Pathology of Hematology (Dept. of Pathology)

Question 1

Two subtypes of RBC disorders

Answer 1

Anemia (inadequate RBC) and polycythemia (excess RBC)

Question 2

What can mean cell volume, mean cell hemoglobin, and red cell distribution width values indicate with regards to the property of the RBCs?

Answer 2

MCV - microcytic, macrocytic, etc.
MCH - hypochromic, hyperchromic, etc.
RDW - percentage of RBC with poikilocytosis

Question 3

Platelet count indicative of thrombocytosis

Answer 3

Anything above 400000 to 450000

Question 4

What is the magic number for leukemia? What is the exception?

Answer 4

20% (ex. >=20% blasts in AML)

Exception: Multiple myeloma (>= 30% blasts, plasmacytosis)

Question 5

Definitive evidence of myeloid differentiation

Answer 5

Presence of Auer rod

Question 6

Disease associated with the “Philadelphia gene” (chromosome 9, 22 translocation)

Answer 6

Chronic myelogenous leukemia (CML)

Question 7

Disease associated with “butt cells”

Answer 7

Acute lymphoblastic leukemia (ALL)

Question 8

Disease associated with “smudge cells”

Answer 8

Chronic lymphocytic leukemia (CLL)

Question 9

Disease associated with rouleaux formation

Answer 9

Multiple myeloma

Question 10

T/F: Neoplasms may arise at any maturation stage involving one or more cell lines

Answer 10

True

Question 11

Define: Hematopoiesis

Answer 11

How blood elements are formed

Question 12

Enumerate the myeloid stem cells

Answer 12

Erythroblast (RBC)
Megakaryoblast (Megakaryocyte)
Myeloblast (Bone Marrow Cell)

Question 13

Enumerate the lymphoid stem cells

Answer 13

Pre B lymphocyte

Pro T lymphocyte

Question 14

Two main subtypes of red cell disorders

Answer 14

Anemias

Polycythemias

Question 15

In aplastic anemia, error occurs at which stage?

Answer 15

Multipotent myeloid stem cell

Question 16

Characteristics of Aplastic Anemia in PBS

Answer 16

Pancytopenia

Question 17

Characteristics of Aplastic Anemia in BM

Answer 17

Hypocellular
Replaced by fat cells
With residual lymphoid tissue

Question 18

Characteristics of Iron Deficiency Anemia in PBS

Answer 18

Hypochromic, microcytic red cells

Question 19

Characteristics of Iron Deficiency Anemia in BMS

Answer 19

Increased erythropoiesis

Question 20

T/F: There is decreased RDW in Iron Deficiency Anemia

Answer 20

False

It is increased!

Question 21

RDW indicates the percentage of RBC with what?

Answer 21

Poikilocytosis (abnormal cellular shape)

Question 22

Two main subtypes of platelet disorders

Answer 22

Qualitative

Quantitative

Question 23

Platelet count for thrombocytosis

Answer 23

> 400 – 450k

Question 24

Normal platelet count in OIF

Answer 24

20 – 25

Question 25

Two main subtypes of WBC disorders

Answer 25

Reactive | Neoplastic

Question 26

T/F: ALL tends to occur among the elderly, while CLL tends to occur in the young.

Answer 26

False It’s the other way around.

Question 27

Subtypes of neoplastic WBC disorders

Answer 27

Myeloid | Lymphoid

Question 28

Myeloid neoplastic WBC disorders

Answer 28

Acute Myeloid Leukemia (AML) Chronic Myelogenous Leukemia (CML) Myelodysplastic Syndrome (MDS)

Question 29

Lymphoid neoplastic WBC disorders

Answer 29

Acute Lymphoblastic Leukemia (ALL) Chronic Lymphocytic Leukemia (CLL) Multiple Myeloma (MM)

