Deck 41: Chromosome Analysis of Hematopoietic and Lymphoid Disorders

Question 1

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 1

A source with nucleated cells that can be manipulated into mitosis

Question 2

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

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

Answer 2

Monocytic

Question 3

A 60-year-old patient was admitted to the local hospital presenting with petechiae on his upper torso.Physical examination revealed a thin,pale man.Admission labs came back,and the results revealed the presence of 50% blasts and 25% hypergranular promyelocytes.A bone marrow aspirate was ordered that confirmed the peripheral blood picture.Cytogenetic analysis revealed the following: t (11;17) ( q23;q21).How does 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.

Answer 3

The patient will be resistant to all-trans retinoic acid,so another treatment will be needed.

Question 4

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)It would indicate possible metastasis of the lymphoma to that of other hematopoietic organs.
D)Lymphoma cells are always present in the bone marrow if the patient has minimal residual disease.

Question 5

Which of the following can result in trisomy?

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

Question 6

A patient is receiving chemotherapy for Hodgkin lymphoma.When the treatment ends,a cytogenetic analysis is ordered to determine whether 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 7

A laboratory professional should process a bone marrow aspirate for cytogenetic analysis in a patient with a lymphoma by using which of the following?

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

Question 8

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

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

Question 9

The process of cell division is called:

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

Question 10

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 11

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 12

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 nonviable cell,whereas nondisjunction results in a viable cell.
D)There is no difference between anaphase lag and Nondisjunction.

Question 13

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 14

During the harvesting phase of sample preparation,the cells are arrested in metaphase by:

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

Question 15

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 16

Which specimen would be optimal for studying lymphoma?

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

Question 17

Cytogenetic analysis focuses on:

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

Question 18

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 19

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

A)In the complete cell
B)In the center of the cell
C)On opposite poles of the cell
D)In the nucleolus

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

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

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

Question 22

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

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

Question 23

Monosomy is an example of:

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

Question 24

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 followed by 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

Question 25

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 FISH identify that conventional cytogenetics cannot?

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

Question 26

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

Question 27

A patient is receiving treatment for Hodgkin lymphoma.Six weeks after cessation of the treatment,a cytogenetic analysis is performed.A structural aberration is found.Name the most probable aberration(s),and explain how these may occur..

Question 28

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 29

A 3-year-old girl is confirmed to have ALL by immunophenotyping.She is positive for the CALLA antigen.Cytogenetic analysis results indicate the presence of the Philadelphia chromosome.Which of the following applies to her?

A)A poor prognosis
B)A good prognosis
C)An atypical presentation
D)A tyrosine kinase inhibitor response.

Question 30

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

Question 31

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

Question 32

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 33

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

Question 34

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

A)Deletions on chromosomes 4,10,and 17
B)Translocation on chromosomes 4,10,and 17
C)Trisomies of chromosomes 4,10,and 17
D)Gene translocation at 17q12

Question 35

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