Hematology Test 7 Flashcards Preview

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Flashcards in Hematology Test 7 Deck (120):
0

Which myeloproliferative disease has very elevated WBC counts (often greater than 200 x 103/uL)?

CHRONIC MYELOGENOUS LEUKEMIA

1

Which myeloproliferative disease is characterized by numerous fibroblasts in the bone marrow?

CHRONIC IDIOPATHIC MYELOFIBROSIS

2

Which myeloproliferative disease has a low Leukocyte Alkaline Phosphatase score?

CHRONIC MYELOGENOUS

3

Which myeloproliferative disease has the Philadelphia chromosome?

CHRONIC MYELOGENOUS

4

Which chromosomes are involved in the translocation of genes to produce the Philadelphia chromosome?

9 and 22

5

List a common inexpensive treatment for Polycythemia Vera.

THERAPEUTIC PHLEBOTOMY

6

Which myeloproliferative disease is characterized by platelet counts that usually exceed 600x109/L?

ESSENTIAL THROMBOCYTHEMIA

7

What is meant by “Refractory” anemia?

STUBBORN, OBSTINATE. RESISTANT TO ORDINARY TREATMENT
THESE ANEMIAS PROGRESS TO ACUTE LEUKEMIAS –ORIGINALLY THOUGHT TO BE PRELEUKEMIC DISEASES

8

MDS are a group of acquired clonal hematologic disorders characterized by progressive ____________.

Cytopenia

9

Which age group is most likely to acquire an MDS?

PEOPLE OVER THE AGE OF 50

10

List three other names for Myelodysplastic Syndromes?

DYSERYTHROPOIESIS AFFECTS RED CELLS
DYSMYELOPOIESIS AFFECTS MYELOCYTIC (GRANULOCYTE) CELL LINE
DYSMEGAKARYOPOIESIS AFFECTS THE MEGAKARYOCYTES (PLATELETS)

11

In peripheral blood, what common morphological finding in dyserythropoesis would cause the physician to order B12 and Folic Acid levels?

Oval macrocytes

12

List the five FAB classifications of the melodysplastic syndromes.

REFRACTORY ANEMIA
REFRACTORY ANEMIA WITH RINGED SIDEROBLASTS
REFRACTORY ANEMIA WITH EXCESS BLASTS
CHRONIC MYELOMONOCYTIC LEUKEMIA
REFRACTORY ANEMIA WITH EXCESS BLASTS IN TRANSFORMATION

13

Which of the FAB classified myelodysplastic syndromes should probably be better listed as a myeloproliferative disease instead of with the myelodysplastic diseases?

CHRONIC MYELOMONOCYTIC LEUKEMIA

14

Which of the FAB classified myelodysplastic diseases has the best prognosis?

REFRACTORY ANEMIA (RA)AND REFRACTORY ANEMIA WITH RINGED SIDEROBLASTS (RARS)

15

Which acute leukemia in children has the highest remission and cure rate?

.Acute lymphocytic leukemia

16

Which acute leukemia has very fine granules that when released into the circulation can precipitate Disseminated Intravascular Coagulation (DIC)?

M3- ACUTE PROMYELOCYTIC LEUKEMIA- Microgranular

17

Which acute leukemia in children occurs primarily in Down’s Syndrome patients?

M7- ACUTE MEGAKARYOCYTE LEUKEMIA

18

What are the two types of chronic lymphocytic leukemia called?

CHRONIC LYMPHOCYTIC AND HAIRY CELL LEUKEMIAS

19

What can you assume if you see Auer rods in myeloblasts or promyelocytes?

ACUTE myelogenous

20

Which leukemia is characterized by many small lymphocytes and smudge cells?

CHRONIC LYMPHOCYTIC LEUKEMIA

21

What is the name of the unique bi-nuclear “owl-eye” cells in lymph nodes?

REED-STERNBERG

22

Which lymphoma occurs mostly in children and is characterized by highly vacuolated lymphocytes?

Burkett's lymphoma

23

Which lymphoma diagnosis is considered a “medical emergency"?

RAPID PROLIFERATION OF CELLS
Burkett's lymphoma

24

Which plasma cell disease causes bone lesions?

