SQs Leukocyte Disorders Flashcards
(157 cards)
1
Q
Inherited leukocyte disorders caused by a mutation in the lamin B receptor.
A
Pelger-Huet anomaly
2
Q
Inherited leukocyte disorder that is one of a group of disorders with mutations in nonmuscle myosin heavy-chain IIA.
A
May-Hegglin anomaly
3
Q
Inherited leukocyte disorders that might be seen in Hurler syndrome.
A
Alder-Reilly anomaly
4
Q
A lysosomal storage disease characterized by macrophages with striated cytoplasm and storage of glucocerebroside.
A
Gaucher disease
5
Q
The neutrophils in chronic granulomatous disease are incapable of producing:
A
Hydrogen peroxide
Hypochlorite
Superoxide
6
Q
Individuals with X-linked SCID have a mutation that affects their ability to synthesize:
A
IL-2 receptor
7
Q
An absolute lymphocytosis with reactive lymphocytes suggests what condition?
A
Viral infection
8
Q
What leukocyte cytoplasmic inclusion is composed of ribosomal RNA?
A
Dohle bodies
9
Q
The expected complete blood count results for women in active labor would include:
A
High total WBC count with a slight shift to the left in neutrophils
10
Q
Which is true of an absolute increase in lymphocytes with reactive morphology?
a. The population of lymphocytes appears morphologically homogeneous.
b. They are usually effector B cells.
c. The reactive lymphocytes have increased cytoplasm with variable basophilia.
d. They are most commonly seen in bacterial infections.
A
C. The reactive lymphocytes have increased cytoplasm with variable basophilia
11
Q
Leukocytosis can be caused by
a. increased movement of immature cells out of the bone marrow’s proliferative compartment
b. increased mobilization of granulocytes from the maturation-storage compartment
c. increased movement of granulocytes from the marginating pool to the circulating pool
A
All of the choices (hehe)
12
Q
Neutrophilia can be related to a variety of conditions or disorders. Select the appropriate conditions.
a. surgery
b. burns
c. stress
A
All of the choices
Surgery
Burns (tissue necrosis)
Stress (physiologic)
13
Q
Charcot-Leyden crystals can be found in the ff. of patients with active eosinophilic inflammation, except:
a. sputum
b. tissues
c. stool
d. AOTC
e. NOTC
A
None of the choices.
14
Q
Monocytosis can be observed in
a. tuberculosis
b. fever of unknown origin
c. rheumatoid arthritis
d. AOTC
e. NOTC
A
All of the choices
15
Q
Neutropenia can be observed in the ff., except:
a. bone marrow injury
b. nutritional deficiency
c. increased destruction and utilization
d. AOTC
e. NOTC
A
None of the choices
16
Q
Indicate the abnormality based on the characteristic stated below:
Precipitated mucopolysaccharides
A
Alder-Reilly inclusions
17
Q
Indicate the abnormality based on the characteristic stated below:
Gigantic peroxidase-positive deposits
A
Chediak-Higashi syndrome
18
Q
Indicate the abnormality based on the characteristic stated below:
Single or multiple pale-blue staining inclusions
A
Dohle body inclusions
19
Q
Indicate the abnormality based on the characteristic stated below:
Dohle body-like inclusions
A
May-Hegglin anomaly
20
Q
What abnormality is being described:
Failure of the nucleus to segment/decreased nuclear segmentation
A
Pelger-Huet anomaly
21
Q
What abnormality is being described:
Dark blue-black precipitates of RNA
A
Toxic granulation
22
Q
What abnormality is being described:
Five or more nuclear segments
A
hypersegmentation
23
Q
What abnormality is being described by the following condition:
Associated with frequent infections in children or young adults
A
Chediak-Higashi syndrome
24
Q
What abnormality is being described by the following condition:
Associated with viral infections and burns
A
Dohle Bodies
25
What abnormality is being described by the following condition:
May be related to a maturational arrest in some acute infections
Pelger-Huet anomaly
26
What abnormality is being described by the following condition:
Associated with a deficiency of vitamin B12 or folic acid
Hypersegmentation
27
What is the appropriate cell type involved in this disorder:
Gaucher disease
A. Neutrophilic series
B. Monocytic-macrophagic series
Monocytic-macrophagic series
28
What is the appropriate cell type involved in this disorder:
Niemann-pick disease
A. Neutrophilic series
B. Monocytic-macrophagic series
Monocytic-macrophagic series
29
What is the appropriate cell type involved in this disorder:
Chediak-higashi syndrome
A. Neutrophilic series
B. Monocytic-macrophagic series
Neutrophilic series
30
What is the appropriate cell type involved in this disorder:
Chronic granulomatous disease
A. Neutrophilic series
B. Monocytic-macrophagic series
Neutrophilic series
31
What is the appropriate cell type involved in this disorder:
Lazy leukocyte syndrome
A. Neutrophilic series
B. Monocytic-macrophagic series
Neutrophilic series
32
Gaucher cells have
a. wrinkled cytoplasm
b. one to three nuclei
c. a deficiency of B-glucocerebrosidase
All of the choices :)
33
A peripheral blood film that shows increased neutrophils, basophils, eosinophils, and platelets is highly suggestive of __________.
