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Hematology > WBCs/Blood Cell Mutations/Myeloproliferative Disorders > Flashcards

WBCs/Blood Cell Mutations/Myeloproliferative Disorders Flashcards

1
Q

Which of the following bones are an appropriate choice to access marrow for a biopsy?

A

Flat (sternum, illium)

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2
Q

Which cells are considered agranulocytes?

A

Monocytes

Lymphocytes

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3
Q

(T or F) Monocytes are immature macrophages who have yet to migrate from the blood into tissue.

A

True

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4
Q

Most variations in the leukocyte count are due to increases or decreases in the number of ______________ since by percentage they are more numerous.

A

Neutrophils

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5
Q

Eosinophils stain ___________ with Wright’s stain due to the stain’s affinity for the ___________ pH of their granules.

A

Orange-red; basic

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6
Q

What color do basophil granules stain with Wright stain?

A

Blue

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7
Q

Which of the following conditions are associated with lymphocytosis?

Some viral infections
Some bacterial infections
Radiation therapy
AIDS

A

Some viral infections

Some bacterial infections

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8
Q

(T or F) WBC counts on a CBC give an accurate and complete representation of WBCs throughout the body.

A

False

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9
Q

What is the relative number (%) of lymphocytes observed on WBC differential count in a healthy adult?

A

30%

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10
Q

Toxic granulation of neutrophils can be a result of what?

A

Severe inflammatory state

Significant infection

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11
Q

Which of the following leads to a neutrophil left shift?

a. Bacterial infection
b. Bone marrow depression
c. B12 or folate deficiency
d. Chemotherapy

A

a. Bacterial infection

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12
Q

(T or F) Basophils are immature mast cells who have yet to leave the blood and migrate into tissue.

A

False

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13
Q

Which conditions are associated with eosinophilia (5%)?

A

Parasitic infections

Allergic infections

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14
Q

What condition is associated with basophilia?

a. Myeloproliferative disease
b. Prolonged steroid therapies
c. Hyperthyroidism
d. Stress reactions

A

a. Myeloproliferative disease

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15
Q

What causes hypersegmented neutrophils?

A

B12 or folate deficiency

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16
Q

What is the correct criteria for neutrophil hypersegmentation?

A

More than 3 cells with 5 lobes or one with 6 lobes

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17
Q

Which cells have a nucleus classically shaped like a horse shoe?

A

Monocyte

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18
Q

T cells, B cells and natural killer cells are all this cell type

A

Lymphocytes

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19
Q

(T or F) LAP stain is low in leukemoid reactions

A

False

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20
Q

What describes a leukemoid reaction?

A

A non-leukemic WBC reaction with no more than 5% metamyelocytes or earlier

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21
Q

Myeloproliferative disorders can lead to enlargement of which organ?

A

Spleen

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22
Q

What is the role of JAK2 in polycythemia vera?

A

A mutation of JAK2 leads to stimulation of new RBCs in the absence of erythropoietin

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23
Q

Polycythemia and myelofibrosis and both examples of

A

Myeloproliferative disorders

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24
Q

Erythropoietin levels in secondary polycythemia (reactive) are

A

elevated

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25
Q

Which of the following is a common symptom in polycythemia vera?

A

Pruritus

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26
Q

Myelofibrosis, a condition in which bone marrow becomes fibrotic, can cause

A

Hepatosplenomegaly
Pancytopenia
Osteosclerosis
Displacement of hematopoiesis to extramedullary tissue

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27
Q

Myelofibrosis is diagnosed:

A

WIth a biopsy demonstrating fibrosis

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28
Q

Which finding on peripheral smear is particularly indicative of myelofibrosis?

A

Dacrocytes

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29
Q

IN what way do myelodysplastic syndromes differ from myeloproliferative disorders?

A

Myeloproliferative disorders typically result in an increase in circulating cells. In MDS there are fewer circulating cells.

The cells in Myeloproliferative disorders and mature and functioning. In MDS they are dysfunctional

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30
Q

Leukemia results from cells losing their ability to control ______ + _______

A

Replication and apoptosis

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31
Q

What are established risk factors for leukemia?

A 
Down syndrome
EBV
HIV
Maternal exposure to pesticides/herbicides
Age older than 60
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32
Q

Which is the most common malignancy in children

A

Acute lymphoblastic leukemia (ALL)

33
Q

What differentiates acute from chronic leukemia?

A

A bone marrow biopsy with >20% blasts

34
Q

Auer rods are pathognomonic for ____

A

ALL

35
Q

Philadelphia chromosome abnormalities are found in individuals with

A

CML

36
Q

Which of the following is NOT true concerning smudge cells?

a. They are generally immature lymphocytes
b. They indicate increased cell fragility
c. They may be a result of operator (user) error
d. They are pathognomonic for leukemia

A

d. They are pathognomonic for leukemia

37
Q

(T or F) Leukemia is a rare cancer, affecting older individuals.

A

False

38
Q

(T or F) Individuals with chronic myeloid leukemia can develop an acute myeloid leukemia.

A

True

39
Q

What age group(s) is/are commonly affected by Hodgkin’s lymphoma?