Multiple myeloma

25

What are the excess proteins excreted into the urine in multiple myeloma called?

Bence jones proteins

26

List three other names for Primary Myelofibrosis.

CHRONIC IDIOPATHIC MYELOFIBROSIS
AGNOGENIC MYELOID METAPLASIA
EXTRAMEDULLARY HEMATOPOIESIS

27

Which of the FAB classified myelodysplastic diseases has the poorest prognosis?

REFRACTORY ANEMIA WITH EXCESS BLASTS(RAEB)AND REFRACTORY ANEMIA WITH BLASTS IN TRANSFORMATION(RAEB-t)

28

Which lymphoma is characterized by unique bi-nuclear “owl-eye” cells in lymph nodes?

.Hodgkin

29

Which plasma cell disease is due to plasma cells producing an excess of IgM antibodies?

WALDENSTROM

30

WHICH DISEASE HAS WBC COUNTS OF 300,000?

CML- CHRONIC MYELOGENOUS LEUKEMIA

31

WHICH DISEASE HAS PHILADELPHIA CHROMOSOME?

CML - CHRONIC MYELOGENOUS LEUKEMIA

32

WHICH DISEASE IS CHARACTERIZED BY FIBROBLASTS IN THE BONE MARROW?

AMM (CHRONIC IDIOPATHIC MYELOFIBROSIS)

33

WHICH DISEASE HAS PLATELET COUNTS GREATER THAN 600,000?

ESSENTIAL THROMBOCYTHEMIA

34

WHICH DISEASE IS TREATED BY THERAPEUTIC PHLEBOTOMY?

PV - POLYCYTHEMIA VERA

35

WHICH DISEASE HAS TRANSLOCATION OF GENE 9 AND 22 (t9:22) (bcr attaches to abl)?

CML- chronic MYELOGENOUS leukemia

36

What is the 4 MYELOPROLIFERATIVE and name the over abundance of which cells?

Chronic myelogenous leukemia –LEUKOCYTES (MYELOCYTIC SERIES)
Polycythemia Vera –ERYTHROCYTES
Essential thrombocytemia –PLATELETS
AGNOGENIC MYELOID METAPLASIA (AMM), CHRONIC IDIOPATHIC MYELOFIBROSIS (CIM)- FIBROBLASTS

37

What do all of the myeloproliferative anemias progress to?

Acute leukemia

38

What is the chronic myelogenous also called?

MYELOCYTIC OR GRANULOCYTIC

39

What is the age group for CML

Middle age

40

CML affects what stages of cell maturity?

All stages of cell maturity

41

What are some of the clinical findings for CML?

INCREASED WBC
Low lap score
Elevated uric acid levels
Philadelphia chromosome present
Normocytic anemia
Bleeding- platelets are abnormal

42

What age group is the polycythemia Vera?

Over 60

43

Polycythemia Vera PRODUCES EXCESS of what?

ALL ERYTHROID CELL LINES

44

Polycythemia Vera greatly increases what?

RBC mass

45

What type of cells are present in the polycythemia Vera?

Tear drop

46

What does a high plasma viscosity go with?

Polycythemia Vera

47

Cheapest and easiest treatment for polycythemia Vera?

Therapeutic phlebotomy

48

ESSENTIAL THROMBOCYTHEMIA is marked by an increase in what cells?

Platelets

49

Name three things needed to diagnose polycythemia Vera?

INCREASED RBC, NORMAL O2 SAT, SPLENOMEGALY

50

Proliferation of what in marrow in essential thrombocytemia?

Megakaryocytes

51

What problems can happen with essential thrombocytemia?

Hemorrhage or THROMBOEMBOLISM

52

Is there splenomegaly with essential thrombocytemia?

No

53

Chronic idiopathic myelofibrosis has excessive what in marrow?

Fibroblasts

54

In CHRONIC IDIOPATHIC MYELOFIBROSIS, the fibroblasts produce what and how does it cause anemia?

PRODUCES COLLAGEN THAT CROWDS OUT HEMATOPOIETIC CELLS and RESULT IS ANEMIA

55

What is a secondary problem with chronic idiopathic myelofibrosis?

