase?

A

Transformation to acute leukemia

33
Q

Normal ranges of WBC

A

4.5 -11.5 X 10^9/L

34
Q

Normal ranges of RBC

A

4 - 6 X 10^9/L

35
Q

Normal ranges of Hgb

A

14 - 18 g/dL

36
Q

Normal ranges of HCT

A

40 - 54 %

37
Q

Normal ranges of HCT

A

40 - 54 %

38
Q

Normal ranges of MCV

A

80 - 100 fL

39
Q

Normal ranges of MCHC

A

32 - 36 g/dL

40
Q

Normal ranges of MCH

A

26 - 32 pg

41
Q

Normal ranges of platelet

A

150 - 450 x 10^9/L

42
Q

Normal ranges of RDW

A

11.5 - 14.5 %

43
Q

Normal ranges of reticulocyte

A

25 - 75 x 10^9/L

44
Q

In a table differentiate CML and Leukomoid reaction

A

CML LEUKOMID REACTION
1. There is increase in 1. increase in
all granules neutrophils and
their immature forms
2. Precence of dyspoietic 2. Reactive
morphology morphology is
is present
but no dyspoietic
morphology
3. Platelet are involved; giant 3. No abnormal
and hypogranular forms platelet morphology
seen
4. Leukocyte alkaline 4. Leukocyte
phosphatase score is markedly phosphatase
decreased markedly
increased

45
Q

The neoplastic cells in Nodular sclerosis morphological subtype of classical
Hodgkin lymphoma (3)

A
  1. Reed sternberg cells
  2. Lacular cells
  3. Hodkin cells
46
Q

The hallmark feature of Burkitt lymphoma is a high proliferation rate, a feature linked
to constitutive expression of(1):

A

MYC gene

47
Q

The cell of origin for chronic lymphocytic leukemia/small lymphocytic lymphoma (2)

A
  1. Naive B cell
  2. Memory B cell
48
Q

WHO classification variant of Burkitt lymphoma common in Africa and its
presentation(2)

A

endemic, presenting with jawbone

49
Q

The genetic feature that interconnect ET, PV and PMF and suggests a continuum of
diseases(1)

A

JAK2 gene mutation

50
Q

Disintegrated lymphoid cells present on the PB film in CLL not seen in other types of
malignant lymphoma (1)

A

smudge cells

51
Q

one important difference between
chronic lymphocytic leukemia and small lymphocytic lymphoma

A

Chronic lymphocycytic leukemia are present in a peripheral blood and bone marrow while small lymphocytic lymphoma is present in lymoh nodes and other lymphoid organs

52
Q

one important difference between the Pre-germinal center CLL and post-germinal center CLL (2 marks)

A

Pregeminal center of CLL there is no mutation of VH gene and there is trisomy 12 while in post germinal center there is mutation of VH gene and deletion of chromosome 13q14

53
Q

Whta is the important difference between Accelerated phase and Blastic phase of CML (2 marks)

A

Accelerated phase there is 10 - 19 of blast while in blastic phase there is greater than or equal to 20% of blast.

54
Q

one important difference between Small lymphoblast and large lymphoblast (2 marks)

A

small lymphocytes are involved in antibody production while large lymphoblasts are involved in differentiation process to produce more specialized and functional cells such as mature lymphocytes

55
Q

one important difference between Blast count in Blastic crisis and metamorphosis (acceleration) phase of CML (2
narks)

A

Blast count in blastic crisis os greater than or equal to 20% while in acceralation phase is 10-19

56
Q

Write a scientific reason for the occurrence of the following:
1.12 Higher dosages of Imatinib will restore remission in most patients who acquire
additional BCR/ABL during treatment of CML (4 marks).

A

Normal dosage of imatinib will restore remission in patient who have a single mutation of chromosome which has came due to translocation ofchromosome 9 and 22

57
Q

Write a scientific reason for the occurrence of When performing differential counts and encountering a lymphocytic cell that
looks like a blast is most likely a reactive lymphocyte if all other findings are normal.

A
  1. Chemical Exposure: Exposure to certain chemicals, such as benzene, can elevate the risk of lymphocytosis. While this link is stronger for acute myeloid leukemia (AML), it can also apply to acute lymphocytic leukemia (ALL).
  2. Viral Infections: Rarely, viral infections like the human T-cell lymphoma/leukemia virus-1 (HTLV-1) or Epstein-Barr virus (EBV) can lead to blast-like lymphocytes, especially in specific geographic regions
  3. Infection: Reactive lymphocytes can resemble blasts due to an immune response triggered by infections. These activated lymphocytes undergo rapid proliferation, leading to their blast-like appearance
58
Q

Write a scientific reason for the occurrence, Clinical symptoms mimic those of acute leukemia in the Blastic phase of CML .

A

Neutrophil Deficits: Patients with acute myeloid leukemia (AML) exhibit qualitative and quantitative deficits in granulocytes, which predispose them to bacterial and fungal infections. These deficits arise from the underlying malignancy and are compounded by periods of neutropenia induced by chemotherapeutic agents1.

Hematology II (19 decks)

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