Hema review questions
Which of the following inherited leukocyte disorders is caused by a mutation in the lamin B receptor?
Pelger-Huët anomaly
Chédiak-Higashi disease
Alder-Reilly anomaly
May-Hegglin anomaly
Which of the following inherited leukocyte disorders involves mutations in nonmuscle myosin heavy-chain IIA?
Pelger-Huët anomaly
Chédiak-Higashi disease
Alder-Reilly anomaly
May-Hegglin anomaly
Which of the following inherited leukocyte disorders might be seen in Hurler syndrome?
Pelger-Huët anomaly
Chédiak-Higashi disease
May-Hegglin anomaly
Alder-Reilly anomaly
Which of the following lysosomal storage diseases is characterized by macrophages with striated cytoplasm and storage of glucocerebroside?
Sanfilippo syndrome
Gaucher disease
Fabry disease
Niemann-Pick disease
The neutrophils in chronic granulomatous disease are incapable of producing:
Hydrogen peroxide
Hypochlorite
Superoxide
AOTA
Individuals with X-linked SCID have a mutation that affects their ability to synthesize:
Deaminase
Oxidase
IL-8 receptor
IL-2 receptor
An absolute lymphocytosis with reactive lymphocytes suggests which of the following conditions?
DiGeorge syndrome
Bacterial infection
Parasitic infection
Viral infection
What leukocyte cytoplasmic inclusion is composed of ribosomal RNA?
Primary granules
Toxic granules
Döhle bodies
Howell-Jolly bodies
The expected complete blood cell count (CBC) results for women in active labor would include:
High total white blood cell (WBC) count with increased lymphocytes
High total WBC count with a slight shift to the left in neutrophils
Normal WBC count with increased eosinophils
Low WBC count with increased monocytes
Which of the following is true of an absolute increase in lymphocytes with reactive morphology?
The population of lymphocytes appears morphologically homogeneous.
They are usually effector B cells.
The reactive lymphocytes have increased cytoplasm with variable basophilia
They are most commonly seen in bacterial infections
Lymphomas differ from leukemias in that they are:
Solid tumors
Not considered systemic diseases
Never found in peripheral blood
Do not originate from hematopoietic cells
Which one of the following viruses is known to cause lymphoid neoplasms in humans?
HIV-1
HTLV-1
Hepatitis B
Parvovirus B
Loss-of-function of tumor suppressor genes increase the risk of hematologic neoplasms by:
Suppressing cell division
Activating tyrosine kinases which promote proliferation
Promoting excessive apoptosis of hematopoietic cells
Allowing cells with damaged DNA to progress through the cell cycle
Oncogenes are said to act in a dominant fashion because:
Leukemia is a dominating disease that is systemic
The oncogene product is a gain-of-function mutation
A mutation in only one allele is sufficient to promote a malignant phenotype
They are inherited by autosomal dominant transmission
Which one of the following is NOT one of the cellular abnormalities produced by oncogenes:
Constitutive activation of a growth factor receptor
Constitutive activation of a signaling protein
Acceleration of DNA catabolism
Dysregulation of apoptosis
Which one of the following is an example of a tumor suppressor gene?
ABL1
RARA
TP53
JAK2
G-CSF is provided as supportive treatment during leukemia treatment regimens to:
Suppress GVHD
Overcome anorexia
Prevent anemia
Reduce the risk of infection
Imatinib is an example of what type of leukemia treatment?
Supportive care
Chemotherapy
Bone marrow conditioning agent
Targeted therapy
Which one of the following is FALSE about epigenetic mechanisms?
Epigenetic mechanisms control how genes are expressed and silenced
Micro RNAs can bind to specific mRNAs and block their translation.
C. Hypermethylation of CpG islands in gene promoters result in their overactivation.c. Hypermethylation of CpG islands in gene promoters result in their overactivation.
Histone deacetylases keep chromatin of target genes in a closed inactive state.
Which one of the following is NOT a source of hematopoietic stem cells for transplantation:
Spleen
Bone marrow
Peripheral blood
Umbilical cord blood
According to the WHO classification, except in leukemias with specific genetic anomalies, the minimal percentage of blasts necessary for a diagnosis of acute leukemia is:
10%
20%
30%
50%
Which of the following would be considered a sign of potentially favorable prognosis in children with ALL?
Hyperdiploidy
Presence of CD19 and CD20
Absence of trisomy 8
Presence of BCR/ABL gene
Signs and symptoms of cerebral infiltration with blasts are more commonly seen in:
AML with recurrent cytogenetic abnormalities
Therapy-related myeloid neoplasms
AML with myelodysplasia-related changes
D. ALL
An oncology patient exhibiting signs of renal failure with seizures after initial chemotherapy may potentially develop:
Hyperleukocytosis
Tumor lysis syndrome
Acute leukemia secondary to chemotherapy
Myelodysplasia
Which of the following leukemias affects primarily children, is characterized by an increase in monoblasts and monocytes, and often is associated with gingival and skin involvement?
