Question 1

The diagnosis of multiple myeloma (MM)depends on:

Accepted Answer

A)  more than 10% plasma cells in the bone marrow. 
B)  a decreased concentration of B lymphocytes. 
C)  excretion of Bence Jones protein. 
D)  increased albumin concentration in serum protein. 
A)  more than 10% plasma cells in the bone marrow. 
B)  a decreased concentration of B lymphocytes. 
C)  excretion of Bence Jones protein. 
D)  increased albumin concentration in serum protein. A

Question 2

DNA hybridization or blotting is the newest technology available and can be used to detect:

Accepted Answer

A)  abnormal gene arrangements. 
B)  mutations in cellular oncogenes. 
C)  increased protein synthesis. 
D)  both a and b 
A)  abnormal gene arrangements. 
B)  mutations in cellular oncogenes. 
C)  increased protein synthesis. 
D)  both a and b D

Question 3

Patients with Waldenström's macroglobulinemia (WM)exhibit abnormally large amounts of:

Accepted Answer

A)  IgM. 
B)  IgG. 
C)  IgE. 
D)  IgA. 
A)  IgM. 
B)  IgG. 
C)  IgE. 
D)  IgA. A

Question 4

When an M spike is observed on serum protein electrophoresis,the suggested sequence of testing includes testing by:

Accepted Answer

A)  immunoelectrophoresis. 
B)  immunofixation. 
C)  flow cytometry. 
D)  both a and b 
A)  immunoelectrophoresis. 
B)  immunofixation. 
C)  flow cytometry. 
D)  both a and b

Question 5

MATCHING
Match the terms with the appropriate definition.

-Polyclonal gammopathy

Accepted Answer

A) Benign or malignant condition that results from a single clone of lymphoid-plasma cells producing elevated levels of a single class and type of immunoglobulin 
B) Condition characterized by the elevation of two or more immunoglobulins by several clones of plasma cells 
A) Benign or malignant condition that results from a single clone of lymphoid-plasma cells producing elevated levels of a single class and type of immunoglobulin 
B) Condition characterized by the elevation of two or more immunoglobulins by several clones of plasma cells

Question 6

Match the types of cryoglobulin with the correct description.

-Type I

Accepted Answer

A) Mixed cryoglobulins in which both constituent immunoglobulins are polyclonal.More than 90% contain IgM rheumatoid factor and IgG.These cryoglobulins are seen in a variety of autoimmune,systemic rheumatic diseases and persistent infections with immune complexes (e.g. ,bacterial endocarditis). 
B) Cryoglobulins composed of a single class;IgM and IgG classes most common;IgA or light-chain,single cryoglobulins seen less frequently.This type constitutes about 25% of cryoglobulins and is generally associated with multiple myeloma,macroglobulinemia,and other,rarer neoplastic proliferations of plasma cells and lymphocytes. 
C) Cryoglobulins consist of two forms.The monoclonal form always has rheumatoid factor activity and usually is an IgM with k light chains.The second form is polyclonal IgG,which reacts with the monoclonal IgM rheumatoid factor. 
A) Mixed cryoglobulins in which both constituent immunoglobulins are polyclonal.More than 90% contain IgM rheumatoid factor and IgG.These cryoglobulins are seen in a variety of autoimmune,systemic rheumatic diseases and persistent infections with immune complexes (e.g. ,bacterial endocarditis). 
B) Cryoglobulins composed of a single class;IgM and IgG classes most common;IgA or light-chain,single cryoglobulins seen less frequently.This type constitutes about 25% of cryoglobulins and is generally associated with multiple myeloma,macroglobulinemia,and other,rarer neoplastic proliferations of plasma cells and lymphocytes. 
C) Cryoglobulins consist of two forms.The monoclonal form always has rheumatoid factor activity and usually is an IgM with k light chains.The second form is polyclonal IgG,which reacts with the monoclonal IgM rheumatoid factor.

Question 7

Fill in the blanks,choosing the correct temperature.
Bence Jones (BJ)proteins are soluble at room temperature,become insoluble near (1)_______,and then resolubilize (dissolve)at (2)________.
A)37° C
B)50° C
C)60° C
D)100° C

Accepted Answer

1,C;2,D
BJ proteins are unusual in their

Question 8

Cryoglobulins are proteins that precipitate at:

Accepted Answer

A)  -18° C. 
B)  -4° C. 
C)  0° C. 
D)  4° C. 
A)  -18° C. 
B)  -4° C. 
C)  0° C. 
D)  4° C.

Question 9

The difference in antibody class between multiple myeloma (MM)and Waldenström's macroglobulinemia (WM)is that the most common form of MM displays _________,but WM displays ____________.