Chronic Myelogenous Leukemia (CML)
34
What chromosome abnormality is associated with CML?
t (9;22)
35
A patient has a WBC count of 30x10^9/L and the following WBC differential:
Segmented neutrophils: 38%
Bands: 17%
Metamyelocytes: 7%
Myelocytes: 20%
Promyelocytes: 10%
Eosinophils: 3%
Basophils: 5%
What test would be helpful in determining whether the patient has CML?
Fish positive for BCR/ABL1 fusion
36
A patient in whom CML has previously been diagnosed has circulating blasts and promyelocytes that total 30% of leukocytes. The disease is considered to be in what phase?
Transformation to acute leukemia
37
The most common mutation found in patients with primary polycythemia vera (PV) is:
JAK2 V617F
38
The peripheral blood in polycythemia vera (PV) typically manifests:
erythrocytosis, thrombocytosis, and granulocytosis
39
A patient has a platelet count of 700x10^9/L with abnormalities in the size, shape, and granularity of platelets; a WBC count of 12x10^9/L; and hemoglobin of 11g/dL. The philadelphia chromosome is not present. The most likely diagnosis is:
Essential Thrombocythemia (ET)
40
Complications of essential thrombocythemia include all of the following except:
a. thrombosis
b. hemorrhage
c. seizures
d. infections
d. infections
41
Which of the following patterns is a characteristic of the peripheral blood in patients with PMF?
a. Teardrop-shaped erythrocytes, nucleated, RBCs, immature granulocytes
b. abnormal platelets only
c. Hypochromic erythrocytes, immature granulocytes, and normal platelets
d. Spherocytes, immature granulocytes, and increased number of platelets
A. Teardrop-shaped erythrocytes, nucleated RBCs, immature granulocytes
42
The myelofibrosis associated with PMF is a result of:
Enhanced activity of fibroblasts owing to increased stimulatory cytokines.
43
The most characteristic morphological features of variant lymphocytes include:
a. increased overall size, possibly 1 to 3 nucleoli, and abundant cytoplasm
b. increased overall size, round nucleus, and increased granulation in the cytoplasm
c. segmented nucleus, light-blue cytoplasm, and no nucleoli
d. enlarged nucleus, six to eight nucleoli, and dark-blue cytoplasm
a. increased overall size, possibly 1 to 3 nucleoli, and abundant cytoplasm
44
Match the following with the given choices:
Rieder cells
A. Niemann-pick disease and burkitt lymphoma
B. CLL
C. Leukosarcoma
D. Natural artifact
B. CLL (Chronic Lymphogenous Leukemia)
45
Match the following with the given choices:
Vacuolated lymphocytes
A. Niemann-pick disease and burkitt lymphoma
B. CLL
C. Leukosarcoma
D. Natural artifact
A. Niemann-pick disease and burkitt lymphoma (plus tay sachs disease and hurley syndrome)
46
Match the following with the given choices:
Crystalline inclusions
A. Niemann-pick disease and burkitt lymphoma
B. CLL
C. Leukosarcoma
D. Natural artifact
C. Leukosarcoma
47
Match the following with the given choices:
Smudge cells
A. Niemann-pick disease and burkitt lymphoma
B. CLL
C. Leukosarcoma
D. Natural artifact
D. natural artifact
*Also usually seen in CLL*
48
T cells are
A. lymphocytes
B. monocytes
C. helper or suppressor types
D. Both A and C
D. Lymphocytes & Helper or Suppressor Types
49
B cells are
A. lymphocytes
B. associated with antigen recognition
C. found in thymus and bone marrow
D. AOTC
All of the choices
50
NK cells are classified as
A. macrophages
B. monocytes
C. effector lymphocytes
D. K-type lymphocytes
C. effector lymphocytes
51
Which of the ff. statements is (are) true of T cells?
