Question 1

What does immunoelectrophoresis determine?

Accepted Answer

A)  The specific antibody class present in the serum 
B)  The presence or absence of a lipoprotein 
C)  Osteoblast activating factor 
D)  24-hour urine protein 
E)  None of the above 
A)  The specific antibody class present in the serum 
B)  The presence or absence of a lipoprotein 
C)  Osteoblast activating factor 
D)  24-hour urine protein 
E)  None of the above

Question 2

Macroglobulinemia refers to the overproduction of monoclonal __________.

Accepted Answer

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

Question 3

Which variant of multiple myeloma produces a malignant clone of plasma cells that are too immature to secrete immunoglobulins and does not produce an M-spike by electrophoretic studies?

Accepted Answer

A)  Smoldering myeloma 
B)  Classic multiple myeloma 
C)  Advanced myeloma 
D)  Nonsecretory myeloma 
E)  None of the above 
A)  Smoldering myeloma 
B)  Classic multiple myeloma 
C)  Advanced myeloma 
D)  Nonsecretory myeloma 
E)  None of the above

Question 4

What is the etiology of macroglobulinemia?

Accepted Answer

A)  Loss of regulation of a clone of immature lymphocytes 
B)  Loss of regulation of a clone of cells that are staged between the mature lymphocytes and early plasma cells 
C)  Loss of regulation of granulocytic cells 
D)  All of the above 
E)  None of the above 
A)  Loss of regulation of a clone of immature lymphocytes 
B)  Loss of regulation of a clone of cells that are staged between the mature lymphocytes and early plasma cells 
C)  Loss of regulation of granulocytic cells 
D)  All of the above 
E)  None of the above

Question 5

The clone of cells produced in Waldenström's macroglobulinemia is an intermediate stage of development between the mature lymphocytes and the early plasma cells. These cells are commonly referred to as:

Accepted Answer

A)  Plasmacytoid lymphocytes 
B)  Prolymphocytes 
C)  Reed-Sternberg cells 
D)  A and B 
E)  A and C 
A)  Plasmacytoid lymphocytes 
B)  Prolymphocytes 
C)  Reed-Sternberg cells 
D)  A and B 
E)  A and C

Question 6

__________ light chains are most commonly found in patients with myeloma-related amyloidosis.

Accepted Answer

A)  Epsilon 
B)  Delta 
C)  Lambda 
D)  Mu 
E)  None of the above 
A)  Epsilon 
B)  Delta 
C)  Lambda 
D)  Mu 
E)  None of the above

Question 7

Which monoclonal gammopathy occurs in the sixth to eighth decade of life and is characterized by the presence of an M-spike with IgG < 3.5 g/dL, IgA < 20 g/dL, urinary light chains < 1.0 g/24 hr, and < 10% plasma cells in the bone marrow?

Accepted Answer

A)  Multiple myeloma 
B)  Waldenström's macroglobulinemia 
C)  Solitary plasmacytoma 
D)  Monoclonal gammopathy of undetermined significance 
E)  None of the above 
A)  Multiple myeloma 
B)  Waldenström's macroglobulinemia 
C)  Solitary plasmacytoma 
D)  Monoclonal gammopathy of undetermined significance 
E)  None of the above

Question 8

β2-Microglobulin used in conjunction with serum __________ may be the best system for staging myeloma based on prognosis.

Accepted Answer

A)  α2 macroglobulin 
B)  Albumin 
C)  Calcium 
D)  Creatine 
E)  None of the above 
A)  α2 macroglobulin 
B)  Albumin 
C)  Calcium 
D)  Creatine 
E)  None of the above

Question 9

A 63-year-old black man presents with an elevated ESR, 10-30% plasma cells in the bone marrow, M-spike by SPEP, and 4.0 g/dL of serum IgG by radial diffusion. Which plasma cell disorder is implicated?