Accepted Answer

A)  IgG;IgM 
B)  IgG;IgD 
C)  IgM;IgG 
D)  IgA;IgM 
A)  IgG;IgM 
B)  IgG;IgD 
C)  IgM;IgG 
D)  IgA;IgM

Question 10

If an IgG spike is observed on a serum electrophoretic pattern,what diagnosis does this suggest?

Accepted Answer

A)  Multiple myeloma (MM) 
B)  Waldenström's macroglobulinemia (WM) 
C)  Acute lymphoblastic leukemia (ALL) 
D)  Hypogammaglobulinemia 
A)  Multiple myeloma (MM) 
B)  Waldenström's macroglobulinemia (WM) 
C)  Acute lymphoblastic leukemia (ALL) 
D)  Hypogammaglobulinemia

Question 11

MGUS is characterized by all the following except:

Accepted Answer

A)  fewer than 10% plasma cells in the bone marrow. 
B)  presence of lytic bone lesions. 
C)  anemia. 
D)  hypercalcemia. 
A)  fewer than 10% plasma cells in the bone marrow. 
B)  presence of lytic bone lesions. 
C)  anemia. 
D)  hypercalcemia.

Question 12

Which laboratory assay has been adopted as a prognostic indicator in multiple myeloma?

Accepted Answer

A)  b2-microglobulin level 
B)  IgG serum concentration 
C)  IgM serum concentration 
D)  IgA serum concentration 
A)  b2-microglobulin level 
B)  IgG serum concentration 
C)  IgM serum concentration 
D)  IgA serum concentration

Question 13

The major growth factor for multiple myeloma (MM)cells is:

Accepted Answer

A)  IL-2. 
B)  IL-6. 
C)  IL-20. 
D)  IL-22. 
A)  IL-2. 
B)  IL-6. 
C)  IL-20. 
D)  IL-22.

Question 14

The most consistent immunologic feature of multiple myeloma (MM)is:

Accepted Answer

A)  constant synthesis of a dysfunctional single monoclonal protein. 
B)  incessant synthesis of immunoglobulin chains of fragments. 
C)  suppression of the synthesis of normal functional antibody. 
D)  all of the above. 
A)  constant synthesis of a dysfunctional single monoclonal protein. 
B)  incessant synthesis of immunoglobulin chains of fragments. 
C)  suppression of the synthesis of normal functional antibody. 
D)  all of the above.

Question 15

Mortality exceeds 50% in patients with multiple myeloma (MM)because of:

Accepted Answer

A)  sepsis. 
B)  renal insufficiency. 
C)  aplastic anemia. 
D)  bone fractures. 
A)  sepsis. 
B)  renal insufficiency. 
C)  aplastic anemia. 
D)  bone fractures.

Question 16

Monoclonal gammopathy of undetermined significance (MGUS)represents (a):

Accepted Answer

A)  monoclonal protein in patients with no features of multiple myeloma (MM)or related malignant disorders. 
B)  disorder that can evolve into a malignant monoclonal gammopathy. 
C)  serum monoclonal protein concentration less than 3 g/dL. 
D)  all of the above. 
A)  monoclonal protein in patients with no features of multiple myeloma (MM)or related malignant disorders. 
B)  disorder that can evolve into a malignant monoclonal gammopathy. 
C)  serum monoclonal protein concentration less than 3 g/dL. 
D)  all of the above.

Question 17

An automated nephelometric assay allows for the quantitation of:

Accepted Answer

A)  k free light chains. 
B)  l free light chains. 
C)  light chains on automated instruments. 
D)  all of the above. 
A)  k free light chains. 
B)  l free light chains. 
C)  light chains on automated instruments. 
D)  all of the above.

Question 18

More than one third of patients with Waldenström's macroglobulinemia (WM)display:

Accepted Answer

A)  hepatomegaly and splenomegaly. 
B)  lymphadenopathy. 
C)  Raynaud's phenomenon. 
D)  all of the above. 
A)  hepatomegaly and splenomegaly. 
B)  lymphadenopathy. 
C)  Raynaud's phenomenon. 
D)  all of the above.

Question 19

Match the types of cryoglobulin with the correct description.