A. Responsible for humoral responses
B. Responsible for cellular immune responses
C. Responsible for chronic rejection in organ transplantation
D. Both A and B
E. Both B and C
E. Both B and C
52
Which of the ff. statements is (are) true of B cells?
A. Responsible for antibody responses
B. Protect against intracellular pathogens
C. Responsible for chronic rejection in transplantation
D. Both A and B
A. Responsible for antibody responses
53
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:
20%
54
Sudan Black B stains what component of the cell?
Lipids
55
MDSs (Myelodysplastic Syndromes) are common in which age group?
Older than 50 years
56
What is a major indication of MDS in the peripheral blood and bone marrow?
Dyspoiesis (hematopoiesis is ineffective)
57
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
b. Target cells
58
For an erythroid precursor to be considered a ring sideroblast, the iron-laden mitochondira must encircle how much of the nucleus?
1/3
59
According to the WHO classification of MDS, what percentage of blasts would constitute transformation to an acute leukemia?
20%
60
A patient has anemia, oval macrocytes, and hypersegmented neutrophils. Which of the following tests would be most efficient in differential diagnosis of this disorder?
Vitamin B12 and folate levels
61
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
neuropathy
62
In what other hematologic disease does MDS often convert?
AML
63
Chronic myelomonocytic leukemia is classified in the WHO system as:
MDS/MPN
64
In most cases, the diagnosis of lymphoma relies on all of the ff. except:
a. Microscopic examination of affected lymph nodes
b. Immunophenotyping using immunohistochemistry or flow cytometry
c. Molecular or cytogenetic analysis
d. Peripheral blood examination and a complete blood count
d. Peripheral blood examination and a complete blood count
65
The most common lymphoma occurring in young adults is:
Hodgkin lymphoma
66
In a normal lymph node, the medulla includes predominantly:
Plasma cells
67
The t(11;14) is the defining feature of:
Mantle cell lymphoma
68
The immunophenotype of mycosis fungoides is:
An abnormal T cell immunophenotype with expression of CD4 and loss of CD7 antigen
69
What is the major morphologic difference between Hodgkin lymphoma and other B cell lymphomas?
The presence of numerous reactive lymphocytes and only a few malignant cells in Hodgkin lymphoma
70
Which morphologic diagnosis has to be confirmed with molecular studies demonstrating the presence of t(8;14)?
Burkitt lymphoma
71
What is the function of the germinal center?
Generation of B cells producing immunoglobulins with the highest affinity for a particular antigen through the process of somatic mutation
72
Marked paracortical expansion is most commonly seen in:
Dermatopathic lymphadenopathy
73
Monoclonal gammopathy of undetermined significance (MGUS) is best described as:
The presence of monoclonal immunoglobulin in serum with only mild bone marrow plasmacytosis
74
Lymphocytopenia means
a total decrease in lymphocytes
75
The helper subset of T lymphocytes is _________ in AIDS
a. increased
b. decreased
c. not altered
b. decreased
76
Match the given disorder with the following choices.
Radiation exposure
A. lymphocytosis
b. lymphocytopenia
B. lymphocytopenia
77
Match the given disorder with the following choices.
Infectious mononucleosis
A. lymphocytosis
b. lymphocytopenia
A. lymphocytosis
78
Match the given disorder with the following choices.
