Question 1

Patients with CLL:

Accepted Answer

Patients with CLL often develop hypogammaglobulinemia, which predisposes them to recurrent infections.

Question 2

The most characteristic change seen in the peripheral smear of a patient with multiple myeloma is the presence of:

Accepted Answer

Rouleaux formation, where red blood cells stack together like a roll of coins, is a characteristic finding in the peripheral blood smear of patients with multiple myeloma. This is due to the high serum protein concentration, particularly immunoglobulins, which alters the red blood cells' ability to repel each other.

Question 3

All of the following are related to the pathophysiology of multiple myeloma except:

Accepted Answer

Increased levels of tyrosine kinase activity are more commonly associated with other types of cancers, such as chronic myeloid leukemia (CML), rather than with the pathophysiology of multiple myeloma. Multiple myeloma is characterized by the proliferation of plasma cells in the bone marrow, activation of osteoclasts leading to bone lesions, and the production of abnormal monoclonal proteins.

Question 4

Which of the following statements is true about chronic lymphoproliferative disorders?

Accepted Answer

Chronic lymphoproliferative disorders are more commonly seen in elderly patients and are characterized by a slow progression. These disorders involve the accumulation of lymphocytes, a type of white blood cell, over time.

Question 5

Russell bodies are associated with:

Accepted Answer

Russell bodies are eosinophilic, large, homogeneous immunoglobulin-containing inclusions usually found in plasma cells, and they are commonly associated with multiple myeloma.

Question 6

A significant feature of hairy cell leukemia not seen is other acute leukemias is:

Accepted Answer

Hairy cell leukemia is characterized by pancytopenia, which involves a reduction in the number of red and white blood cells, as well as platelets. This is a distinctive feature not typically seen in other forms of acute leukemia, which may show different patterns of blood cell counts.

Question 7

The TRAP stain is useful in the diagnosis of:

Accepted Answer

TRAP (tartrate-resistant acid phosphatase) stain is particularly useful in the diagnosis of hairy cell leukemia, as it helps to identify the characteristic hairy cells that are resistant to the tartrate.

Question 8

Which of the following genetic alterations is associated with a poor prognosis in CLL?

Accepted Answer

Trisomy 12 is associated with a poor prognosis in Chronic Lymphocytic Leukemia (CLL). It is one of the genetic alterations that can affect the course and treatment response of the disease.

Question 9

The immunoglobulin responsible for secondary immunological response and a monoclonal over-production in multiple myeloma is:

Accepted Answer

IgG is the immunoglobulin primarily responsible for the secondary immune response and is also the type of immunoglobulin that is most commonly overproduced in the condition known as multiple myeloma.

Question 10

The CD markers associated with CLL include all of the following except:

Accepted Answer

CD 4 is not associated with CLL; it is a marker for T-helper cells. CLL is typically associated with CD 19 and CD 20, which are B-cell markers.

Question 11

All of the following are consistent with the clinical and pathological picture of Waldenström's macroglobulinemia except:

Accepted Answer

Waldenström's macroglobulinemia is characterized by an M spike due to IgM, lymphadenopathy and splenomegaly, and proliferation of lymphocytes and plasmacytoid lymphocytes. Destructive bone lesions are more characteristic of multiple myeloma, not Waldenström's macroglobulinemia.

Question 12

Lymphoma cells in the peripheral smear are associated with:

Accepted Answer

The answer of Lymphoma cells in the peripheral smear are...

Question 13

An abnormal proliferation of B lymphocytes seen in lymph node biopsy with a morphology resembling an owl's eye is commonly associated with:

Accepted Answer

The description of cells resembling an owl's eye is characteristic of Reed-Sternberg cells, which are a hallmark of Hodgkin's disease. These cells are a type of abnormal B lymphocyte.

Question 14

A peripheral blood picture dominated by mature lymphocytes that resemble nucleated red blood cells would most likely be seen in:

Accepted Answer

CLL, or Chronic Lymphocytic Leukemia, is characterized by an increased number of mature lymphocytes in the peripheral blood, which can resemble nucleated red blood cells.

Question 15

All of the following describe characteristics of a plasma cell except:

Accepted Answer

Plasma cells are characterized by having an abundant, basophilic (dark blue) cytoplasm due to the presence of rough endoplasmic reticulum needed for antibody production, not very little, light blue cytoplasm.

Question 16

A new treatment for multiple myeloma that was once banned from use in pregnant women is:

Accepted Answer

Thalidomide was once banned from use in pregnant women due to its association with severe birth defects when it was used as a treatment for morning sickness. It has since been found to be effective in treating multiple myeloma, a type of cancer, under strict controls.

Question 17

Hypogammaglobulinemia is a significant feature in half of patients with CLL.This complication can lead to:

Accepted Answer

Hypogammaglobulinemia in CLL patients can lead to increased susceptibility to infections due to the decreased production of immunoglobulins. Autoimmune hemolytic anemia (AIHA) is a known complication of CLL, where the immune system mistakenly attacks and destroys red blood cells, leading to anemia. This is not directly caused by hypogammaglobulinemia but is related to the underlying immune dysregulation in CLL.

Question 18

Which of the following statements about Hodgkin's disease is false?

Accepted Answer

Hodgkin's disease, also known as Hodgkin's lymphoma, is not a precursor to T-cell lymphoma. Instead, it is characterized by the presence of Reed-Sternberg cells. The other statements are true: it has a bimodal age distribution peaking at 15-40 years and again in older age, it is more common in males, and there is an association with Epstein-Barr virus exposure.

Quiz 13: Lymphoproliferative Disorders and Related Plasma Cell Disorders