Question 1

DIC is a paradoxical condition in which clotting and hemorrhage occur within the vascular system simultaneously.

Accepted Answer

Most symptoms are the result of either hemorrhage or thrombosis.

Question 2

RS cells represent malignant transformation and proliferation of:
A)IL-1, IL-2, IL-5, and IL-6.
B)tumor necrosis factor-beta.
C)B cells.
D)T cells.

Accepted Answer

The molecular events causing malignant transformation remain controversial; although RS cells are apparently from B-cell lineage, they express very few B-cell markers and express markers normally not found on B cells.

Question 3

In infectious mononucleosis (IM), what does the Monospot test detect?
A)IgE
B)IgM
C)IgG
D)IgA

Accepted Answer

Heterophile antibodies are a heterogeneous group of IgM antibodies that are agglutinins against nonhuman red blood cells (e.g., sheep, horse) and are detected by qualitative (Monospot) or quantitative methods (heterophile antibody test).

Question 4

A 20-year-old is diagnosed with infectious mononucleosis (IM).Which of the following is one of the classic clinical manifestations?
A)Lymph node enlargement
B)Hepatitis
C)Rash on the trunk and extremities
D)Edema in the area of the eyes

Accepted Answer

At the time of diagnosis the individual usually has the classic triad of symptoms: fever, pharyngitis, and lymphadenopathy of the cervical lymph nodes.

Question 5

The two major forms of leukemia, acute and chronic, are classified by a predominant cell type and the rate at which the affected person develops clinical symptoms.

Accepted Answer

The current classification of leukemia is based on (1) the predominant cell of origin (either myeloid or lymphoid) and (2) the rate of progression, which usually reflects the degree at which cell differentiation was arrested when the cell became malignant (acute or chronic) .

Question 6

In Hodgkin disease and non-Hodgkin lymphoma (NHL), T cell function is severely decreased.

Accepted Answer

Reed-Sternberg (RS) cells do not express immunoglobulin, but do express CD15 (a carbohydrate adhesion molecule found on neutrophils), TARC (a Th2-cell specific chemokine), and T-cell-associated antigens (e.g., b-chain of the T-cell receptor). NHL is best described as a progressive clonal expansion of B cells, T cells, or natural killer (NK) cells.

Question 7

Which of the following is a description consistent with chronic myelogenous leukemia (CML)?
A)There are defects in the ras oncogene, TP53 tumor-suppressor gene, and INK4A, the gene encoding a cell-cycle regulatory protein.
B)The bone marrow and peripheral blood are characterized by leukocytosis and a predominance of blast cells. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
C)There is failure of B cells to mature into plasma cells that synthesize immunoglobulins.
D)The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL.

Accepted Answer

The Philadelphia chromosome is present in more than 95% of CML, and the presence of the BCR-ABL protein is responsible for initiation of CML.

Question 8

In the leukemias, a single progenitor cell undergoes malignant transformation.

Accepted Answer

The common feature of all forms of leukemia is an uncontrolled proliferation of malignant leukocytes, causing an overcrowding of bone marrow and decreased production and function of normal hematopoietic cells.

Question 9

What change is seen in leukocytes during an allergic disorder (type I) often caused by asthma, hay fever, and drug reactions?
A)Neutrophilia
B)Basophilia
C)Eosinophilia
D)Monocytosis

Accepted Answer

Allergic disorders (type I hypersensitivity) associated with asthma, hay fever, and drug reactions, as well as parasitic infections (particularly with metazoal parasites) are often cited as causes.

Question 10

Which of the following is a description consistent with acute lymphocytic leukemia (ALL)?
A)It is a progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood.
B)The bone marrow and peripheral blood are characterized by leukocytosis and a predominance of blast cells. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
C)There is failure of B cells to mature into plasma cells that synthesize immunoglobulins.
D)The translocation of genetic material from genes 9 and 22 create an abnormal, fused gene identified as BCR-ABL.

Accepted Answer

ALL is a progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood.

Question 11

In DIC, a large amount of microvascular and macrovascular occlusion may occur that is not clinically obvious.

Accepted Answer

A large amount of microvascular and macrovascular occlusion may occur that is not clinically obvious.