Cytotoxic drugs
A. lymphocytosis
b. lymphocytopenia
b. lymphocytopenia
79
Match the given disorder with the following choices.
Whooping cough
A. lymphocytosis
b. lymphocytopenia
A. lymphocytosis
80
Match the given disorder with the following choices.
Immune deficiency disorders
A. lymphocytosis
b. lymphocytopenia
b. lymphocytopenia
81
Match the given disorder with the following choices.
Toxoplasmosis
A. lymphocytosis
b. lymphocytopenia
a. lymphocytosis
82
Which of the following characterizes infectious lymphocytes?
a. an adult disorder
b. leukocytopenia in the early stages
c. lymphocyte differential counts over 95%
d. lymphoblasts on the peripheral blood smear
c. lymphocyte differential counts over 95%
83
AIDS is caused by
HIV-1
84
A definition of leukemia could include
a. an overproduction of leukocytes
b. solid, malignant tumors of the lymph nodes
c. malignant cells trespass the blood-brain barrier
d. both A and C
e. AOTC
d. both A and C
85
Descriptive terms for most lymphomas can include
a. a nonneoplastic proliferative disease
b. a solid malignant tumor of the lymph nodes
c. a lymphocytopenia
d. freely trespassing the blood-brain barrier
b. a solid malignant tumor of the lymph nodes
86
An acute leukemia can be described as being
of short duration with many immature leukocyte forms in the peripheral blood
87
The etiological agents of leukemias can include
a. ionizing radiation
b. certain infectious agents
c. chemical exposure to benzene
d. AOTC
d. All of the choices
88
HIV is associated with
AIDS
89
The incidence of leukemia is higher in _______.
Scandinavian versus Japanese populations
90
Which of the following are typical characteristics of an acute leukemia?
a. replacement of normal marrow elements by leukocytic blasts and bleeding episodes
b. blasts and immature leukocyte forms in the peripheral blood and anemia
c. leukocytosis
All of the choices :)
91
Match the type of leukemia with its FAB classifications
Myeloid and monocytic
M4
92
Match the type of leukemia with its FAB classifications
Monocytic
M5
93
Match the type of leukemia with its FAB classifications
Myeloid without maturation
M1
94
Match the type of leukemia with its FAB classifications
Lymphoblastic (one cell population)
L1
95
Characteristics of FAB M1 include ...
Leukocytosis without maturation of the myeloid cell line in the peripheral blood
96
The incidence of FAB M1 is high in _______.
children younger than 18 months of age and middle-aged adults
97
Match the following predominant peripheral blood cell morphological appearances with its FAB classification
A mixture of myeloid and monocytic blasts
FAB M4
98
Match the following predominant peripheral blood cell morphological appearances with its FAB classification
Blasts of the monocytic type
FAB M5
99
Match the following predominant peripheral blood cell morphological appearances with its FAB classification
Many coarsely granular promyelocytes with dumbbell-shaped or bilobed nuclei
FAB M3
100
Match the following predominant peripheral blood cell morphological appearances with its FAB classification
Myeloblasts, promyelocytes, and myelocytes
FAB M2
101
Match the following predominant peripheral blood cell morphological appearances with its FAB classification
Immature leukocytic and erythrocytic cell types
FAB M6
102
FAB classification:
Leukemia secondary to burkitt lymphoma
FAB L3
103
FAB classification:
Childhood lymphoblastic leukemia
FAB L1
104
FAB classification:
Older children and adults
FAB L2
105
Chloromas are associated with
FAB M1
106
A common characteristic of ALL is
bone and joint pain
107
Chromosomal alterations with the appropriate FAB type:
t(15q+;17q)
FAB M3
108
Chromosomal alterations with the appropriate FAB type:
t(8q-;21q+)
FAB M2
109
Chromosomal alterations with the appropriate FAB type:
t(9;22)
FAB ALL
110
Cytochemical stain with the appropriate constituent:
Sudan black B
Lipids
111
Cytochemical stain with the appropriate constituent:
Myeloperoxidase
Enzymes
112
Cytochemical stain with the appropriate constituent:
PAS
Glycogen
113
The Sudan Black B cytochemical stain differentiates
acute myeloid from ALL
114
Myeloperoxidase differentiates
acute myelomonocytic from acute monocytic leukemia
115
The PAS reaction is