Accepted Answer

A)  Solitary plasmacytoma 
B)  Multiple myeloma 
C)  Waldenström's macroglobulinemia 
D)  Alpha heavy chain disease 
E)  Gamma heavy chain disease 
A)  Solitary plasmacytoma 
B)  Multiple myeloma 
C)  Waldenström's macroglobulinemia 
D)  Alpha heavy chain disease 
E)  Gamma heavy chain disease

Question 10

A patient suspected of multiple myeloma presents with the following results: Hb 12 g/dL; corrected serum calcium, 11 mg/dL; one lytic bone lesion; and small M-spike by SPEP, with IgG <5 g/dL; urine light chains 2 g/24 hr. Which stage in multiple myeloma is consistent with the given results?

Accepted Answer

A)  Low myeloma mass 
B)  Intermediate myeloma mass 
C)  High myeloma mass 
D)  All of the above 
E)  None of the above 
A)  Low myeloma mass 
B)  Intermediate myeloma mass 
C)  High myeloma mass 
D)  All of the above 
E)  None of the above

Question 11

Which of the following is characterized by the excessive production of the heavy chain portion of the antibody subunit?

Accepted Answer

A)  Waldenström's macroglobulinemia 
B)  Heavy chain disease 
C)  Monoclonal gammopathy of undetermined significance (MGUS) 
D)  Solitary plasmacytoma 
E)  Multiple myeloma 
A)  Waldenström's macroglobulinemia 
B)  Heavy chain disease 
C)  Monoclonal gammopathy of undetermined significance (MGUS) 
D)  Solitary plasmacytoma 
E)  Multiple myeloma

Question 12

The presence of __________ circulating in the blood is a late finding seen in advanced multiple myeloma.

Accepted Answer

A)  Megakaryocytes 
B)  Plasma cells 
C)  Neutrophils 
D)  Eosinophils 
E)  None of the above 
A)  Megakaryocytes 
B)  Plasma cells 
C)  Neutrophils 
D)  Eosinophils 
E)  None of the above

Question 13

An evaluation of multiple myeloma includes:

Accepted Answer

A)  Bone marrow biopsy 
B)  SPEP 
C)  Immunoelectrophoresis and immunofixation 
D)  Serum free light chain (FL
C)  assays 
E)  All of the above 
A)  Bone marrow biopsy 
B)  SPEP 
C)  Immunoelectrophoresis and immunofixation 
D)  Serum free light chain (FL
C)  assays 
E)  All of the above

Question 14

A patient suspected of multiple myeloma presents with the following results: Hb 8.0 g/dL; corrected serum calcium, 11 mg/dL; two lytic bone lesions, and a large M-spike by SPEP, with IgG 8 g/dL. Which stage in multiple myeloma is consistent with the given results?

Accepted Answer

A)  Low myeloma mass 
B)  Intermediate myeloma mass 
C)  High myeloma mass 
D)  All of the above 
E)  None of the above 
A)  Low myeloma mass 
B)  Intermediate myeloma mass 
C)  High myeloma mass 
D)  All of the above 
E)  None of the above

Question 15

Multiple myeloma can be differentiated from primary plasma cell leukemia by which of the following?

Accepted Answer

A)  Hyperviscosity 
B)  Platelet dysfunction 
C)  Presence of plasma cells in circulation 
D)  Splenomegaly 
E)  Hypercalcemia 
A)  Hyperviscosity 
B)  Platelet dysfunction 
C)  Presence of plasma cells in circulation 
D)  Splenomegaly 
E)  Hypercalcemia

Question 16

Which hemostasis parameter is usually normal in patients with Waldenström's macroglobulinemia?

Accepted Answer

A)  Bleeding time 
B)  Platelet count 
C)  Prothrombin time (PT) 
D)  Activated partial thromboplastin time (APTT) 
E)  None of the above 
A)  Bleeding time 
B)  Platelet count 
C)  Prothrombin time (PT) 
D)  Activated partial thromboplastin time (APTT) 
E)  None of the above

Question 17

When rouleaux is present, the erythrocyte sedimentation rate (ESR) will be ____________.

