Deck 20: Introduction to Hematopoietic Neoplasms

Question 1

Which disease state has Auer bodies present on examination of the blood smear?

A)MDS
B)MPD
C)MDS/MPD
D)AML

Answer 1

AML

Question 2

Which of the following is a complication of leukemia treatment?

A)Increased uric acid levels
B)Graft-versus-host disease
C)DIC
D)All of the above

Answer 2

All of the above

Question 3

Which of the following disorders is characterized by signs of dyshematopoiesis?

A)Acute leukemias
B)Chronic leukemias
C)Myelodysplastic syndromes
D)Myeloproliferative disorders

Answer 3

Myelodysplastic syndromes

Question 4

Which of the following has the best prognosis?

A)ALL in children
B)ALL in adults
C)AML in adults
D)AML in children

Question 5

Which of the following combinations leads to tumor formation?

A)Activation of oncogenes and suppression of proto-oncogenes
B)Activation of proto-oncogenes with concurrent suppression of oncogenes
C)Activation of oncogenes and suppression of tumor suppressor genes
D)Activation of tumor suppressor genes and suppression of proto-oncogenes

Question 6

A routine CBC from a 5-year-old boy shows 90% blasts in peripheral circulation.Cytochemical staining with MPO and SBB was negative.Based on these findings, from what is the patient most likely suffering?

A)AML
B)ALL
C)CML
D)CLL

Question 7

Which progenitor cells normally do not have the capacity for self-renewal?

A)CMP and CLP
B)HSC
C)Somatic cells
D)Primitive hematopoietic precursor cells

Question 8

All of the following have an increased risk of progressing into acute leukemia except:

A)Myeloproliferative disorders.
B)Myelodysplastic syndromes.
C)Refractory anemias.
D)Reactive leukocytosis.

Question 9

In what age group does chronic leukemia usually occur?

A)All ages
B)Children
C)Adults
D)15-20 years of age

Question 10

Which patient population is most affected by acute lymphoblastic leukemia?

A)Children
B)Adults
C)Geriatrics
D)Females

Question 11

Acute leukemias are classified as:

A)Benign neoplasms.
B)Malignant neoplasms.
C)Neoplasms.
D)Benign tumors.

Question 12

An abundance of blasts and some mature forms with an apparent decrease in the intermediate maturational stages is referred to as:

A)Acute lymphoid leukemia.
B)Chronic myelogenous leukemia.
C)Chronic lymphocytic leukemia.
D)Leukemic hiatus.

Question 13

All of the following have been proposed as being leukemogenic except:

A)Therapeutic radiation.
B)Living in high altitudes.
C)Chromosome translocations.
D)Benzene.

Question 14

A patient has a WBC count of 250 x 109/L and the peripheral blood smear contains many granulocytes and granulocytic precursors including 2% blasts.Pending further tests, from what is the patient most likely suffering?

A)A chronic granulocytic leukemia
B)An acute lymphocytic leukemia
C)A chronic lymphocytic leukemia
D)An acute granulocytic leukemia

Question 15

How are oncogenes and proto-oncogenes different?

A)Protooncogenes are activated tumor genes while oncogenes are inactivated tumor suppressor genes.
B)Oncogenes can lead to tumor formation, while proto-oncogenes prevent tumor formation.
C)Oncogenes can lead to tumor formation, while proto-oncogenes are inactivated forms of oncogenes.
D)Oncogenes are tumor suppressors, whereas proto-oncogenes cause tumor formation.

Question 16

Which laboratory test confirms the lineage of hematologic neoplasms?

A)Cytogenetic analysis
B)Immunophenotyping
C)Nuclear staining
D)Bone marrow differential

Question 17

What is the purpose of the induction phase in chemotherapy?

A)To eradicate normal cells
B)To eradicate tumor cells
C)To initiate an immune response against tumors
D)To help the patient tolerate the tumor

Question 18

A malignant neoplasm is best described as which of the following?

