White Blood Cells, LN, Spleen And Thymus

Question 0

Causes of neutropenia

Answer 0

Inadequate or ineffective granulopoeisis

Accelerated removal/destruction

Question 1

Clinically significant reduction in neutrophils

Answer 1

Agranulocytosis

Question 2

Drugs that cause ineffective granulocytosis
Idiosyncratic and Dose related
Example of dose related

Answer 2

Chemotherapeutic drugs

Question 3

Conditions responsible for accelerated destruction in neutropenia

Answer 3

CML
MDS
Vit B12 deficiency

Question 4

Dry tap on BMA

Answer 4

Hypocellular marrow
Neutropenia
Effect of chemotherapeutic drug

Question 5

WBC count
Leukocytosis
Leukomoid reaction

Answer 5

> 11,000

>50,000

Question 6

Differentiates leukomoid reaction from CML

Answer 6

Neutrophil alk phos
Inc leukomoid
Dec CML

Question 7

Type of leukocytosis in 
Allergic disorders
Chronic infections
Parasitic infections
Bacterial infections
Viral infections
Myeloproliferative disorders

Answer 7

Eosinophilic
Monocytic
Eosinophilic
Neutrophilic
Lymphocytic
Basophilic

Question 8

Patches of dilated ER that appear as sky blue cytoplasmic puddles

Answer 8

Dohle buddles
Toxic granule
Leukocytosis

Question 9

Primary follicles of the lymph nodes enlarge to become germinal centers

Answer 9

Lymphadenitis

Question 10

Nodes become swollen gray red and engorged

Abscess formation

Answer 10

Acute lymphadenitis

Question 11

Hard nontender swelling of inguinal and axillary LN

Answer 11

Chronic lymphadenitis

Question 12

Three key forms of chronic lymphadenitis

Answer 12

Follicular hyperplasia
Paracortical hyperplasia
Sinus histiocytosis

Question 13

Composed of zones with proliferating blast like B cell, B cells with cleaved nuclear contours, and phagocytic macrophages containing nuclear debris of B cells

Answer 13

Dark zones centroblast
Light zones centrocytes
Tingible body macrophages

Follicular hyperplasia

Question 14

T cell region encroaches on B cell regions seen in viral infections and drugs

Answer 14

EBV
Phenytoin
Paracortical hyperplasia

Chronic lymphadenitis

Question 15

Increase in the number and size of macrophages that line lymphatic sinusoids
Seen in breast cancer

Answer 15

Sinus histiocytosis

Question 16

Types of neoplastic WBCs

Answer 16

Lymhoid
Myeloid
Histiocytoses

Question 17

Leukemia

Lymphoma

Answer 17

Neoplasms in BM. Tumor cells in blood

Tumor masses

Question 18

Acute leukemia

Chronic leukemia

Answer 18

Blasts, pedia, short and drastic course

Mature, adult, long but less devastating course

Question 19

85% of immature lymphoblasts found in Acute Lymphoblastic Leukemia is

Answer 19

B ALLs

Question 20

Most common cancer of children

Answer 20

ALL

Question 21

Hypercellular marrow packed with lymphoblasts with more condensed chromatin, less conspicuous nucleoli and smaller cytoplasm that lacks granules

Answer 21

ALL

Question 22

Bone marrow involvement in childhood

Mediastinal mass in adolescent males

Answer 22

ALL

Question 23

Leukemia most responsive to chemotherapy

Answer 23

ALL

Question 24

Sanctuary sites of ALL

Answer 24

CNS | Testes

Question 25

T (12,21)

Answer 25

ALL | Better prognosis

Question 26

DOC for ALL WOF Vehicle for delivery to sanctuary sites

Answer 26

Asparaginase Pancreatitis Ommaya reservoir

Question 27

Hypercellular marrow packed with GREATER THAN 20% myeloblasts with less condensed chromatin, more conspicuous nucleoli and purplish cytoplasm

Answer 27

AML | Blasts are absent from blood

Question 28

Distinct needle like azurophilic granules

Answer 28

Auer rods | APML

Question 29

Pancytopenia | Spontaneous mucosal and cutaneous bleedong

Answer 29

AML

Question 30

Leukemia with highest incidence of DIC

Answer 30

APML

Question 31

APML translocation

Answer 31

T (15,17)

Question 32

Only human cancer treated by vitamins | All trans retinoic acid

Answer 32

APML

Question 33

Philadelphia chromosome | T (9,22)