STEM CELLS ARE DEPOSITED INTO OTHER ORGANS (EXTRAMEDULLARY HEMATOPOIESIS)

56

Name some problems caused by chronic idiopathic myelofibrosis?

HYPERTENSION, ASCITES, VERICES, HEMORRHAGE, HEPATIC ENCEPHALOPATHY

57

What do myelodysplastic syndromes result in?

Cytopenia and sometimes pancytopenia

58

Are myelodysplastic syndromes a lymphocytic disease?

No

59

What age group for myelodysplastic syndromes?

Over 50

60

Which is this: PATIENTS CAN REMAIN STABLE FOR YEARS OR PROGRESS RAPIDLY TO DEATH?

Myelodysplasias

61

What are the three categories for myelodysplasias?

DYSERYTHROPOIESIS, DYSMYELOPOIESIS, DYSMEGAKARYOPOIESIS

62

What has an OVAL MACROCYTES WITH NORMAL B12 AND FOLATE?

DYSERYTHROPOIESIS

63

What has HYPOCHROMIC MICROCYTES WITH NORMAL IRON?

DYSERYTHROPOIESIS

64

What has a DIMORPHIC RBC POPULATION?

DYSERYTHROPOIESIS

65

What are common in dyserythropoiesis without exposure to lead?

Ringed siberoblasts

66

What are the RBC precursors like in dyserythropoiesis?

Have two nucleus or abnormal nuclei

67

Dysmyelopoiesis is marked by what?

Abnormal granulations of neutrophils
Absent or reduced or abnormal

68

What is marked by blue staining of cytoplasm?

Dysmyelopoiesis

69

What can bands be easily be confused with in dysmyelopoiesis?

Monocytes because of lack of granulation

70

What is marked by GIANT, ABNORMAL PLATELETS, CIRCULATING MICROMEGAKARYOCYTES, BILOBED OR MULTIPLE SMALL NUCLEI?

DYSMEGAKARYOPOIESIS

71

What are the 4 FAB classifications for refractory anemia?

1) REFRACTORY ANEMIA
2) REFRACTORY ANEMIA WITH RINGED SIDEROBLASTS
3) REFRACTORY ANEMIA WITH EXCESS BLASTS
4) CHRONIC MYELOMONOCYTIC LEUKEMIA

72

What was the 5th FAB classification and what is it called now?

REFRACTORY ANEMIA WITH EXCESS BLASTS IN TRANSFORMATION BUT IT IS NOW CALLED ACUTE MYELOGENOUS LEUKEMIA -->20% BLASTS

73

How long is the life span for refractory anemias?

1-6 years

74

What do refractory anemias have?

Severe cytopenia

75

What might therapeutic drugs do in refractory anemia?

Exacerbate cytopenia

76

What is acute leukemia?

Circulation of blast cells

77

Acute lymphoblastic is primarily what age group disease?

Childhood

78

Acute lymphoblastic is most curable leukemia if patient is between what age group?

2 to 10

79

In acute lymphoblastic, only half of patients have what?

Lymphocytsis

80

What are the classification for acute lymphoblastic leukemia and what is it based on?

FAB L1, L2, L3 and based on the size of lymphoblasts

81

How many classifications are there for acute myeloid leukemia?

7 use M for myeloid

82

What are M1 and M2?

ACUTE MYELOGENOUS (MYELOBLASTIC) LEUKEMIAS –WITH OR WITHOUT MATURATION

83

Which myeloid FAB is characterized by AUER RODS IN MYELOBLASTS AND PROMYELOCYTES?

M1 and M2
Acute myelogenous

84

What are some characteristics for M1 AND M2 --ACUTE MYELOGENOUS?

HIGH WBC COUNTS
MYELOBLASTS
AUER RODS IN MYELOBLASTS AND PROMYELOCYTES
WITHOUT MATURATION –NOTHING BEYOND PROMYELOCYTE

85

What is the M3 FAB?

ACUTE PROMYELOCYTIC

86

What are the two types of M3- ACUTE PROMYELOCYTIC?