-Type II

Accepted Answer

A) Mixed cryoglobulins in which both constituent immunoglobulins are polyclonal.More than 90% contain IgM rheumatoid factor and IgG.These cryoglobulins are seen in a variety of autoimmune,systemic rheumatic diseases and persistent infections with immune complexes (e.g. ,bacterial endocarditis). 
B) Cryoglobulins composed of a single class;IgM and IgG classes most common;IgA or light-chain,single cryoglobulins seen less frequently.This type constitutes about 25% of cryoglobulins and is generally associated with multiple myeloma,macroglobulinemia,and other,rarer neoplastic proliferations of plasma cells and lymphocytes. 
C) Cryoglobulins consist of two forms.The monoclonal form always has rheumatoid factor activity and usually is an IgM with k light chains.The second form is polyclonal IgG,which reacts with the monoclonal IgM rheumatoid factor. 
A) Mixed cryoglobulins in which both constituent immunoglobulins are polyclonal.More than 90% contain IgM rheumatoid factor and IgG.These cryoglobulins are seen in a variety of autoimmune,systemic rheumatic diseases and persistent infections with immune complexes (e.g. ,bacterial endocarditis). 
B) Cryoglobulins composed of a single class;IgM and IgG classes most common;IgA or light-chain,single cryoglobulins seen less frequently.This type constitutes about 25% of cryoglobulins and is generally associated with multiple myeloma,macroglobulinemia,and other,rarer neoplastic proliferations of plasma cells and lymphocytes. 
C) Cryoglobulins consist of two forms.The monoclonal form always has rheumatoid factor activity and usually is an IgM with k light chains.The second form is polyclonal IgG,which reacts with the monoclonal IgM rheumatoid factor.

Question 20

Patients with multiple myeloma (MM)have defects in ______________ but not in _____________.

Accepted Answer

A)  cellular immunity;humoral immunity 
B)  humoral immunity;cellular immunity 
C)  blood cell multiplication;protein synthesis 
D)  complement;the structure of other protein molecules 
A)  cellular immunity;humoral immunity 
B)  humoral immunity;cellular immunity 
C)  blood cell multiplication;protein synthesis 
D)  complement;the structure of other protein molecules

Exam 27: Immunoproliferative Disorders

The diagnosis of multiple myeloma (MM)depends on:

DNA hybridization or blotting is the newest technology available and can be used to detect:

Patients with Waldenström's macroglobulinemia (WM)exhibit abnormally large amounts of:

When an M spike is observed on serum protein electrophoresis,the suggested sequence of testing includes testing by:

MATCHING Match the terms with the appropriate definition. -Polyclonal gammopathy

Match the types of cryoglobulin with the correct description. -Type I

Fill in the blanks,choosing the correct temperature. Bence Jones (BJ)proteins are soluble at room temperature,become insoluble near (1)_______,and then resolubilize (dissolve)at (2)________. A)37° C B)50° C C)60° C D)100° C

Cryoglobulins are proteins that precipitate at:

The difference in antibody class between multiple myeloma (MM)and Waldenström's macroglobulinemia (WM)is that the most common form of MM displays _________,but WM displays ____________.

If an IgG spike is observed on a serum electrophoretic pattern,what diagnosis does this suggest?

MGUS is characterized by all the following except:

Which laboratory assay has been adopted as a prognostic indicator in multiple myeloma?

The major growth factor for multiple myeloma (MM)cells is:

The most consistent immunologic feature of multiple myeloma (MM)is:

Mortality exceeds 50% in patients with multiple myeloma (MM)because of:

Monoclonal gammopathy of undetermined significance (MGUS)represents (a):

An automated nephelometric assay allows for the quantitation of:

More than one third of patients with Waldenström's macroglobulinemia (WM)display:

Match the types of cryoglobulin with the correct description. -Type II

Patients with multiple myeloma (MM)have defects in ______________ but not in _____________.

An Overview of Immunology

Antigens and Antibodies

Cells and Cellular Activities of the Immune System: Granulocytes and Mononuclear Cells

Cells and Cellular Activities of the Immune System: Lymphocytes and Plasma Cells

Soluble Mediators of the Immune System

Safety in the Immunology-Serology Laboratory

Quality Assurance and Quality Control

Basic Serologic Laboratory Techniques

Point-Of-Care Testing

Agglutination Methods

Electrophoresis Techniques

Labeling Techniques in Immunoassay

Automated Procedures

Molecular Techniques

The Immune Response in Infectious Diseases

A Primer on Vaccines

Streptococcal Infections

Syphilis

Vector-Borne Diseases

Toxoplasmosis

Cytomegalovirus

Infectious Mononucleosis

Viral Hepatitis

Rubella and Rubeola Infections

Acquired Immunodeficiency Syndrome

Hypersensitivity Reactions

Autoimmune Disorders

Systemic Lupus Erythematosus

Rheumatoid Arthritis

Solid Organ Transplantation

Bone Marrow Transplantation

Tumor Immunology

Filters

Fill in the blanks,choosing the correct temperature. Bence Jones (BJ)proteins are soluble at room temperature,become insoluble near (1)_,and then resolubilize (dissolve)at (2)__. A)37° C B)50° C C)60° C D)100° C

The difference in antibody class between multiple myeloma (MM)and Waldenström's macroglobulinemia (WM)is that the most common form of MM displays _,but WM displays ____.

Patients with multiple myeloma (MM)have defects in __ but not in _.