Deck 12: Chronic Myeloproliferative Disorders

Question 1

___indicates the transformation of a chronic process to an acute process.

A) An increased WBC count
B) Bone marrow fibrosis
C) The presence of the Philadelphia chromosome
D) An increase in the percentage of blasts in the peripheral blood or bone marrow

Answer 1

D

Question 2

The accelerated phase of chronic myeloid leukemia is marked by:

A) Increased basophils
B) Thrombocytopenia
C) Increase in blasts
D) Increased fibrosis

Answer 2

A

Question 3

Plethora is a condition associated with:

A) Polycythemia vera
B) CML
C) Leukemoid reaction
D) Myelofibrosis

Answer 3

A

Question 4

All of the following are causes of secondary erythrocytosis except:

A) Hypertension
B) Alcohol
C) Sleep apnea
D) Smoking

Question 5

A "dry tap" is a characteristic of myeloid fibrosis with myeloid metaplasia due to:

A) Increased infiltration of blast cells
B) Increased infiltration of abnormal platelets
C) Increased infiltration of abnormal red cells
D) Increased infiltration of fibrotic elements

Question 6

Pancytosis is a prominent feature of which of the following disorders?

A) Chronic myelocytic leukemia
B) Idiopathic myelofibrosis
C) Polycythemia vera
D) Essential thrombocythemia

Question 7

A high-risk factor for the diagnosis of essential thrombocythemia is:

A) A platelet count of greater than 600,000
B) Extramedullary hematopoiesis
C) The presence of BCR/ABL
D) Fibrotic bone marrow

Question 8

A patient has the following CBC results:
WBC count: 35 $\times$ 10⁹/L
Differential:
60 segmented neutrophils
12 lymphocytes
8 metamyelocytes
10 band neutrophils
7 monocytes
3 eosinophils
Platelets: Normal
RBC morphology: Normocytic, normochromic
LAP score: 5
These results are consistent with:

A) Chronic myelocytic leukemia
B) Reaction to severe infection
C) Acute leukemia
D) Polycythemia vera

Question 9

A term describing a peripheral blood finding of leukocytosis with a shift to the left accompanied by occasional nucleated red cells and platelet abnormalities is:

A) Dysplasia
B) Leukoerythroblastic
C) Megaloblastoid
D) Leukemoid

Question 10

What is the pathophysiology of the myeloproliferative disorders?

A) Fibroid infiltration of major organs
B) Neoplastic transformation of multipotential stem cells
C) Widespread deterioration of cellular function
D) Splenic sequestration of normal blood cells

Question 11

Myocardial infarctions, transient ischemic attacks, and deep vein thrombosis are likely to be complications of:

A) Chronic myelocytic leukemia
B) Acute myelocytic leukemia
C) Polycythemia vera
D) Myelofibrosis with myeloid metaplasia

Question 12

The JAK2 chromosomal mutation is associated with:

A) Polycythemia vera
B) CML
C) Leukemoid reaction
D) Myelofibrosis

Question 13

Which of the following is associated with CML but not AML?

A) Infections
B) WBC greater than 20,000
C) Hemorrhage
D) Splenomegaly

Question 14

What effect does the Ph chromosome have on the prognosis of patients with chronic myelocytic leukemia?

A) It is not predictive.
B) The prognosis is better if the Ph chromosome is present.
C) The prognosis is worse if the Ph chromosome is present.
D) The disease usually transforms into AML when the Ph chromosome is present.

Question 15

The red cell morphology associated with IMF is:

A) Burr cells
B) Acanthocytes
C) Teardrop cells
D) Target cells

Question 16

The translocation of genetic material, t9:22, is associated with:

A) The Philadelphia chromosome
B) ALL
C) A leukemoid reaction
D) Polycythemia vera

Question 17

The LAP stain is helpful in distinguishing:

A) A leukemoid reaction from CGL
B) CML from CLL
C) CML from AML
D) CML from ALL

Question 18

To calculate the LAP score on a blood smear:

A) Add the scores for the 100 neutrophils counted
B) Average the scores for all cells counted
C) Add the scores for the 100 leukocytes counted
D) Calculate the percentage of positive reacting cells

Question 19

Tyrosine kinase is an important mediator in leukocyte metabolic pathways because it suppresses:

A) Opsonization
B) Phagocytosis
C) Leukoerythroblastosis
D) Apoptosis

Question 20

When referring to a leukemoid reaction, which of the following is a false statement?

A) Toxic granulation is usually seen.
B) The LAP score is increased.
C) The WBC count shows a shift to the left.
D) Anemia is usually present.

Question 21

Essential thrombocytosis can affect all three cell lines, but the main cell line affected is the:

A) Megakaryocytes
B) Erythrocytes
C) Granulocytes
D) Lymphocytes

Question 22

Chronic myelogenous leukemia will present with less than _blasts in the peripheral blood.

A) 5%
B) 10%
C) 20%
D) 30%

Question 23

All of the following are causes of thrombocytosis except:

A) Malignancy
B) Infection
C) Smoking
D) Blood loss

Question 24

____has the worst prognosis of all the myeloproliferative disorders.

A) Polycythemic vera
B) Essential thrombocythemia
C) Idiopathic myelofibrosis
D) Chronic myelogenous leukemia