Question 1

What is the benefit of plasmapheresis used for treating patients with Waldenström's macroglobulinemia?

Accepted Answer

A)  Removes IgM from circulation 
B)  Removes IgG from circulation 
C)  Removes IgA from circulation 
D)  Removes IgD from circulation 
E)  Removes IgE from circulation 
A)  Removes IgM from circulation 
B)  Removes IgG from circulation 
C)  Removes IgA from circulation 
D)  Removes IgD from circulation 
E)  Removes IgE from circulation A

Question 2

Myeloma cells may diffusely infiltrate organs such as the __________ resulting in enlargement and dysfunction.

Accepted Answer

A)  Liver 
B)  Spleen 
C)  Kidney 
D)  All of the above 
E)  None of the above 
A)  Liver 
B)  Spleen 
C)  Kidney 
D)  All of the above 
E)  None of the above D

Question 3

Myeloma patients treated with alkylating agents have a significant risk of developing treatment-related __________.

Accepted Answer

A)  Acute myelogenous leukemia 
B)  Chronic myelogenous leukemia 
C)  Chronic lymphocytic leukemia 
D)  Acute lymphoblastic leukemia 
E)  None of the above 
A)  Acute myelogenous leukemia 
B)  Chronic myelogenous leukemia 
C)  Chronic lymphocytic leukemia 
D)  Acute lymphoblastic leukemia 
E)  None of the above A

Question 4

Which multiple myeloma manifestation describes the formation of abnormal proteins in organ systems due to deposition of immunoglobulin light chains leading to kidney and renal dysfunction?

Accepted Answer

A)  Spherocytosis 
B)  Amyloidosis 
C)  Osteocytosis 
D)  Thrombocytosis 
E)  None of the above 
A)  Spherocytosis 
B)  Amyloidosis 
C)  Osteocytosis 
D)  Thrombocytosis 
E)  None of the above

Question 5

Serum protein electrophoresis (SPEP) demonstrates the absence of a gamma peak. This finding is consistent with which plasma cell disorder?

Accepted Answer

A)  IgG myeloma with M-spike 
B)  Hypergammaglobulinemia 
C)  Hypogammaglobulinemia 
D)  Waldenström's macroglobulinemia 
E)  None of the above 
A)  IgG myeloma with M-spike 
B)  Hypergammaglobulinemia 
C)  Hypogammaglobulinemia 
D)  Waldenström's macroglobulinemia 
E)  None of the above

Question 6

Urine immunoelectrophoresis is used to distinguish between __________ and __________ light chains in urine.

Accepted Answer

A)  Kappa/epsilon 
B)  Kappa/lambda 
C)  Kappa/mu 
D)  Gamma/lambda 
E)  None of the above 
A)  Kappa/epsilon 
B)  Kappa/lambda 
C)  Kappa/mu 
D)  Gamma/lambda 
E)  None of the above

Question 7

When evaluating a plasma cell disorder, which immunologic technique is capable of quantitating a monoclonal immunoglobulin?

Accepted Answer

A)  Radial immunodiffusion 
B)  Immunoelectrophoresis 
C)  Immunofixation 
D)  SPEP 
E)  All of the above 
A)  Radial immunodiffusion 
B)  Immunoelectrophoresis 
C)  Immunofixation 
D)  SPEP 
E)  All of the above

Question 8

Multiple myeloma affects which age group?

Accepted Answer

A)  Children 
B)  Elderly 
C)  Newborns 
D)  Adolescents 
E)  None of the above 
A)  Children 
B)  Elderly 
C)  Newborns 
D)  Adolescents 
E)  None of the above

Question 9

In multiple myeloma, a plasma cell will sometimes contain clumps of aggregated immunoglobulin that stain red with Wright-Giemsa stain. These aggregates are referred to as:

Accepted Answer

A)  Russell bodies 
B)  Howell-Jolly bodies 
C)  Flame cells 
D)  Basophilic stippling 
E)  Döhle bodies 
A)  Russell bodies 
B)  Howell-Jolly bodies 
C)  Flame cells 
D)  Basophilic stippling 
E)  Döhle bodies

Question 10

Neurologic manifestations such as blurred vision, headaches, and episodes of consfusion occur in patients with Waldenström's macroglobulinemia due to __________.

Accepted Answer

A)  Hyperviscosity syndrome 
B)  Splenomegaly 
C)  Bone lesions 
D)  Renal failure 
E)  None of the above 
A)  Hyperviscosity syndrome 
B)  Splenomegaly 
C)  Bone lesions 
D)  Renal failure 
E)  None of the above

Question 11

Which of the following immunoglobulins are associated with heavy chain disease?

