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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
Which of the following is a common symptom in polycythemia vera?
Pruritus
26
Myelofibrosis, a condition in which bone marrow becomes fibrotic, can cause
Hepatosplenomegaly Pancytopenia Osteosclerosis Displacement of hematopoiesis to extramedullary tissue
27
Myelofibrosis is diagnosed:
WIth a biopsy demonstrating fibrosis
28
Which finding on peripheral smear is particularly indicative of myelofibrosis?
Dacrocytes
29
IN what way do myelodysplastic syndromes differ from myeloproliferative disorders?
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
30
Leukemia results from cells losing their ability to control ______ + _______
Replication and apoptosis
31
What are established risk factors for leukemia?
``` Down syndrome EBV HIV Maternal exposure to pesticides/herbicides Age older than 60 ```
32
Which is the most common malignancy in children
Acute lymphoblastic leukemia (ALL)
33
What differentiates acute from chronic leukemia?
A bone marrow biopsy with >20% blasts
34
Auer rods are pathognomonic for ____
ALL
35
Philadelphia chromosome abnormalities are found in individuals with
CML
36
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
d. They are pathognomonic for leukemia
37
(T or F) Leukemia is a rare cancer, affecting older individuals.
False
38
(T or F) Individuals with chronic myeloid leukemia can develop an acute myeloid leukemia.
True
39
What age group(s) is/are commonly affected by Hodgkin's lymphoma?
Ages 15-34 and greater than 60
40
Reed-Sternberg cells are pathognomonic for which lymphoma?
Hodgkin's lymphoma
41
The clinical history of pain in a lymph node following alcohol consumption is highly suspicious for
Hodgkin's lymphoma
42
What environmental exposure is a known risk factor for Non-hodgkin's lymphoma?
Benzene herbicides like glyphosate
43
The diagnosis of Non-hodgkin's lymphoma is made via
Lymph node biopsy
44
The age at diagnosis for Non-hodgkin's lymphoma is typically
67+
45
Which virus is associated with Burkitt's lymphoma?
EBV
46
Which geographical location is Burkitt's lymphoma associated with?
Central Africa
47
"Starry sky" presentation of cell on a peripheral smear is associated with which type of lymphoma?
Burkitt's lymphoma
48
(T or F) Hodgkin's lymphoma is more common than Non-hodgkin's lymphoma.
False
49
Plasma cell dyscrasias (PCDs) are defined as
Proliferation of one clone of plasma cells
50
In which condition are Bence Jones proteins found in the urine?
Multiple myeloma
51
What does the "C" in the CRAB mnemonic used for multiple myeloma stand for?
Hypercalcemia
52
What type of anemia is associated with multiple myeloma?
Normocytic, normochromic
53
What is typically found with ESR in multiple myeloma?
ESR is often markedly elevated
54
Which antibodies are typically associated with multiple myeloma?
IgG
55
Which antibody is produced in Waldenstrom's macroglobulinemia?
IgM
56
What condition is strongly associated with Waldenstrom's macroglobulinemia?
Raynaud's phenomenon
57
(T or F) Waldenstrom's macroglobulinemia can be diagnosed in an asymptomatic individual.
True
58
(T or F) Myeloproliferative disorders can mimic benign or reactive blood conditions.
True, because many conditions can cause an increase in blood products
59
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. Type 1 and type 2 mutations have the same effect on thrombopoiesis
60
What are established risk factors for polycythemia vera?
Certain genetic mutations Individuals over 60YO Exposures to intense radiation Males
61
(T or F) Presence of the JAK2 mutation is required for the diagnosis of polycythemia vera.
False
62
What is considered best practice for the treatment of low-risk polycythemia vera?
Low dose aspirin
63
In polycythemia vera, phlebotomy is associated with
Decreased risk of thrombotic events | Decreased risk of leukemic transformation
64
What is the most indolent myeloproliferative disorders?
Essential thrombocytosis
65
What percentage of patients with essential thrombocytosis are asymptomatic?
50%
66
What does the term 'triple negative' refer to in myeloproliferative disorders?
Absence of JAK2, CALR or MPL mutations
67
(T or F) Females and individuals over 60 are at greater risk of developing essential thrombocytosis.
True
68
What causes systemic mastocytosis?
It is caused by a mutation leading to an overproduction of mast cells
69
What is the 'minor' criteria for essential thrombocythemia diagnosis?
Presence of clonal marker or absence of evidence for reactive thrombocytosis
70
What is the most common presenting complaint in primary myelofibrosis?
Severe fatigue
71
(T or F) Due to the nature of the disease, primary myelofibrosis always requires use of a JAK1/JAK2 inhibitor.
False
72
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.
15
73
Hypereosinophilic syndrome is caused by
A mutation that increases production of eosinophils
74
What is the most commonly involved system in hypereosinophilic syndrome?
Cardiac system
75
(T or F) Hypereosinophilic syndrome is found in males 90% of the time
True
76
What is often used as the initial treatment for hypereosinophilic syndrome?
Corticosteroids
77
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
c. It will present with extramedullary blastic infiltrates
78
What are major complication of the myeloproliferative disorders?
``` Anemia Stroke Leukemia Hepatosplenomegaly Excessive bleeding ```

Hematology (9 decks)

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