WBC 2

Question 1

Which chromosomal abnormality is a good prognosticc indicator in ALL?

Answer 1

t(12;21)

Question 2

Most important differentiating criterion for chronic vs acute leukemias:

Answer 2

Number of blast cells

Elevated (>20) in acute
Decreased in chronic

Question 3

(+) tartrate-resistant acid phosphatase (TRAP)

Answer 3

Hairy cell leukemia

Question 4

Manifestation as an ADULT or presence of Philadelphia chromosome is a POOR prognostic indicator of what?

Answer 4

ALL

Philadelphia chromosome is usually associated with CML

Question 5

CNS + testicular enlargement is a manifestation of:

Answer 5

ALL

Question 6

AML classification with inv(16) as chromosome abnormality

Answer 6

M4

Question 7

AML classification with hypergranular promyelocytes

Answer 7

M3

Question 8

Massive splenomegaly and splenic rupture most associated with this leukemia

Answer 8

Hairy cell leukemia

Question 9

4 y/o patient with ALL is positive for which?

PAS
CD5
Myeloperoxidase
or Auer rods

Answer 9

The answer is PAS

CD5 is only positive in Pre-T ALL. The patient has Pre-B ALL (4 year old patient!!!)

Myeloperoxidase is positive in AML not ALL.

Auer rods are present in AML not ALL.

PAS is positive in ALL not AML because it indicates lymphoblasts.

Question 10

Chloroma seen in which AML type?

Answer 10

M1 and M2

Question 11

Filamentous projections on WBC surface

Answer 11

Hairy cell leukemia

Question 12

AML classification with chromosome malformation of t(15;17)

Answer 12

M3

Question 13

Gums and skin manifestation in AML types:

Answer 13

M4, M5

Question 14

Stem cell disorders leading to ineffective hematopoiesis

Answer 14

Myelodysplastic syndrome (MDS)

Question 15

MPD (Myeloproliferative disorder) specific for megakaryocytes

Answer 15

Myelofibrosis

Question 16

AML classification with DIC as a common presentation

Answer 16

M3

Question 17

Triad of:
calvarian bone defects
diabetes insipidus
exophthalmos

Answer 17

Hand-Schuller-Christian disease (LCH)

Question 18

Plasma cell dyscrasia featuring increase of ___ chain fragment of IgG

Answer 18

heavy

Answer = heavy chain disease

Question 19

MDS has an increased risk of developing into:

Answer 19

AML

Question 20

AML classification with (+) NONSPECIFIC ESTERASE and monocyte involvement

Answer 20

M5

Question 21

Special stains:

nonspecific esterase = ?
myeloperoxidase = ?
PAS = ?

Answer 21

nonspecific esterase = monoblast
myeloperoxidase = myeloblasts
PAS = lymphoblasts

Question 22

These are needle-like clumps of cytoplasmic granular material present in AML and myelodysplastic syndromes

Answer 22

Auer rods

Found in AML myeloblasts, not in ALL lymphoblasts

Question 23

Grape cells or Mott cells are seen in

Answer 23

Multiple myeloma

Question 24

Plasma cell dyscrasia with increased M protein but no signs and symptoms

Answer 24

MGUS

Monoclonal gammopathy of undetermined significance

Question 25

Affects middle-aged males > females

Answer 25

Hairy cell leukemia

Question 26

MPD (Myeloproliferative disorder) with positive Philadelphia chromosome

Answer 26

CML bcr-abl transformation leads to increased cell division and inhibition of apoptosis

Question 27

Pseudo Pelger-Huet neutrophils are mostly associated with:

Answer 27

MDS

Question 28

AML classification (-) peroxidase and (+) myeloid Ag

Answer 28

M1

Question 29

AML classification that is responsive to all-trans retinoic acid

Answer 29

M3

Question 30

Fried egg/honeycomb appearance of bone marrow

Answer 30

Hairy cell leukemia

Question 31

JAK2 mutation is implicated in this MPD (Myeloproliferative disorder)

Answer 31

ALL except CML Especially PVera

Question 32

Russels bodies found in

Answer 32

multiple myeloma

Question 33

TK mutation is common pathogenic feature of this group of disorders

Answer 33

Myeloproliferative disorders

Question 34

AML classification with Auer rods

Answer 34

M3 > M2

Question 35

Treatment of CML

Answer 35

imatinib bcr-abl TK inhibitor

Question 36

Proliferative disorders of dendritic cells from monocyte lineage

Answer 36

Langerhans cell histiocytosis

Question 37

RARA gene mutation is associated with

Answer 37

M3 variant of AML

Question 38

Bence Jones protein is positive in individuals with

Answer 38

Multiple myeloma

Question 39

Plasma cell dyscrasia featuring increase of B cell and plasma cell with resultant increase in IgM leading to increased blood viscosity

Answer 39

Waldenstrom macroglobulinemia

Question 40

AML classification showing dysplastic erythroid precursors

Answer 40

M6

Question 41

MPD (Myeloproliferative disorder) showing increased hematopoiesis due to sensitivity to growth factors

Answer 41

Polycythemia vera

Question 42

Soap bubble appearance on x-ray

Answer 42

Multiple myeloma

Question 43

Fever + development of cutaneous lesions resembling seborrheic erruptions

Answer 43

Probably Letterer–Siwe LCH infections like otitis media and mastoiditis also seen

Question 44

Myasthenia gravis + mediastinal mass =

Answer 44

thymoma

Question 45

M-spike (increased IgG) suggests

Answer 45

Multiple myeloma

Question 46

Dutcher bodies are found in

Answer 46

multiple myeloma

Question 47

MPD (Myeloproliferative disorder) with teardrop cells (dacryocytes) in PBS

Answer 47

Myelofibrosis Bone marrow is crying because it's fibrosed.

Question 48

Absent or decreased alkaline phosphatase

Answer 48

CML Due to immature granulocytes

Question 49

Rouleaux formation seen in this blood disorder

Answer 49

Multiple myeloma Results in increased ESR

Question 50

LCH entity which is rapidly fatal

Answer 50

Letterer–Siwe disease or multifocal unisystem

Question 51

Most benign LCH entity

Answer 51

eosinophilic granuloma or unifocal

Question 52

Ringed sideroblasts are found in

Answer 52

MDS