Deck 37: Chromosome Analysis of Hematopoietic and Lymphoid Disorders

Question 1

How should a technician process a bone marrow aspirate for cytogenetic analysis in a patient with a lymphoma?

A)Tissue culture
B)Direct harvest
C)Suspension tissue culture
D)Mitogen stimulation with PHA

Answer 1

Direct harvest

Question 2

Which of the following is an appropriate specimen source for cytogenetic analysis?

A)A source with nucleated cells that can be manipulated into mitosis
B)A source with normal constitutive proteins and nucleic acids
C)A source of cell aggregates
D)Any cell that contains DNA

Answer 2

A source with nucleated cells that can be manipulated into mitosis

Question 3

Which of the following structural aberrations results in loss of an entire chromosomal arm?

A)Inversion
B)Deletion
C)Isochromosome
D)Translocation

Answer 3

Isochromosome

Question 4

What is the main difference between nondisjunction and anaphase lag?

A)Nondisjunction results in a trisomy and monosomy, whereas anaphase lag results in a monosomy only.
B)Nondisjunction results in polyploidy, whereas anaphase lag results in aneuploidy.
C)Anaphase lag results in a non-viable cell, whereas nondisjunction results in a viable cell.
D)There is no difference between anaphase lag and Nondisjunction.

Question 5

How are the cells arrested in metaphase, during the harvesting phase of sample preparation?

A)Incubation with colchicine
B)Fixing with Carnoy's fixative
C)Incubation with KCl
D)Addition of phytohemagglutinin

Question 6

Which of the following terms is used to describe a chromosomal aberration present in a human cell that is a multiple of n?

A)Trisomy
B)Aneuploid
C)Polyploidy
D)Diploid

Question 7

Which of the following represents the location of the chromosomes during metaphase?

A)All over the cell
B)Center of the cell
C)On opposite poles of the cell
D)In the nucleolus

Question 8

The cell cycle contains four phases: G1, S, G2, and mitosis.Which phase must be active to study human chromosomes?

A)S
B)G2
C)G1
D)Mitosis

Question 9

The chromosome abnormality type that results in a daughter cell with an extra chromosome, or trisomy, or a daughter cell with a loss of chromosome is characterized as which of the following?

A)Constitutional aberration or mosaic
B)Numerical aberration
C)Structural aberration
D)Acquired aberration

Question 10

A 60-year-old patient is admitted to the local hospital presenting with petechiae on his upper torso.Physical examination revealed a thin, pale man.Admission labs come back and the results reveal 50% blasts and 25% hypergranular promyelocytes present.A bone marrow aspirate is ordered that confirms the peripheral blood picture.Cytogenetic analysis revealed the following: t (11; 17) (q23; q21).How will this impact the patient's care?

A)The patient has a poorer prognosis because of the chromosomal aberration.
B)The patient has a favorable prognosis because of the chromosomal aberration.
C)The patient will be responsive to all trans-retinoic acid.
D)The patient will be resistant to all trans-retinoic acid, so another treatment will be needed.

Question 11

Which specimen would be optimal for the study of lymphoma?

A)Peripheral blood
B)Amniotic fluid
C)Involved Lymph node
D)Solid tumor biopsy

Question 12

Incubation with ________ stops rapid cell division in metaphase and occurs _______ incubation in hypotonic solution.

A)KCl; after
B)Carnoy's fixative; before
C)Giemsa stain; after
D)Colchicine; before

Question 13

A 42-year-old female patient has a solid tumor in her left lung.The physician has ordered cytogenetic analysis.What type of specimen is needed?

A)Bone marrow aspirate
B)Pleural effusion
C)Peripheral blood
D)Lymph node biopsy

Question 14

Acute myeloid leukemia patients have acquired clonal chromosome aberrations in the leukemic blast cells.One cytogenetic aberration is identified as 11q23 abnormality with a MLL gene rearrangement.What is the typical morphologic feature?

A)Myelocytic
B)Monocytic
C)Lymphocytic
D)Promyelocytic

Question 15

A patient is receiving chemotherapy for Hodgkin's lymphoma.After his treatment ends, a cytogenetic analysis is ordered to see if the treatment was successful.Which of the following would be the most appropriate specimen to collect for this?

A)Bone marrow
B)Lymphoid tissue
C)Peripheral blood
D)Skin biopsy

Question 16

The process of cell division is called:

A)Meiosis.
B)Cell cycle.
C)Mitosis.
D)Allele.

Question 17

Which of the following can result in trisomy?

