Question 1

Which of the following findings is a diagnostic criterion for monoclonal gammopathy of undetermined significance?&#10;A) Serum monoclonal protein greater than 3 g/dL&#10;B) Plasma cell count lower than 10% of total cells in bone marrow&#10;C) Increased calcium in the blood&#10;D) Presence of CRAB features

Accepted Answer

The diagnostic criteria for monoclonal gammopathy of undetermined significance (MGUS) include serum monoclonal protein level less than 3 g/dL, bone marrow plasma cell count of less than 10%, no evidence of end-organ damage (CRAB features), and absence of other plasma cell disorders. Option A (serum monoclonal protein greater than 3 g/dL) is actually a diagnostic criterion for multiple myeloma. Option C (increased calcium in the blood) and option D (presence of CRAB features) are also diagnostic criteria for multiple myeloma and do not apply to MGUS.

Question 2

Which of the following is not a characteristic in the identification of lymphoma of B-cell origin?&#10;A) Surface immunoglobulins&#10;B) Cell-surface proteins CD19 and CD20&#10;C) Rearrangement of immunoglobulin genes&#10;D) Presence of CD14 and CD15

Accepted Answer

Presence of CD14 and CD15 are not characteristics in the identification of lymphoma of B-cell origin. CD19, CD20, surface immunoglobulins, and rearrangement of immunoglobulin genes are commonly used to identify B-cell lymphomas.

Question 3

What is the correct order of protein migration,starting at the cathode and moving to anode,following serum protein electrophoresis?&#10;A) Albumin, gamma, alpha 1, alpha 2, beta&#10;B) Albumin, alpha 1, alpha 2, beta, and gamma&#10;C) Gamma, beta, alpha 2, alpha 1, albumin&#10;D) Beta, gamma, alpha 2, and alpha 1, albumin

Accepted Answer

Gamma, beta, alpha 2, alpha 1, albumin

Question 4

Malignant plasma cells exhibiting CD38,CD56,and CD138 are found in:&#10;A) Waldenstr&#246;m macroglobulinemia.&#10;B) chronic myeloid leukemia.&#10;C) multiple myeloma.&#10;D) monoclonal gammopathy of undetermined significance.

Accepted Answer

Malignant plasma cells exhibiting CD38, CD56, and CD138 are characteristic of multiple myeloma, while the other listed conditions do not exhibit these specific markers.

Question 5

Which cytogenetic abnormality is associated with an excellent prognosis in children with B-cell acute lymphoblastic leukemia (ALL)?&#10;A) t(12:21)(p13;q22)&#10;B) t(14:18)(p13;q22)&#10;C) t(9;22)&#10;D) Hypodiploidy

Accepted Answer

The cytogenetic abnormality t(12:21)(p13;q22) is associated with an excellent prognosis in children with B-cell acute lymphoblastic leukemia (ALL), with a 5-year event-free survival rate of over 90%. This abnormality results in the fusion of the ETV6 and RUNX1 genes, which is thought to contribute to the favorable prognosis by promoting differentiation of the leukemic cells. The other options, t(14:18)(p13;q22), t(9;22), and hypodiploidy, are associated with poorer prognoses.

Question 6

A patient whose malignant clone is positive for the CD markers CD15 and CD30 is most likely to have what clinical disease?&#10;A) Non-Hodgkin lymphoma&#10;B) Hodgkin lymphoma&#10;C) Acute lymphocytic leukemia&#10;D) Hairy-cell leukemia

Accepted Answer

CD15 and CD30 are typically expressed by Reed-Sternberg cells in Hodgkin lymphoma, making it the most likely clinical diagnosis for a patient with a malignant clone positive for these markers. Negative for CD marker CD20 eliminates Non-Hodgkin lymphoma as a possibility. CD markers specific to acute lymphocytic leukemia and hairy-cell leukemia are not mentioned.

Question 7

Which marker is highly specific for hairy-cell leukemia?&#10;A) CD19&#10;B) CD20&#10;C) CD25&#10;D) CD103

Accepted Answer

CD103 is highly specific for hairy-cell leukemia and has been found to have sensitivity and specificity of 86% and 95%, respectively. CD19 and CD20 are markers commonly expressed on B-cells and are not specific for hairy-cell leukemia. CD25 is also expressed on other B-cell malignancies and is not highly specific for hairy-cell leukemia.

Question 8

Which statement regarding myelogenous leukemias is true?&#10;A) They originate from a common colony-forming cell line.&#10;B) They originate from a common myeloid precursor cell.&#10;C) They originate from a common erythroid precursor cell.&#10;D) They originate from a common megakaryocytic precursor cell.

Accepted Answer

Myelogenous leukemias, also known as myeloid leukemias, originate from a common myeloid precursor cell, which can differentiate into various types of blood cells including red blood cells, platelets, and immune cells. This is different from lymphocytic leukemias, which originate from a common lymphoid precursor cell.

Question 9

Which type of gene is required for cell growth and division but can cause malignant transformation when altered?&#10;A) Tumor suppressor gene&#10;B) Proto-oncogene&#10;C) Anti-tumor gene&#10;D) Immunoglobulin gene

Accepted Answer

Proto-oncogenes are genes that regulate cell growth and division, but when altered or mutated, they can become oncogenes and lead to malignant transformation and cancer. Tumor suppressor genes, on the other hand, inhibit cell growth and division and prevent the development of tumors. Anti-tumor genes are not a recognized category of genes, and immunoglobulin genes are involved in the production of antibodies by the immune system, but not in cell growth and division or cancer development.

Question 10

A patient's immunofixation electrophoresis shows excessive amounts of free monoclonal light chains.These light chains are referred to as:&#10;A) Bence Jones proteins.&#10;B) precipitated immunoglobulin A&#10;C) albumin.&#10;D) alpha-1 antitrypsin.

Accepted Answer

Excessive amounts of free monoclonal light chains found on immunofixation electrophoresis are referred to as Bence Jones proteins.

Deck 18: Immunoproliferative Diseases