Question 12

Non-Hodgkin lymphoma may be associated with Epstein Barr virus or HIV.

Accepted Answer

Lymphomas from HIV and EBV have accounted for some of the increase but an actual cause has yet to be determined.

Question 13

Philadelphia chromosome is present in lymph nodes of an individual with Hodgkin disease.

Accepted Answer

Hodgkin disease is characterized by its progression from one group of lymph nodes to another, the development of systemic symptoms, and the presence of RS cells , not the involvement of the Philadelphia chromosome.

Question 14

Which electrolyte imbalance accompanies multiple myeloma (MM)?
A)Hyperkalemia
B)Hypercalcemia
C)Hyperphosphatemia
D)Hypernatremia

Accepted Answer

The common presentation of MM is characterized by elevated levels of calcium in the blood (hypercalcemia).

Question 15

A shift to the left describes the premature release of immature neutrophils when the demand for mature neutrophils exceeds the supply.

Accepted Answer

When the demand for circulating mature neutrophils exceeds the supply, the marrow begins to release immature neutrophils (and other leukocytes) into the blood. Premature release of the immature white cells is responsible for the phenomenon known as a shift to the left or leukemoid reaction.

Question 16

One of the most common causes of disseminated intravascular coagulation (DIC) is sepsis.

Accepted Answer

Sepsis is the most common condition associated with DIC.

Question 17

Arterial thrombi are composed of erythrocytes with larger amounts of fibrin and very few platelets, whereas venous thrombi are composed of mostly platelets held together by fibrin strands.

Accepted Answer

Arterial thrombi form under conditions of high blood flow and are composed mostly of platelet aggregates held together by fibrin strands. Venous thrombi form in conditions of low flow and are composed mostly of red cells with larger amounts of fibrin and few platelets.

Question 18

Which of the following is a description consistent with chronic lymphocytic leukemia (CLL)?
A)There are defects in the ras oncogene, TP53 tumor-suppressor gene, and INK4A, the gene encoding a cell-cycle regulatory protein.
B)The bone marrow and peripheral blood are characterized by leukocytosis and a predominance of blast cells. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
C)There is failure of B cells to mature into plasma cells that synthesize immunoglobulins.
D)The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL.

Accepted Answer

Thus CLL is derived from transformation of a partially mature B cell that has not yet encountered antigen.

Question 19

Early detection of acute leukemia would include which of the following symptoms?
A)Dizziness, dehydration, palpitations, hypotension
B)Dyspnea, paresthesia, malaise
C)Bradycardia, abdominal pain, fever
D)Bruising, fatigue, bone pain, anorexia

Accepted Answer

Signs and symptoms related to bone marrow depression include fatigue caused by anemia, bleeding resulting from thrombocytopenia (reduced numbers of circulating platelets), and fever caused by infection. Anorexia can occur in all varieties of acute leukemia and is associated with weight loss. Pain in the bones and joints is thought to result from leukemia infiltration with secondary stretching of the periosteum.

Question 20

Frequently the initial sign of Hodgkin disease is a painless mass, lump, or swelling, most commonly on the neck.

Accepted Answer

These substances induce infiltration and proliferation of inflammatory cells, resulting in an enlarged, painless lymph node in the neck (often the first sign of Hodgkin disease)

Quiz 27: Alterations of Leukocyte, Lymphoid, and Hemostatic Function

DIC is a paradoxical condition in which clotting and hemorrhage occur within the vascular system simultaneously.

RS cells represent malignant transformation and proliferation of:

In infectious mononucleosis (IM) , what does the Monospot test detect?

A 20-year-old is diagnosed with infectious mononucleosis (IM) .Which of the following is one of the classic clinical manifestations?

The two major forms of leukemia, acute and chronic, are classified by a predominant cell type and the rate at which the affected person develops clinical symptoms.

In Hodgkin disease and non-Hodgkin lymphoma (NHL), T cell function is severely decreased.

Which of the following is a description consistent with chronic myelogenous leukemia (CML) ?

In the leukemias, a single progenitor cell undergoes malignant transformation.

What change is seen in leukocytes during an allergic disorder (type I) often caused by asthma, hay fever, and drug reactions?

Which of the following is a description consistent with acute lymphocytic leukemia (ALL) ?