Answer 33

CML

Question 34

Hypercellular marrow with LESS THAN 10% myeloblasts Very low alkaline phosphatase WBC>100,000

Answer 34

CML

Question 35

Scattered macrophages with abundant wrinkled green blue cytoplasm

Answer 35

CML

Question 36

WHO criteria for accelerated phase

Answer 36

``` 10-19% myeloblasts >20% basophils PC1,000,000 unresponsive to tx Cytogenetic evolution Inc splenomegaly or WBC count ```

Question 37

Final phase of evolution of CML wherein myeloblasts or lymphoblasts are greater than 20%

Answer 37

Blast crisis

Question 38

Development of solid focus of leukemia outside BM

Answer 38

Chloroma Blast crisis CML

Question 39

DOC for CML | WOF

Answer 39

Imatinib (Gleevec) | Fluid retention, CHF

Question 40

Peripheral blood leukocytosis Absolute lymphocyte count >4000 <4000

Answer 40

CLL | SLL

Question 41

Most common leukemia of adults and elderly

Answer 41

CLL

Question 42

LN infiltrates of small lymphocytes Larger activated lymphocytes that gather in loose aggregates Small lymphocytes disrupted in the process of making smears Nucleated red blood cells

Answer 42

Proliferation centers Smudge or basket cells CLL

Question 43

CLL complication | Transformation into diffuse large B cell lymphoma

Answer 43

Richter syndrome

Question 44

Mature B cell tumor in the elderly with cells that have hairlike projections stained with TRAP

Answer 44

Hairy cell leukemia

Question 45

Leukemia with dry tap on BMA

Answer 45

Hairy cell leukemia

Question 46

Age brackets on leukemia

Answer 46

0-14 ALL 15-39 AML 40-59 AML CML >60 CLL

Question 47

Large cells with multiple nuclei or single nuclei with multiple nuclear lobes Owl's eyes

Answer 47

Reed Sternberg cell | Hodgkin's lymphoma

Question 48

Lymphoma that has multiple peripheral nodes mostly mesenteric Extranodal 20-40 yo

Answer 48

NHL

Question 49

Lymphoma involving mostly chest LN with contiguous spread and frequent constitutional ssx Bimodal EBV Good prognosis

Answer 49

HL

Question 50

Chemotherapy regimen HL NHL

Answer 50

ABVD | CHOP

Question 51

Increased _ roughly correlates with good prognosis in HL

Answer 51

Lymphocyte to RS ratio

Question 52

Lacunar variant RS cells | Deposition of collagen bands

Answer 52

Nodular sclerosis | HL

Question 53

Plentiful RS cells admixed with lymphocytes | EBV

Answer 53

Mixed cellularity | HL

Question 54

Mononuclear variants of RS cells

Answer 54

Lymphocyte rich | HL

Question 55

Worst prognosis | Abundance of RS cells

Answer 55

Lymphocyte depleted | HL

Question 56

Popcorn cells

Answer 56

Lymphocyte predominant | HL

Question 57

T or F | Most NHLs are T cell origin

Answer 57

B

Question 58

T (14,18)

Answer 58

Follicular lymphoma | NHL

Question 59

Most common form of indolent NHL | Centrocyte morphology

Answer 59

Follicular lymphoma

Question 60

Most common form of NHL | Diffuse pattern of growth

Answer 60

Diffuse large B cell lymphoma

Question 61

Rapidly enlarging mass at a nodal or extranodal site | Massive hepatosplenomegaly

Answer 61

Diffuse large B cell lymphoma

Question 62

T (8,14)

Answer 62

Burkitt's lymphoma | NHL

Question 63

High mitotic index Numerous apoptotic cells Nuclear remnants phagocytosed by interspersed macrophages with abundant clear cytoplasm

Answer 63

Burkitt cells with lipid droplets Starry sky pattern Burkitt's lymphoma NHL

Question 64

Most tumors manifest at extranodal sites

Answer 64

Burkitt's lymphoma | NHL

Question 65

T (11,14)

Answer 65

Mantle cell lymphoma

Question 66

High cyclin D1 Homogenous production of small lymphocytes No centroblasts No proliferation centers

Answer 66

Mantle cell lymphoma | NHL

Question 67

Painless lymphadenopathy

Answer 67

Mantle cell lymphoma | NHL

Question 68

Painless lymphadenopathy | Painful on alcohol intake

Answer 68

HL

Question 69

Neoplasm of CD4 T crlls HTLV-1 Cloverleaf or flower cells

Answer 69

Adult T cell lymphoma | NHL

