Deck 19: Nonmalignant Lymphocyte Disorders

Question 1

An 18-year old patient has a WBC count of 9 x 109/L and 60% lymphs, 30% neutrophils, 6% monocytes, 3% eosinophils and 1% basophils.The following best describes this condition:

A)Relative and absolute neutrophilia.
B)Absolute neutropenia and absolute lymphocytosis.
C)Relative neutropenia and absolute lymphocytosis.
D)Relative lymphocytopenia and relative neutropenia.

Answer 1

Relative neutropenia and absolute lymphocytosis.

Question 2

A 5-year-old patient is suspected of having infectious mononucleosis.The patient's blood smear reveals 55% reactive lymphocytes along with a WBC count of 15 x 10⁹/L.The heterophile antibody test is negative.IgG and IgM antibodies to EBV both come back positive.What is the best explanation for these results?

A)50% of children under the age of 10 do not have a positive heterophile test when infected with EBV.
B)The patient does not have EBV but rather acute lymphoid leukemia.
C)The serologic tests are false positive for IgG and IgM antibodies to EBV.
D)The heterophile test is never positive in children under 10 years of age.

Answer 2

50% of children under the age of 10 do not have a positive heterophile test when infected with EBV.

Question 3

A patient with infectious mononucleosis is having serologic blood tests.Results are as follows: EBVCA IgG: 1:320; EBVCA IgM: not detected; EBNA: 1:20.What stage of infection is the patient in?

A)Acute
B)Recent
C)Past
D)Cannot be determined

Answer 3

Recent

Question 4

A 5-year-old girl has a WBC count of 11 x 109/L with 55% lymphocytes.Which of the following best describes this phenomenon?

A)Absolute lymphocytosis
B)Relative lymphocytosis
C)Normal leukocyte count
D)Absolute lymphocytopenia

Question 5

What is the agent responsible for infectious mononucleosis?

A)Toxoplasmosis
B)CMV
C)EBV
D)Bordetella pertussis

Question 6

The prominent lymphocytosis in whooping cough is due to:

A)An exacerbated immune response.
B)Cell-mediated immunity accompanying a neutrophilia.
C)Redistribution of lymphocytes from the lymphatics into peripheral circulation.
D)Increased cytokine stimulation of lymphopoiesis in the bone marrow.

Question 7

Which of the following is used as a screening test for infectious mononucleosis?

A)Heterophile antibody test
B)EBV IgG and IgM tests
C)HBsAg
D)ANA IFA

Question 8

What characteristics are associated with reactive lymphocytes?

A)Can contain vacuoles, and chromatin pattern is very fine.
B)Can contain vacuoles, deep blue abundant cytoplasm..
C)Nucleus has a fine Chromatin pattern and the N:C ratio is increased.
D)High N:C ratio with small amount of deep blue cytoplasm

Question 9

Which of the following is an expected finding regarding the morphology of an activated lymphocyte that is different from a normal lymphocyte?

A)Oval nucleus
B)Prominent nucleoli
C)Abundant cytoplasm
D)Clumped chromatin

Question 10

The Epstein-Barr virus targets B cells that express _______.Once infected, they cause expression of the_______ marker.

A)CD21; CD23
B)CD23; CD21
C)CD22; CD23
D)CD34; CD19

Question 11

Which of the following cell types is commonly infected by the HIV-1 virus?

A)Cytotoxic T cells
B)CD8 cells
C)CD4 cells
D)Neutrophils

Question 12

Which of the following statements best describes the pathogenesis of HIV infection?

A)HIV virus selectively infects T helper cells, incorporates its own DNA into the DNA of the T helper, and lyses the cell.
B)HIV virus infects all lymphocytes, incorporates its own DNA into the DNA of the T helper, and changes the identity of the T helper.
C)HIV virus infects all cells involved in cell-mediated immunity, incorporates its own DNA into the DNA of the infected cells, and lyses the cells.
D)HIV infects T-suppressor cells and initiates apoptosis.

Question 13

CMV infections complicate transplants by which of the following mechanisms?

A)Formation of antibodies to CMV infected cells which cross-react with stem cells
B)Suppress normal immune function and elicit the formation of autoantibodies that are lymphocytotoxic
C)Impair mitotic division of normal hematopoietic cells and stimulate neoplastic cells to proliferate
D)Stimulate antibodies against RBCs resulting in an autoimmune hemolytic anemia

Question 14

All of the following are expected findings of AIDS except:

A)Lymphocytopenia.
B)Leukocytopenia.
C)Anemia.
D)Thrombocytosis.

