Myelodysplastic Syndromes Flashcards

1
Q
  1. MDSs are most common in which age group?
    a. 2 to 10 years
    b. 15 to 20 years
    c. 25 to 40 years
    d. Older than 50 years
A

d. Older than 50 years

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2
Q
  1. What is a major indication of MDS in the peripheral blood
    and bone marrow?
    a. Dyspoiesis
    b. Leukocytosis with left shift
    c. Normal bone marrow with abnormal peripheral blood
    features
    d. Thrombocytosis
A

a. Dyspoiesis

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3
Q
  1. An alert hematologist should recognize all of the following
    peripheral blood abnormalities as diagnostic clues in MDS
    except:
    a. Oval macrocytes
    b. Target cells
    c. Agranular neutrophils
    d. Circulating micromegakaryocytes
A

b. Target cells

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4
Q
  1. For an erythroid precursor to be considered a ring sideroblast, the iron-laden mitochondria must encircle how much
    of the nucleus?
    a. One quarter
    b. One third
    c. Two thirds
    d. Entire nucleus
A

b. One third

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5
Q
  1. According to the WHO classification of MDS, what percentage of blasts would constitute transformation to an acute
    leukemia?
    a. 5%
    b. 10%
    c. 20%
    d. 30%
A

c. 20%

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6
Q
  1. A patient has anemia, oval macrocytes, and hypersegmented
    neutrophils. Which of the following tests would be most
    efficient in differential diagnosis of this disorder?
    a. Serum iron and ferritin levels
    b. Erythropoietin level
    c. Vitamin B12 and folate levels
    d. Chromosome analysi
A

c. Vitamin B12 and folate levels

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7
Q
  1. A 60-year-old woman comes to the physician with fatigue
    and malaise. Her hemoglobin is 8 g/dL, hematocrit is 25%,
    RBC count is 2.00 3 1012/L, platelet count is 550 3 109/L,
    and WBC count is 3.8 3 109/L. Her WBC differential is
    unremarkable. Bone marrow shows erythroid hypoplasia
    and hypolobulated megakaryocytes; granulopoiesis appears
    normal. Ring sideroblasts are rare. Chromosome analysis
    reveals the deletion of 5q only. Based on the classification
    of this disorder, what therapy would be most appropriate?
    a. Supportive therapy; lenalidomide if the disease progresses
    b. Aggressive chemotherapy
    c. Bone marrow transplantation
    d. Low-dose cytosine arabinoside, accompanied by cis-retinoic
    acid
A

a. Supportive therapy; lenalidomide if the disease progresses

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8
Q
  1. Which of the following is least likely to contribute to the
    death of patients with MDS?
    a. Neutropenia
    b. Thrombocytopenia
    c. Organ failure
    d. Neuropathy
A

d. Neuropathy

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9
Q
  1. Into what other hematologic disease does MDS often convert?
    a. Megaloblastic anemia
    b. Aplastic anemia
    c. AML
    d. Myeloproliferative disease
A

c. AML

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10
Q
  1. Chronic myelomonocytic leukemia is classified in the
    WHO system as:
    a. A myeloproliferative neoplasm
    b. Myelodysplastic syndrome, unclassified
    c. MDS/MPN
    d. Acute leukemia
A

c. MDS/MPN

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