HYPERGRANULAR AND MICROGRANULAR

87

What does micro granular acute PROMYELOCYTES cause?

DIC WHEN CELLS ARE DISRUPTED AND GRANULES RELEASED INTO CIRCULATON

88

What is the M4 FAB?

ACUTE MYELOMONOCYTIC

89

M4- ACUTE MYELOMONOCYTIC has a mixture of what?

MYELOBLASTS AND MONOBLASTS

90

M4- ACUTE MYELOMONOCYTIC has what precursors?

MYELOCYTIC AND MONOCYTIC PRECURSORS

91

MONOCYTIC PRECURSORS CAN BE IDENTIFIED BY USING WHat STAINS?

Esterase

92

M5 FAB is what?

ACUTE MONOCYTIC LEUKEMIA

93

M5- ACUTE MONOCYTIC LEUKEMIA has what in the marrow?

PROLIFERATION OF MONOBLASTS IN BONE MARROW

94

M6 FAB IS WHAT?

ACUTE ERYTHROLEUKEMIA

95

M6-ACUTE ERYTHROLEUKEMIA what are the precursors?

Erythroblasts

96

M7 FAB IS WHAT?

ACUTE MEGAKAROCYTIC LEUKEMIA

97

The WHO classifications are for what and what are they?

Acute myeloid leukemia
1) M:E RATIO MUST BE GREATER THAN 1
2) 20% OR MORE OF NUCLEATED CELLS IN BOTH THE PERIPHERAL BLOOD AND BONE MARROW ARE BLAST CELLS

98

Lymphoid neoplasms are mostly what type of diseases?

DISEASES OF LYMPH NODES AND LYMPH TISSUE RATHER THAN BONE MARROW

99

Chronic lymphocytic leukemia is also called what?

SMALL LYMPHOCYTE LYMPHOMA DEPENDING ON SITE OF NEOPLASM

100

CLL has what type of cells?

MATURE LYMPHOCYTES AND “SMUDGE” CELLS
HIGH WBC COUNTS

101

What is the "INDOLENT” DISEASE OF OLD AGE associated with?

CLL

102

What makes up 30% of leukemias?

CLL

103

BOTH CLL AND HAIRY CELL ARE what CELL DISEASES?

B

104

The is no lymphoid involvement in what type of leukemia?

Hairy cell leukemia

105

Hairy cell leukemia is TARTARIC ACID (TARTRATE) RESISTANT DUE TO what?

ACID PHOSPHATASE ISOENZYME NUMBER 5

106

What are the main two PLASMA CELL NEOPLASMS (DYSCRASIAS)?

Multiple myeloma and waldenstrom

107

ABUNDANCE OF PLASMA CELLS IN BONE MARROW and PLASMA CELLS OFTEN IN CIRCULATION is associated with what?

PLASMA CELL NEOPLASMS (DYSCRASIAS)
Multiple myeloma and waldenstrom

108

HIGH VISCOSITY in multiple myeloma and waldenstrom is DUE TO?

High protein (gamma globulin)

109

Reversed A/G ratio is associated with what?

PLASMA CELL NEOPLASMS (DYSCRASIAS)
Multiple myeloma and waldenstrom

110

IgG OR IgA, BENCEJONES PROTEINS, BONE LESIONS is associated with what?

Multiple myeloma

111

IgM ANTIBODY, NO BONE LESIONS, MORE BLEEDING PROBLEMS is associated with what?

Waldenstroms

112

IF MORE THAN 20% BLASTS, WE CALL THEM what?

Plasma leukemias

113

THE PLASMA CELL MYELOMAS ARE what?

Monoclonal Gammopathies

114

DISEASE OF CHILDHOOD AND ADOLESCENCE?

Burkett's disease

115

What is associated with EPSTEIN-BARR VIRUS?

Burkett's

116

RAPID PROLIFERATION OF CELLS “DIAGNOSTIC EMERGENCY"

Burkett's

117

DISEASE OF LYMPH NODES?

Hodgkin lymphoma

118

What does a LYMPH NODE BIOPSY show in hodgkins?

Reed-sternburg cells

119

Hodgkins is a disease of what age group?

Young adults