HEME03 - Leukemias and Lymphomas

  1. The basic pathophysiological mechanisms responsible for producing signs and symptoms in leukemia include all of the following except:




    B)  Decreased erythropoietin production.
  2. Which of the following cells is considered pathognomonic (diagnostic) for Hodgkin's disease?




    C)  Reed Sternberg cells
  3. Waldenstrom's macroglobulinemia is a malignancy of the:




    B)  lymphoplasmacytoid cells
  4. Auer rods may be seen in all of the following except:




    A)  actue lymphoblastic leukemia (L1, L2, L3)
  5. The following laboratory values are seen:
    RBCs 1.90 x 10^6
    Hgb 6.0 g/dL
    Hct 18.5%
    Platelets 130,000
    WBCs 3.0 x 10^3
    WBC differential: 6% PMNs, 50% lymphocytes, 4% monocytes, 40% immature cells, 8 NRBCs/100 WBCs
    Bone Marrow: 50% erythroblasts, some multinucleated megaloblasts, 30% myeloblasts
    Serum B12 and folic acid: low

    These results are most characteristic of:




    C)  Erythroleukemia (M6)
  6. In myelofibrosis, the characteristic abnormal red cell morphology is that of:




    D)  teardrop cells
  7. Name 3 parameters which help distinguish CML from a leukemoid reaction. List the results of each parameter for each condition.
    • jQuery110108024666112654633_1484273480173? (3/5)
    • CML sufferers will have the "philadelphia chromosome" mutation which is not present in "normal" patients.
    • CML will have a high basophil count (seeing multiple basophils in one field should "make you think CML")
  8. (T/F) Chronic lymphocytic leukemia is primarily considered to be a disease of children.
    False
  9. (T/F) A high beta 2 microglobulin level is considered to be predictive of a poor prognosis in a patient with CLL.
    True
  10. A 62 year old man with fatigue and vague abdominal pain for one month had the results shown in the accompanying table:
    WBCs 21.0 x 10^9/L
    Platelets 780 x 10^9/L
    Hgb 9.0 g/dL
    Hct 26.7%
    WBC Differential:
    53% PMNs
    16% bands
    12% lymphocytes
    8% monocytes
    6% metamyelocytes
    3% myelocytes
    2% blasts
    20 NRBCs/100 WBC
    Cytogenetics reveals negative for Philadelphia chromosome.
    RBC Morphology:
    Moderate anisocytosis
    Marked poikilocytosis
    Few bizarre agranular, giant platelets
    Bone Marrow:
    Marked fibrosis
    Increased megakaryocytes
    These values are most suggestive of a diagnosis of:




    D)  Idiopathic myelofibrosis (IMF)
  11. Polycythemia vera is characterized by:




    A)  absolute increase in total red cell mass
  12. In Polycythemia vera (PV), what is characteristically seen in blood?




    D)  pancytosis
  13. A striking feature of the peripheral blood of a patient with CML is:




    A)  profusion of granulocytes at different stages of development
  14. (T/F) Chronic myelogenous leukemia is considered a disease of middle aged adults and is rarely found in children.Many patients carry the Philadelphia chromosome.
    True
  15. Which type of anemia is usually present in a patient with acute leukemia?




    A)  normocytic, normochromic
  16. What is the characteristic finding seen in the peripheral smear of a patient with multiple myeloma?




    D)  rouleaux
  17. All of the following are associated with the diagnosis of multiple myeloma except:




    A)  Philadelphia chromosome
  18. Which of the following parameters does the WHO use for classification of myeloproliferative disorders?




    B)  Cytogenetics and immunophenotyping
  19. An M:E ratio of 10:1 is most often seen in:




    A)  leukemia
  20. Which of the following studies helps distinguish AML from ALL?




    C)  Myeloperoxidase stain
  21. A 22yearold male presented in the ER with lethargy and hepatosplenomegaly. His WBC count was 23,000 with the white cell differential showing 56% blasts. Cytogenetics testing was positive for the Philadelphia chromosome. Flow cytometry indicated the patient was CD10+, CD19+ an TdT+. What is the most likely diagnosis?




    C)  B cell ALL with t(9;22) BCR ABL1
  22. A 17yearold male presented to the ER with a large mediastinal mass, fever, malaise and slight anemia. His white blood cell differential showed 15% blasts. Special tests were MPO negative and Philadelphia chromosome negative. Immunophenotyping revealed TdT+, CD1a+, CD3+ and CD7+. Which is the most likely diagnosis?




    D) T cell ALL
  23. A 49yearold male complained of gum bleeding and skin lesions. His differential showed 80% monoblasts. Cytochemistry was positive for Sudan Black B and nonspecific esterase. Flow cytometry results were positive for MPO, CD13, CD33, CD 17, CD14, CD4, CD11b and c, CD64, CD68, CD36, HLA DR and lysozyme. Which is the most probable diagnosis?




    D)  Acute monoblastic leukemia
  24. The following are stages of chronic myelogenous leukemia EXCEPT:




    D)  Spent phase
  25. Which condition involves panmyelosis in the bone marrow (up to 100% cellularity), an increased count in the peripheral blood of all cell lines (RBCs, WBCs and platelets) and stem cells with increased sensitivity to erythropoietin?




    A)  Polycythemia vera
  26. Which of the following is the cytogenetic abnormality which describes the Philadelphia chromosome?




    D)  t(9;22)
  27. Of which category is chronic myelomonocytic leukemia?




    B)  Myelodysplastic disorder/myeloproliferative neoplasm
  28. What is the difference between CML and atypical CML?




    C)  Absence of Philadelphia chromosome
  29. A 70yearold woman presented with lymphadenopathy and splenomegaly. Her WBC count was 220,000. A peripheral blood smear showed numerous mature appearing lymphocytes and moderate smudge cells. What is the most likely diagnosis?




    B)  B cell CLL
  30. A 65yearold woman presents with lymphadenopathy and massive splenomegaly with a WBC count of 116,000, Hct of 28% and platelet count of 70,000. A peripheral blood smear showed 60% lymphoid cells with prominent nucleoli. What is the most likely diagnosis?




    B) Acute Prolymphocytic leukemia
  31. Multiple myeloma is most difficult to distinguish from:




    A) benign monoclonal gammopathy
  32. Reactive lymphocytes may best be distinguished from blasts by which of the following morphologic characteristics?




    B) Fine chromatin
  33. Image Upload 1






    A) promyelocytes in acute leukemia (M3)
  34. Image Upload 2


    This patient has a white blood cell count of 25,000 with 90% lymphocytes. Select the best possible answer for this condition.




    A)  chronic lymphocytic leukemia
  35. Image Upload 3


    (T/F) The cells in this image are undifferentiated myeloblasts typically seen in acute myeloblastic leukemia without maturation (M1).
    True
  36. Image Upload 4


    Identify the type of cell seen in this image of advanced multiple myeloma.
    Plasma Cell
  37. Image Upload 5


    Use two separate parameters to describe the platelets in this specimen from a patient with myelofibrosis?
    • Agranular platelets
    • Giant platelets
  38. A 70 year old man comes to the lab with routine lab orders for his annual physical. His CBC indicates the following: WBC 40,000, Hgb/Hct 14/43, platelet ct: 204,000. WBC differential revealed 75% lymphocytes and 10% smudge cells. The lymphocytes all appeared mature. What is the most likely diagnosis?
    Chronic Lymphocytic Leukemia
Author
victimsofadown
ID
327373
Card Set
HEME03 - Leukemias and Lymphomas
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HEME03 - Leukemias and Lymphomas
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