Accepted Answer

A)  IgG, IgD, IgE 
B)  IgG, IgM, IgE 
C)  IgG, IgM, IgA 
D)  IgA, IgD, IgE 
E)  None of the above 
A)  IgG, IgD, IgE 
B)  IgG, IgM, IgE 
C)  IgG, IgM, IgA 
D)  IgA, IgD, IgE 
E)  None of the above

Question 12

Which light chain protein is characteristically present in multiple myeloma?

Accepted Answer

A)  Protein C 
B)  Protein 4.1 
C)  Tamm-Horsfall 
D)  Bence-Jones 
E)  None of the above 
A)  Protein C 
B)  Protein 4.1 
C)  Tamm-Horsfall 
D)  Bence-Jones 
E)  None of the above

Question 13

Bacterial infection is the most common cause of death in multiple myeloma patients due to __________.

Accepted Answer

A)  Decreased production of normal immunoglobulin 
B)  Increased production of normal immunoglobulin 
C)  Anemia 
D)  All of the above 
E)  None of the above 
A)  Decreased production of normal immunoglobulin 
B)  Increased production of normal immunoglobulin 
C)  Anemia 
D)  All of the above 
E)  None of the above

Question 14

The plasma cell disorders are characterized by:

Accepted Answer

A)  Excess production of immune globulins 
B)  Decrease production of immune globulins 
C)  Normal production of immune globulins 
D)  Decreased erythrocyte sedimentation ratio 
E)  None of the above 
A)  Excess production of immune globulins 
B)  Decrease production of immune globulins 
C)  Normal production of immune globulins 
D)  Decreased erythrocyte sedimentation ratio 
E)  None of the above

Question 15

What is the definition of a solitary plasmacytoma?

Accepted Answer

A)  A benign clone of cells localized to one area 
B)  A malignancy composed of a clone of cells that is systemically exacerbated 
C)  A malignancy composed of a clone of cells localized to one area 
D)  A benign clone of cells systemically exacerbated 
E)  None of the above 
A)  A benign clone of cells localized to one area 
B)  A malignancy composed of a clone of cells that is systemically exacerbated 
C)  A malignancy composed of a clone of cells localized to one area 
D)  A benign clone of cells systemically exacerbated 
E)  None of the above

Question 16

Extramedullary infiltration of plasmacytoid lymphs in Waldenström's macroglobulinemia occurs in the __________.

Accepted Answer

A)  Liver 
B)  Spleen 
C)  Lymph nodes 
D)  All of the above 
E)  None of the above 
A)  Liver 
B)  Spleen 
C)  Lymph nodes 
D)  All of the above 
E)  None of the above

Question 17

A __________ is a protein that precipitates on exposure to cold, causing such symptoms as Raynaud's phenomenon and thrombosis of small arteries in Waldenström's macroglobulinemia.

Accepted Answer

A)  Microglobulin 
B)  Macroglobulin 
C)  Cryoglobulin 
D)  Gammaglobulin 
E)  None of the above 
A)  Microglobulin 
B)  Macroglobulin 
C)  Cryoglobulin 
D)  Gammaglobulin 
E)  None of the above

Question 18

Which class of immunoglobulin has the largest molecular weight?

Accepted Answer

A)  IgG 
B)  IgA 
C)  IgM 
D)  IgD 
E)  IgE 
A)  IgG 
B)  IgA 
C)  IgM 
D)  IgD 
E)  IgE

Question 19

What is the cause of decreased production of formed elements in the marrow (red cells, white cells, platelets) seen in patients with multiple myeloma?

Accepted Answer

A)  Stem cell defect 
B)  Malignant plasma cell mass replaces normal marrow 
C)  Growth factor deficiency 
D)  All of the above 
E)  None of the above 
A)  Stem cell defect 
B)  Malignant plasma cell mass replaces normal marrow 
C)  Growth factor deficiency 
D)  All of the above 
E)  None of the above

Question 20

Immune globulins (antibodies) are proteins produced by __________.

Accepted Answer

A)  B lymphocytes 
B)  T lymphocytes 
C)  NK cells 
D)  Granulocytes 
E)  None of the above 
A)  B lymphocytes 
B)  T lymphocytes 
C)  NK cells 
D)  Granulocytes 
E)  None of the above

Exam 22: Multiple Myeloma and Related Plasma Cell Disorders

What is the benefit of plasmapheresis used for treating patients with Waldenström's macroglobulinemia?