A)Anaphase lag
B)Nondisjunction
C)Chromosome banding
D)Endomitosis

Question 18

Cytogenetic analysis focuses on:

A)Evaluation of the cell cycle.
B)Chromosome assessment.
C)Mitotic rates.
D)Quantitation of alleles.

Question 19

Why would a bone marrow aspirate be needed as a specimen for cytogenetic analysis in a patient with a lymphoma?

A)Bone marrow aspirate is an optimal source of rapidly dividing cells.
B)Bone marrow cells have good reactivity to colchicine.
C)To monitor possible metastasis of the lymphoma to other hematopoietic organs
D)Lymphoma cells are always present in the bone marrow if the patient has minimal residual disease.

Question 20

The first abnormality described in the lymphomas was in Burkitt lymphoma.This first demonstration of a proto-oncogene that was translocated to a location known to be active in B cell lymphoma, resulting in the activation of the oncogene, was at what heavy chain locus?

A)t(12;21)
B)t(8;14)
C)14q32
D)P13;q22

Question 21

FISH is a molecular technique that can provide important clinical information that conventional cytogenetic analysis might not be able to provide.In CML, what can be identified by FISH and not conventional cytogenetics?

A)Cryptic translocations
B)Nondisjunction
C)Constitutional aberration
D)Acquired aberration

Question 22

A cytogenetic analysis is performed, and the result is: inv (7) (q21q32).Name the structural aberration, and explain how it was formed.

Question 23

Discuss the impact of FISH technology in hematolymphoid disorders and bone marrow transplant recipients.

Question 24

The patient who has the most favorable prognosis with acute lymphoblastic leukemia might have hyperdiploid karyotypes with a chromosome count ranging from 54 to 65 with what concurrence?

A)Concurrent deletions on chromosomes 4, 10, and 17
B)Concurrent translocation on chromosomes 4, 10, and 17
C)Concurrent trisomies of chromosomes 4, 10, and 17
D)Concurrent gene translocation at 17q12

Question 25

A patient is receiving treatment for Hodgkin lymphoma.Six weeks after the cessation of his treatment, a cytogenetic analysis is performed.A structural aberration is found.Name the most probable aberration(s), and explain why they performed it.

Question 26

List at least five indications for performing FISH analysis in patients suspected of having a hematolymphoid disorder.

Question 27

Monosomy is an example of:

A)Polyploidy.
B)Aneuploidy.
C)Nondisjunction.
D)Anaphase lag.

Question 28

A 3-year-old girl is confirmed to have ALL by immunophenotyping.The patient is positive for the CALLA antigen.Cytogenetic analysis results indicate the presence of the Philadelphia chromosome.What does this mean for the patient?

A)The patient has a poor prognosis.
B)The patient has a good prognosis.
C)The patient has an atypical presentation.
D)The patient will be responsive to tyrosine kinase inhibitors.

Question 29

Following a successful bone marrow transplant as treatment for a hematopoietic disorder, what is the term used if the recipient's cells are present with a normal karyotype?

A)Partial engraftment
B)Chimerism
C)Mosaic
D)Aneuploid

Question 30

What is the composition of the nucleotides in the chromosome structure?

A)Phosphate and DNA
B)Ribose, deoxyribose, phosphate, and a base
C)Adenine, thymine, guanine, cytosine, and pyrimidine
D)Uracil and thymine

Question 31

Which of the following chromosomal aberrations is associated with Burkitt's lymphoma?

A)t(9;22)(q34;q11.2)
B)5q- deletion
C)t(8;22)(q24.1;q11.2)
D)14q11.2 aberration

Question 32

A karyotype is a representation of:

A)The molecular structure of DNA.
B)The double-helix structure of DNA.
C)The cell's immunophenotype
D)Chromosome grouping.

Question 33

Describe the steps involved in cytogenetic harvesting and banding, and explain the purpose of each step.

Question 34

The presence of a chimerism after a bone marrow transplant indicates:

A)A rejected transplant.
B)A partial engraftment.
C)A complete engraftment.
D)A successful transplant.

Question 35

The harvest procedure for chromosomal banding is accomplished by first activating the cells into mitosis.The active cells are stopped in metaphase by the addition and incubation of agents capable of disrupting the spindle apparatus.The swelling of the nucleated cells and fixation results in a preparation of final cell suspension on a slide, which is evaluated for quality.If the cells' quality is not optimum, what must be done?

A)Start over with inactivation of the cells.
B)Concentrate or dilute the preparation.
C)Age the preparation by heating overnight.
D)Stain the preparation.