positive in the neutrophilic granulocytes, except blasts
116
Esterase (naphthol AS-D chloracetate) differentiates
granulocytic (promyelocytic to segmented neutrophils) from the monocytic line
117
In the nonspecific esterase staining reaction, the cells of monocytic origin are
strongly positive
118
Specific nature B-cell surface marker(s) membrane is
CD 79a, CD19, CD20
119
Patients with AML have a good prognosis is
Less than 45 years of age
Over rods are present in blast cells
Ph chromosome
120
The most common form of chronic leukemia in Western countries is
lymphocytic
121
CLL is classically a
null cell disorder
122
CLL symptoms frequently include
absolute lymphocytosis, malaise, and low-grade fever
123
Characteristics of malignant lymphoma typically include
Overproliferation of lymphoctes and lymph node involvement
124
A lymphoma characterized by Reed-Sternberg cells and occurs more frequently in males than in females
Hodgkin disease
125
Rare forms of lymphoma
Non-hodgkin lymphoma and mycosis fungoides
126
A disorder of plasma cells
multiple myeloma
127
The abnormal protein frequently found in the urine of persons with multiple myeloma is
Bence jones
128
Waldenstrom macroglobulinemia is characterized by increased levels of
IgM
129
What cluster designations are positive in typical HCL?
CD25, CD22, CD19, CD20
130
Myeloproliferative neoplasms are characterized by all of the following except
a. clonal disorders
b. they may evolve into acute leukemia
c. initial increase of immature cells
d. increased production of mature cells
c. initial increase of immature cells
131
In CML, the total leukocyte count is
extremely increased
132
Primary myelofibrosis differs from other types of MPN in which of the following ways?
Marrow fibrosis is greatly increased
133
A remarkable characteristic of PV compared with other types of MPNs
Extremely increased erythrocyte mass
134
Predominant feature of essential thrombocythemia compared with other types of MPNs
extremely increased number of platelets
135
In MPN, the test results of disorders of hemostasis and coagulation that are most likely to be abnormal are:
Increased APTT, decreased factor V level, and increased concentration of antithrombin III in many
136
Interferon alfa has been shown to
suppress proliferation of hematopoietic progenitor cells
137
A leukemia of long duration that affects the neutrophilic granulocytes is referred to as
CML
138
The alkaline phosphatase cytochemical staining reaction is used to differentiate between
CML and severe bacterial infections
139
Patients with the initial phase of CML are prone to
low-grade fevers, night sweats, and splenic infarction
140
The total leukocyte count in CML usually is ______x10^9/L
>50
141
The philadelphia chromosome is typically associated with
CML
142
Patients with PV suffer from
hypervolemia
143
Hyperviscosity can produce
dizziness
144
The major criteria for diagnosis of PV include all of the following except
a. increased red blood cell mass
b. presence of JAK2V617F
c. hypercellular bone marrow
d. splenomegaly
d. splenomegaly
145
Increased blood viscosity in patients with PV can cause a dangerous condition of
vascular occlusion
146
The level of erythropoietin in the urine is ________ in patients with PV compared with other kinds of polycythemia
decreased
147
Patients with PV demonstrate an _________ of hemosiderin in the bone marrow
absence
148
Life expectancy after diagnosis of treated patients with PV
More than 10 years
149
Primary treatment for PV
therapeutic phlebotomy
150
Primary myelofibrosis is also called
agnogenic myeloid metaplasia
151
Incidence of primary myelofibrosis is known to increased after exposure to
benzene
152
Predominant clinical manifestation of primary myelofibrosis
anemia, splenomegaly, medullary fibrosis
153
Most constant feature of primary myelofibrosis
dysmegakaryocytopoiesis
154
Least common form of MPN
essential thrombocythemia
155
Major criterion for the diagnosis of essential thrombocythemia
persistent increase of platelets in the peripheral blood
156
Most common disorder in patients with essential thrombocythemia
neurological manifestations
157
The bone marrow architecture in essential thrombocythemia is similar to the architecture seen in
CML