Myeloma cells may diffusely infiltrate organs such as the __________ resulting in enlargement and dysfunction.

Myeloma patients treated with alkylating agents have a significant risk of developing treatment-related __________.

Which multiple myeloma manifestation describes the formation of abnormal proteins in organ systems due to deposition of immunoglobulin light chains leading to kidney and renal dysfunction?

Serum protein electrophoresis (SPEP) demonstrates the absence of a gamma peak. This finding is consistent with which plasma cell disorder?

Urine immunoelectrophoresis is used to distinguish between __________ and __________ light chains in urine.

When evaluating a plasma cell disorder, which immunologic technique is capable of quantitating a monoclonal immunoglobulin?

Multiple myeloma affects which age group?

In multiple myeloma, a plasma cell will sometimes contain clumps of aggregated immunoglobulin that stain red with Wright-Giemsa stain. These aggregates are referred to as:

Neurologic manifestations such as blurred vision, headaches, and episodes of consfusion occur in patients with Waldenström's macroglobulinemia due to __________.

Which of the following immunoglobulins are associated with heavy chain disease?

Which light chain protein is characteristically present in multiple myeloma?

Bacterial infection is the most common cause of death in multiple myeloma patients due to __________.

The plasma cell disorders are characterized by:

What is the definition of a solitary plasmacytoma?

Extramedullary infiltration of plasmacytoid lymphs in Waldenström's macroglobulinemia occurs in the __________.

A __________ is a protein that precipitates on exposure to cold, causing such symptoms as Raynaud's phenomenon and thrombosis of small arteries in Waldenström's macroglobulinemia.

Which class of immunoglobulin has the largest molecular weight?

What is the cause of decreased production of formed elements in the marrow (red cells, white cells, platelets) seen in patients with multiple myeloma?

Immune globulins (antibodies) are proteins produced by __________.

Morphology of Human Blood and Marrow Cells: Hematopoiesis

Bone Marrow

The Red Blood Cell: Structure and Function

Anemia: Diagnosis and Clinical Considerations

Evaluation of Red Blood Cell Morphology and Introduction to Platelet and White Blood Cell Morphology

Iron Metabolism and Hypochromic Anemias

Megaloblastic Anemias

Aplastic Anemia Including Pure Red Cell Aplasia and Congenital Dyserythropoietic Anemia and Paroxysmal Nocturnal Hemoglobinuria

Introduction to Hemolytic Anemias: Intracorpuscular Defects: I Hereditary Defects of the Red Cell Membrane

Hemolytic Anemias: Intracorpuscular Defects: II Hereditary Enzyme Deficiencies

Hemolytic Anemias: Intracorpuscular Defects: III the Hemoglobinopathies

Hemolytic Anemias: Intracorpuscular Defects: Iv Thalassemia

Hemolytic Anemias: Extracorpuscular Defects

Hypoproliferative Anemia: Anemia Associated With Systemic Diseases

Cell Biology, Disorders of Neutrophils, Infectious Mononucleosis, and Reactive Lymphocytosis

Introduction to Leukemia and the Acute Leukemias

Chronic Myeloproliferative Disorders I: Chronic Myelogenous Leukemia

Chronic Myeloproliferative Disorders Ii: Polycythemia Vera, Essential Thrombocythemia, and Idiopathic Myelofibrosis

Myelodysplastic Syndromes

Chronic Lymphocytic Leukemia and Related Lymphoproliferative Disorders

The Lymphomas

Lipid Lysosomal Storage Diseases and Histiocytosis

Introduction to Hemostasis

Disorders of Primary Hemostasis: Quantitative and Qualitative Platelet Disorders and Vascular Disorders

Disorders of Plasma Clotting Factors

Interaction of the Fibrinolytic, Coagulation, and Kinin Systems; Disseminated Intravascular Coagulation; and Related Pathology

Introduction to Thrombosis and Anticoagulant Therapy

Quality Control in the Hematology Laboratory

Body Fluid Examination: the Qualitative, Quantitative, and Morphologic Analysis of Serous, Cerebrospinal, and Synovial Fluids

Hematology Methods

Principles of Automated Differential Analysis

Coagulation Procedures

Applications of Flow Cytometry to Hematology and Hemostasis

Molecular Diagnostic Techniques in Hematopathology

Special Stainscytochemistry

Filters

Urine immunoelectrophoresis is used to distinguish between and light chains in urine.