Question 70

Chronic proliferative Cutaneous T cell lymphoma

Answer 70

Mycosis fungoides

Question 71

Aggressive nodular eruptive variant

Answer 71

Mycosis fungoides d'emblee

Question 72

Diffuse erythema and scaling of the entire body surface

Answer 72

Sezary surface | Cutaneous T cell lymphoma

Question 73

Cerebriform nuclei | CD4 forming bandlike aggregates

Answer 73

Sezary Lutner cells | Cutaneous T cell lymphoma

Question 74

Invade epidermis as single cells and small clusters

Answer 74

Pautrier microabscesses | Cutaneous T cell lymphoma

Question 75

Neoplastic plasma cells synthesize excess light or heavy chains excreted in the urine

Answer 75

Bence Jones proteins

Question 76

Cytokine associated with plasma cell neoplasms

Answer 76

IL 6

Question 77

HyperCalcemia Renal insufficiency Anemia Bone lytic lesions and Bone pain

Answer 77

Multiple myeloma

Question 78

Destructive plasma cell tumors involving axial skeleton with lytic lesions and punched out defects

Answer 78

Plasmacytoma | Multiple myeloma

Question 79

Multiple nuclei Prominent nucleoli Cytoplasmic droplets containing Ig

Answer 79

Bizarre multinucleated cells | Multiple myeloma

Question 80

Fiery red cytoplasm

Answer 80

Flame cells | Multiple myeloma

Question 81

Multiple grapelike cytoplasmic droplets

Answer 81

Mott cells | Multiple myeloma

Question 82

Pink globular cytoplasmic inclusions

Answer 82

Russell bodies | Multiple myeloma

Question 83

Blue globular nuclear inclusions

Answer 83

Dutcher bodies | Multiple myeloma

Question 84

M proteins cause RBCs to stack

Answer 84

Rouleaux conformation | Multiple myeloma

Question 85

Clonal stem cell disorders with maturation defects | High risk of AML transformationw

Answer 85

Myelodysplastic syndrome

Question 86

Erythroblasts with iron laden mitochondria | Nuclear budding abnormalities

Answer 86

Ringed sideroblasts | MDS

Question 87

Neutrophils with 2 nuclear lobes

Answer 87

Pseudo Pelger Huet cells | MDS

Question 88

Megakaryocytes with single nuclear lobes or multiple separate nuclei

Answer 88

Pawn ball megakaryocytes | MDS

Question 89

Serum protein electrophoresis in Multiple myeloma

Answer 89

Monoclonal M protein spike

Question 90

Types of polycythemia | Dec plasma volume

Answer 90

Relative polycythemia

Question 91

Types of polycythemia Inc plasma volume Dec EPO

Answer 91

Polycythemia vera

Question 92

Types of polycythemia Inc plasma volume Inc EPO Dec O2 Sat

Answer 92

Appropriate absolute

Question 93

Types of polycythemia Inc plasma volume Inc EPO Inc O2 Sat

Answer 93

Inappropriate absolute | Ectopic EPO production from renal cell ca, wilms and HCC

Question 94

HCT>52%

Answer 94

Polycythemia vera

Question 95

Hypercellular marrow with inc red cell progenitors, inc reticulin fibers and some residual fat

Answer 95

Polycythemia vera

Question 96

Extensive marrow fibrosis | Inc extramedullary hematopoiesis

Answer 96

Spent phase | Polycythemia vera

Question 97

Marked thrombocytosis Giant platelets Erythromelalgia

Answer 97

Essential thrombocytosis

Question 98

Fibrotic obliteration of marrow space Leukoerythroblastosis Teardrop cells or dacrocytes Normocytic normochromic anemia

Answer 98

Primary myelofibrosis

Question 99

Proliferative disorder of dendritic cells

Answer 99

Langerhans Cell Histiocytosis

Question 100

Pentalaminar tubules with dilated terminal end (tennis racket) containing LANGERIN protein

Answer 100

Birbeck granules | Langerhans cell histiocytosis

Question 101

Small yellow brown or rust colored foci in the spleen due to congestion

Answer 101

Gandy Gamna nodules | Congestive splenomegaly

Question 102

Jigsaw puzzle shaped masses | Swirling pattern of spindle shaped cells

Answer 102

Thymoma

Question 103

Myasthenia gravis | Associated cancer

Answer 103

Thymoma

Question 104

Paraneoplastic syndrome of thymoma

Answer 104

Pure red cell aplasia