A

Ages 15-34 and greater than 60

40
Q

Reed-Sternberg cells are pathognomonic for which lymphoma?

A

Hodgkin’s lymphoma

41
Q

The clinical history of pain in a lymph node following alcohol consumption is highly suspicious for

A

Hodgkin’s lymphoma

42
Q

What environmental exposure is a known risk factor for Non-hodgkin’s lymphoma?

A

Benzene herbicides like glyphosate

43
Q

The diagnosis of Non-hodgkin’s lymphoma is made via

A

Lymph node biopsy

44
Q

The age at diagnosis for Non-hodgkin’s lymphoma is typically

A

67+

45
Q

Which virus is associated with Burkitt’s lymphoma?

A

EBV

46
Q

Which geographical location is Burkitt’s lymphoma associated with?

A

Central Africa

47
Q

“Starry sky” presentation of cell on a peripheral smear is associated with which type of lymphoma?

A

Burkitt’s lymphoma

48
Q

(T or F) Hodgkin’s lymphoma is more common than Non-hodgkin’s lymphoma.

A

False

49
Q

Plasma cell dyscrasias (PCDs) are defined as

A

Proliferation of one clone of plasma cells

50
Q

In which condition are Bence Jones proteins found in the urine?

A

Multiple myeloma

51
Q

What does the “C” in the CRAB mnemonic used for multiple myeloma stand for?

A

Hypercalcemia

52
Q

What type of anemia is associated with multiple myeloma?

A

Normocytic, normochromic

53
Q

What is typically found with ESR in multiple myeloma?

A

ESR is often markedly elevated

54
Q

Which antibodies are typically associated with multiple myeloma?

A

IgG

55
Q

Which antibody is produced in Waldenstrom’s macroglobulinemia?

A

IgM

56
Q

What condition is strongly associated with Waldenstrom’s macroglobulinemia?

A

Raynaud’s phenomenon

57
Q

(T or F) Waldenstrom’s macroglobulinemia can be diagnosed in an asymptomatic individual.

A

True

58
Q

(T or F) Myeloproliferative disorders can mimic benign or reactive blood conditions.

A

True, because many conditions can cause an increase in blood products

59
Q

Which of the following is NOT true about CALR?

a. Type 1 and type 2 mutations have the same effect on thrombopoiesis
b. CALR mutations are associated with lower hemoglobin and leukocyte counts
c. One study found it to be more associated with abnormal blood markers than JAK2
d. It’s a Ca++ binding protein located primarily in the endoplasmic reticulum

A

a. Type 1 and type 2 mutations have the same effect on thrombopoiesis

60
Q

What are established risk factors for polycythemia vera?

A

Certain genetic mutations
Individuals over 60YO
Exposures to intense radiation
Males

61
Q

(T or F) Presence of the JAK2 mutation is required for the diagnosis of polycythemia vera.

A

False

62
Q

What is considered best practice for the treatment of low-risk polycythemia vera?

A

Low dose aspirin

63
Q

In polycythemia vera, phlebotomy is associated with

A

Decreased risk of thrombotic events

Decreased risk of leukemic transformation

64
Q

What is the most indolent myeloproliferative disorders?

A

Essential thrombocytosis

65
Q

What percentage of patients with essential thrombocytosis are asymptomatic?

A

50%

66
Q

What does the term ‘triple negative’ refer to in myeloproliferative disorders?

A

Absence of JAK2, CALR or MPL mutations

67
Q

(T or F) Females and individuals over 60 are at greater risk of developing essential thrombocytosis.

A

True

68
Q

What causes systemic mastocytosis?

A

It is caused by a mutation leading to an overproduction of mast cells

69
Q

What is the ‘minor’ criteria for essential thrombocythemia diagnosis?

A

Presence of clonal marker or absence of evidence for reactive thrombocytosis

70
Q

What is the most common presenting complaint in primary myelofibrosis?

A

Severe fatigue

71
Q

(T or F) Due to the nature of the disease, primary myelofibrosis always requires use of a JAK1/JAK2 inhibitor.

A

False

72
Q

The major criterion for diagnosis of systemic mastocytosis requires there be multifocal, dense aggregates of at least _____ mast cells in the bone marrow or other extracutaneous organs.

A

15

73
Q

Hypereosinophilic syndrome is caused by

A

A mutation that increases production of eosinophils

74
Q

What is the most commonly involved system in hypereosinophilic syndrome?

A

Cardiac system

75
Q

(T or F) Hypereosinophilic syndrome is found in males 90% of the time

A

True

76
Q

What is often used as the initial treatment for hypereosinophilic syndrome?

A

Corticosteroids

77
Q

Which of the following is NOT true concerning the chronic stable phase of CML?

a. You will likely see increased platelets and basophils
b. It is the most common stage at the time of diagnosis
c. It will present with extramedullary blastic infiltrates
d. It may present with splenomegaly

A

c. It will present with extramedullary blastic infiltrates

78
Q

What are major complication of the myeloproliferative disorders?

A 
Anemia
Stroke
Leukemia
Hepatosplenomegaly
Excessive bleeding

Hematology (9 decks)

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