A)Clone of normal, proliferating cells
B)Clone of abnormal, anaplastic, proliferating cells that have the potential to metastasize
C)A clone of highly organized, differentiated cells that have the potential to metastasize
D)A clone of highly organized, differentiated cells that do not spread

Question 19

How are the FAB and WHO classifications different with respect to acute leukemias?

A)FAB classifies acute leukemias by lineage morphology, whereas WHO classifies acute leukemias by immunophenotyping.
B)FAB classifies acute leukemias by their precursor conditions, whereas WHO classifies acute leukemias by DNA profiling.
C)Acute leukemia is classified by FAB as having greater than 30% blasts, whereas WHO classifies acute leukemia as having greater than 20% blasts.
D)Both a and c

Question 20

Leukemias can be classified by which of the following?

A)Morphology
B)Lineage
C)Cytogenetic abnormality
D)All of the above

Question 21

What is the difference between the HSC and the cancer stem cell?

Question 22

Which two stains are used to differentiate between the myeloid and lymphoid blasts?

A)MPO and SBB
B)PAS and LAP
C)Acid phosphatase and LAP
D)Toluidine blue and reticulin stain

Question 23

Which of the following cytochemical stains can help differentiate AML from ALL?

A)PAS stain
B)LAP stain
C)MPO stain
D)NSE stain

Question 24

Name the two main classification systems that identify the following leukemias.Indicate how they are different.

A)MDS
B)Acute leukemias

Question 25

Somatic cell chromosome mutations resulting in hematologic neoplasms are associated with:

A)Chemicals, drugs, bacterial infection.
B)Drugs, chemicals, renal disease.
C)Therapeutic radiation, drugs and chemicals.
D)Viral and bacterial infections, autoantibodies.

Question 26

What is/are the common complication(s) of chemotherapy?

A)Bleeding, infection, and anemia
B)Bone marrow rejection
C)Thrombocytosis
D)Refractory anemia

Question 27

How are the HSC and the cancer stem cell similar?

A)Morphology
B)CD markers
C)Cytochemical staining
D)Replicating potential

Question 28

Cell lineage of leukemic blasts can be determined by:

A)Morphology, cytochemical stains, cell concentration.
B)Cytochemical stains, immunophenotyping.
C)Presence of Auer rods and Pappenheimer bodies.
D)Immaturity of cytoplasm and presence of nuclear phi bodies.

Question 29

Bleeding, infections and anemia are common complications of chemotherapy due to:

A)Drugs used kill normal cells as well as leukemic cells.
B)Normal cells are more susceptible to drug-induced apoptosis than leukemic cells.
C)Drugs bind preferentially to normal cells.
D)Drugs induce the formation of autoantibodies to normal cells.

Question 30

TSG, or tumor suppressor gene, plays a role in neoplastic transformation of cells by what mechanism?

A)Suppressing the cellular proliferation and neoplastic transformation
B)Initiating the cellular proliferation
C)Triggering the proto-oncogenes to activate to oncogenes
D)Initiating ttranslocation of genes

Question 31

Explain how proto-oncogenes contribute to tumor formation.

Question 32

A gene involved in regulating the growth of myeloid cells is hypermethylated resulting in a block in transcription.This is an example of malignancy as a result of:

A)Post-translational modification.
B)DNA mutation.
C)Epigenetic change.
D)Genomic instability.

Question 33

A bone marrow differential is performed on a patient suspected of having leukemia.Cytochemical stains are performed.MPO and SBB are negative.Blasts appear homogeneous and small in size.What would you expect to find when performing immunophenotyping?

A)Positive reactivity with immature B cell or T cell markers
B)Positive reactivity with immature myeloid markers
C)Positive reactivity with mature myeloid markers
D)Positive reactivity with plasma cell markers

Question 34

For the following cytochemical stains, indicate: 1.what they stain and 2.disease correlation to a positive result.

A)MPO
B)SBB
C)NSE
D)PAS