Question 15

A 19-year-old male visits his physician because of a persistent cough and progressive fatigue over the last month.Physical examination reveals prominent lymphadenopathy.Laboratory analysis reveals a WBC count of 20x 109/L with 23% reactive lymphocytes.Patient serum is positive for both IgG and IgM antibodies against EBV.Based on this information, what is the patient most likely suffering from?

A)Hodgkin lymphoma
B)Reactive leukocytosis
C)Infectious mononucleosis
D)Malaria

Question 16

Which of the following infectious agents can be transmitted from mother to a growing fetus and can result in physically and mentally impaired development?

A)Bordetella pertussis
B)Toxoplasma gondii
C)Coxsackievirus A
D)Clostridium botulinum

Question 17

Lymphocytosis is found about 1 week after symptoms appear in infectious mononucleosis and lymphocytes remain elevated for 2-8 weeks.What morphologic characteristics are present in the blood smear?

A)Leukemic lymphoblasts
B)Reactive lymphocytes with mild thrombocytopenia
C)Decreased lymphocytes
D)Homogeneous lymphocyte population

Question 18

What are the most common laboratory findings in CMV infection in the newborn?

A)Thrombocytopenia and hemolytic anemia
B)Leukocytosis
C)Positive heterophile agglutinin test.
D)Viral DNA assay is negative.

Question 19

What clinical condition is included in the case definition for HIV infection by the Centers for Disease Control and Prevention?

A)Bordetella pertussis
B)Infectious mononucleosis
C)Kaposi's sarcoma
D)Plasmacytosis

Question 20

Which of the following is expected to decrease as the HIV infection progresses into AIDS?

A)WBC count
B)CD4:CD8 ratio
C)Lymphocyte count
D)All of the above

Question 21

A 42-year-old HIV-positive patient recently was diagnosed with disseminated histoplasmosis.Which of the following should be ordered to monitor this patient's progression?

A)HIV antibody screen
B)HBsAg
C)CBC
D)CD4:CD8 ratio

Question 22

Compare and contrast X-linked SCID and autosomal SCID.

Question 23

Correlate each disorder with the following:
1.population (s) most affected by it;
2.whether it produces a lymphocytosis or lymphocytopenia;
3.morphology associated with each.
4.pathophysiology of the infection.

A)Infectious mononucleosis
B)Whooping cough
C)Toxoplasmosis
D)CMV infection

Question 24

Which of the following disorders is associated with a lymphocytosis?

A)X-linked immunodeficiency syndrome
B)AIDS
C)Whooping cough
D)SCID

Question 25

An unknown patient blood sample has the following results: WBC count = 5 x 109/L with 70% lymphocytes.What term describes this condition? Name a disease in which this is seen.

Question 26

Bordetella pertussis is characterized by rapid peripheral lymphocytosis and decreased cellularity of the lymph nodes.What can explain this phenomenom?

A)Loss of homing of B cells to lymphoid tissues
B)Loss of homing of T cells to lymphoid tissue
C)Abnormal homing of lymphocytes to the bone marrow
D)Increase of L-selectin expression by T cells

Question 27

Correlate antibody titers with the stage of infection.What antibody titer excludes current infection?

Question 28

Diagnosis of an active toxoplasmosis infection is established by what comparison?

A)Molecular tests
B)Heterophile antibody test
C)Biopsy of lymph nodes from various sites
D)Rising titer and seroconversion of antibodies to Toxoplasma gondi

Question 29

Bordetella pertussis and chronic lymphocytic leukemia both have increased small lymphocytes with condensed nuclear chromatin on the blood smear.What laboratory test could distinguish whooping cough from CLL?

A)Heterophile testing
B)Biopsy of lymph nodes
C)Molecular testing
D)Culture and serological antibody testing

Question 30

Name five hematologic findings associated with HIV infections other than lymphocytopenia.

Question 31

What component is responsible for the accumulation of lymphocytes in the blood during a whooping cough infection?

A)Pertussis toxin
B)Leukemoid reaction
C)T lymphocytes
D)VCA-IgG

Question 32

A negative heterophile antibody test in a patient with symptoms of infectious mononucleosis could be due to what factor if the patient is being treated for cancer?

A)Infection by another virus
B)The level of the antibody is not high enough to be detected.
C)Immunosuppressed antibody response
D)CMV infection