Accepted Answer

A)  Increased 
B)  Normal 
C)  Decreased 
D)  Variable 
E)  None of the above 
A)  Increased 
B)  Normal 
C)  Decreased 
D)  Variable 
E)  None of the above

Question 18

Another name used in describing the plasma cell disorders is __________.

Accepted Answer

A)  Lymphoma 
B)  Myeloproliferative disease 
C)  Monoclonal gammopathies 
D)  All of the above 
E)  None of the above 
A)  Lymphoma 
B)  Myeloproliferative disease 
C)  Monoclonal gammopathies 
D)  All of the above 
E)  None of the above

Question 19

The plasma cell is the fully differentiated __________.

Accepted Answer

A)  T lymphocyte 
B)  B lymphocyte 
C)  Null killer (NK) cell 
D)  Granulocyte 
E)  None of the above 
A)  T lymphocyte 
B)  B lymphocyte 
C)  Null killer (NK) cell 
D)  Granulocyte 
E)  None of the above

Question 20

What is a plasmacytoma?

Accepted Answer

A)  A disease affecting the blood clotting process 
B)  A fully differentiated T lymphocyte 
C)  A fully differentiated B lymphocyte 
D)  Tumors composed of plasma cells 
E)  None of the above 
A)  A disease affecting the blood clotting process 
B)  A fully differentiated T lymphocyte 
C)  A fully differentiated B lymphocyte 
D)  Tumors composed of plasma cells 
E)  None of the above

Exam 22: Multiple Myeloma and Related Plasma Cell Disorders

What does immunoelectrophoresis determine?

Macroglobulinemia refers to the overproduction of monoclonal __________.

Which variant of multiple myeloma produces a malignant clone of plasma cells that are too immature to secrete immunoglobulins and does not produce an M-spike by electrophoretic studies?

What is the etiology of macroglobulinemia?

The clone of cells produced in Waldenström's macroglobulinemia is an intermediate stage of development between the mature lymphocytes and the early plasma cells. These cells are commonly referred to as:

__________ light chains are most commonly found in patients with myeloma-related amyloidosis.

Which monoclonal gammopathy occurs in the sixth to eighth decade of life and is characterized by the presence of an M-spike with IgG < 3.5 g/dL, IgA < 20 g/dL, urinary light chains < 1.0 g/24 hr, and < 10% plasma cells in the bone marrow?

β2-Microglobulin used in conjunction with serum __________ may be the best system for staging myeloma based on prognosis.

A 63-year-old black man presents with an elevated ESR, 10-30% plasma cells in the bone marrow, M-spike by SPEP, and 4.0 g/dL of serum IgG by radial diffusion. Which plasma cell disorder is implicated?

A patient suspected of multiple myeloma presents with the following results: Hb 12 g/dL; corrected serum calcium, 11 mg/dL; one lytic bone lesion; and small M-spike by SPEP, with IgG <5 g/dL; urine light chains 2 g/24 hr. Which stage in multiple myeloma is consistent with the given results?

Which of the following is characterized by the excessive production of the heavy chain portion of the antibody subunit?

The presence of __________ circulating in the blood is a late finding seen in advanced multiple myeloma.

An evaluation of multiple myeloma includes:

A patient suspected of multiple myeloma presents with the following results: Hb 8.0 g/dL; corrected serum calcium, 11 mg/dL; two lytic bone lesions, and a large M-spike by SPEP, with IgG 8 g/dL. Which stage in multiple myeloma is consistent with the given results?

Multiple myeloma can be differentiated from primary plasma cell leukemia by which of the following?

Which hemostasis parameter is usually normal in patients with Waldenström's macroglobulinemia?

When rouleaux is present, the erythrocyte sedimentation rate (ESR) will be ____________.

Another name used in describing the plasma cell disorders is __________.

The plasma cell is the fully differentiated __________.

What is a plasmacytoma?

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

β₂-Microglobulin used in conjunction with serum __________ may be the best system for staging myeloma based on prognosis.