Pre-B-lymphoblastic leukemia
Pure erythroid leukemia
AML with t(9;11)(p22;q23)
APL with PML-RARA
A 20-year-old patient presents with fatigue, pallor, easy bruising, and swollen gums. Bone marrow examination reveals 82% cells with delicate chromatin and prominent nucleoli that are CD141, CD41, CD11b1, and CD361. Which of the following acute leukemias is likely?A 20-year-old patient presents with fatigue, pallor, easy bruising, and swollen gums. Bone marrow examination reveals 82% cells with delicate chromatin and prominent nucleoli that are CD141, CD41, CD11b1, and CD361. Which of the following acute leukemias is likely?
Minimally differentiated leukemia
Leukemia of ambiguous lineage
Acute monoblastic/monocytic leukemia
Acute megakaryoblastic leukemia
Pure erythroid leukemia is a disorder involving:
Pronormoblasts only
Pronormoblasts and basophilic normoblasts
All forms of developing RBC precursors
Equal numbers of pronormoblasts and myeloblasts
A patient with normal chromosomes has a WBC count of 3.0 3 109 /L and dysplasia in all cell lines. There are 60% blasts of varying sizes. The blasts stain positive for CD61. The most likely type of leukemia is:
Acute lymphoblastic
Acute megakaryoblastic
Acute monoblastic
APL with PML-RARA
SBB stains which of the following component of cells?
Glycogen
Lipids
Structural proteins
Enzymes
The cytochemical stain a-naphthyl butyrate is a nonspecific esterase stain that shows diffuse positivity in cells of which lineage?
Erythroid
Monocytic
Granulocytic
Lymphoid
Non-Hodgkin lymphoma can be best differentiated from reactive disorders by:
Genetic testing
Immunophenotyping
Absolute lymphocyte count
Blood film review
Which laboratory test is most suggestive of autoimmune hemolytic anemia in a patient with CLL?
Direct antiglobulin test
Hemoglobin
Lymphocyte count
Platelet count
What is the best test or method for determining if a clonal population of T cells is present in a specimen?
Molecular diagnostic testing
Flow cytometry for CD3, CD5, and CD7
Immunohistochemical stain
Karyotyping
A rise in the lymphocyte count from 4.1 3 109 /L to 5.5 3 109 /L in a patient with monoclonal B lymphocytosis suggests:
Acute lymphocyte leukemia
Chronic lymphocytic leukemia
Acute myelocytic leukemia
A reactive condition
Which test is often used to differentiate CLL from mantle cell lymphoma?
Annexin A staining
Lymph node biopsy
Immunohistochemistry
FISH for BCL2 translocation
If not treated, which of the following would generally be associated with the best outcome?
Peripheral T cell lymphoma
Burkitt lymphoma
Splenic marginal zone lymphoma
Sézary syndrome
What do CLL and myeloma have in common?
Osteolytic lesions
Light chain restriction
Cell of origin
Immunophenotype
In Hodgkin lymphoma the Reed-Sternberg cell and _________ are malignant.
Popcorn cells
T cells
B cells
Histiocytes
In most cases the diagnosis of lymphoma relies on all of the following except:
Microscopic examination of affected lymph nodes
Immunophenotyping
Molecular analysis
Peripheral blood examination and complete blood count
Which of the following is present in monoclonal gammopathy of underdetermined significance?
Hypercalcemia
Serum monoclonal protein
Anemia
Bone lesion
Produces RED BROWN GRANULES in cytoplasm of granulocytes and monocytes
SBB
PAS
MPO
TDT
Which of the following is negative to NSE
Megakaryocytes
Erythroblasts
Mast cells
Monocytes
LAP Score grading: 50%-80%
0
1+
2+
3+
Decreased LAP Grading caused by?
ALL
Infectious mononucleosis
CLL
CML
SBB/MPO, SE, NSE POSITIVE
AML M3
AML M1-M3
ALL
AML M4
Isoenzyme 5 indicates?
Sezary Cell
Basket Cell
Reactive Lymphochyte
Hairy Cell
SBB/MPO: -, TdT: +
AML M5
CLL
ALL
MPL
SBB/MPO: -, SE: -, NSE: +
AML M5
ALL
CLL
MPL
Bone Marrow Myeloblasts: 95%
Immunophenotyping: CD13, CD117 Positive; CD11b, CD11c Negative
SBB/MPO: Positive
SE: Positive
NSE: Negative
PAS: Negative
AML M5
ALL
AML M1
AML M2
Useful in diagnosis of erythroleukemia (FAB M6)
MPO
TDT
ACP
PAS
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