Question 30

Maturation pathway of myelopoiesis

Answer 30

1. Myeloblast 2. Promyelocyte 3. Myelocyte 4. Metamyelocyte 5. Band Cell 6. Neutrophil

Question 31

Trend as cell matures in myelopoiesis

Answer 31

N:C ratio decreases

Question 32

Confirmatory evidence that cell is myeloid in origin

Answer 32

Presence of granules

Question 33

Magic number for leukemia

Answer 33

20% (except for CLL)

Question 34

Characteristics of Acute Myeloid Leukemia (AML) in PBS

Answer 34

Increased or decreased WBC Anemia Decreased platelets

Question 35

Characteristics of Acute Myeloid Leukemia (AML) in BMS

Answer 35

>/= 20% blasts

Question 36

Formed by fusion of azurophilic granules and definitive evidence of myeloid differentiation

Answer 36

Auer rods

Question 37

Occurrence of Auer rods

Answer 37

20% of AMLs

Question 38

Difference of Acute Promyelocytic Leukemia (APML) from Acute Myeloid Leukemia

Answer 38

No differentiation past promyelocytic stage

Question 39

Characteristics of Acute Promyelocytic Leukemia (APML) in PBS

Answer 39

Numerous Auer rods

Question 40

Characteristics of Acute Promyelocytic Leukemia (APML) in BMS

Answer 40

Hypercellular | Structural adipose disappears

Question 41

Promyelocyte with multiple Auer rods

Answer 41

Faggot cells

Question 42

Characteristics of Chronic Myelogenous Leukemia (CML) in PBS

Answer 42

Leukocytosis with immature cells

Question 43

Characteristics of Chronic Myelogenous Leukemia (CML) in BMS

Answer 43

Hypercellular with granulocytic and megakaryocytic hyperplasia

Question 44

Definitive diagnosis of CML (95% of cases)

Answer 44

Identification of Philadelphia chromosome t(9,22) via karyotyping

Question 45

T/F: Presence of Philadelphia chromosome is specific for CML

Answer 45

False It is also found in all ALL and occasionally AML.

Question 46

Neoplasm of precursor B- or T- lymphoid cells

Answer 46

Acute Lymphoblastic Leukemia (ALL)

Question 47

Characteristics of Acute Lymphoblastic Leukemia (ALL) in PBS

Answer 47

Increased or decreased WBC Anemia Decreased platelets

Question 48

Characteristics of Acute Lymphoblastic Leukemia (ALL) in BMS

Answer 48

Hypercellular w/ numerous lymphoblasts

Question 49

T/F: You cannot tell the type of leukemia using only BM biopsy.

Answer 49

True

Question 50

Subtle cue pointing to ALL

Answer 50

Presence of butt cells

Question 51

Neoplasm of mature B-lymphoid cells

Answer 51

Chronic Lymphocytic Leukemia (CLL)

Question 52

Characteristic of Chronic Lymphocytic Leukemia (CLL) in PBS

Answer 52

Leukocytosis | Lymphocytosis

Question 53

Characteristic of Chronic Lymphocytic Leukemia (CLL) in BMS

Answer 53

Lymphoid aggregates/infiltrates

Question 54

Subtle cue pointing to CLL

Answer 54

Presence of smudge cells (artifacts of ruptured cells)

Question 55

Neoplasms of plasma cells with production of monoclonal Igs (alpha or kappa chains only)

Answer 55

Multiple myeloma

Question 56

Diagnosis of multiple myeloma

Answer 56

Clinical Radiographic (lytic lesions) Laboratory features

Question 57

Characteristics of Multiple Myeloma (MM) in PBS

Answer 57

Anemia

Question 58

Characteristics of Multiple Myeloma (MM) in BMS

Answer 58

Plasmacytosis (>30%)

Question 59

Characteristics of plasma cells

Answer 59

1. Eccentric nuclei 2. Bluish-violet cytoplasm 3. Clockface appearance of nuclei

Question 60

Seen in conditions with increased plasma fibrinogen or globulins like multiple myeloma

Answer 60

Rouleaux formation

Question 61

Presence of RBC rouleaux is due to this

Answer 61

Increased N-proteins