Question 1

Which of the following indicators correlate to children with a poor prognosis for ALL?

Accepted Answer

A)  Older age (>13 years) 
B)  L2 and L3 morphology 
C)  High WBC count 
D)  Chromosome abnormalities 
E)  All of the above 
A)  Older age (>13 years) 
B)  L2 and L3 morphology 
C)  High WBC count 
D)  Chromosome abnormalities 
E)  All of the above

Question 2

The FAB classification M7 in acute leukemia is characterized by the extensive proliferation of __________.

Accepted Answer

A)  Erythroblasts 
B)  Megakaryoblasts 
C)  Myeloblasts 
D)  Monoblasts 
E)  None of the above 
A)  Erythroblasts 
B)  Megakaryoblasts 
C)  Myeloblasts 
D)  Monoblasts 
E)  None of the above

Question 3

L3 acute lymphoblastic leukemia is referred to as __________ type.

Accepted Answer

A)  Precursor B-cell 
B)  T-cell 
C)  Burkitt's 
D)  B-cell 
E)  None of the above 
A)  Precursor B-cell 
B)  T-cell 
C)  Burkitt's 
D)  B-cell 
E)  None of the above

Question 4

The SBB stain is the most sensitive stain for granulocytic precursors with a staining pattern which parallels the __________ stain.

Accepted Answer

A)  Terminal deoxynucleotidyl transferase 
B)  Periodic acid-Schiff (PAS) 
C)  Myeloperoxidase 
D)  Alpha-naphthyl butyrate 
E)  None of the above 
A)  Terminal deoxynucleotidyl transferase 
B)  Periodic acid-Schiff (PAS) 
C)  Myeloperoxidase 
D)  Alpha-naphthyl butyrate 
E)  None of the above

Question 5

Surface marker studies must use fresh specimens from either peripheral blood or bone marrow aspirates with __________ cells.

Accepted Answer

A)  Macrocytic 
B)  Crenated 
C)  Viable 
D)  Nonviable 
E)  None of the above 
A)  Macrocytic 
B)  Crenated 
C)  Viable 
D)  Nonviable 
E)  None of the above

Question 6

This acute leukemia contains primarily abnormal promyelocytes with heavy granulation, and the presence of Auer rods is abundant. The cells react near 100% with Sudan black and peroxidase; however, the reaction is negative for non-specific esterase. Disseminating intravascular coagulation (DIC) is frequently associated with this disorder. What is the FAB classification?

Accepted Answer

A)  M1 
B)  M6 
C)  M2 
D)  M3 
E)  M4 
A)  M1 
B)  M6 
C)  M2 
D)  M3 
E)  M4

Question 7

In acute monocytic leukemia (M5a), which cell predominates in the bone marrow and peripheral blood?

Accepted Answer

A)  Monocytes 
B)  Promonocytes 
C)  Monoblasts 
D)  Myeloblasts 
E)  All of the above 
A)  Monocytes 
B)  Promonocytes 
C)  Monoblasts 
D)  Myeloblasts 
E)  All of the above

Question 8

Which translocation and associated hybrid gene formation is exclusively found in acute promyelocytic leukemia?

Accepted Answer

A)  t(8;21) AML1-ETO 
B)  t(4;11) AF4-MLL 
C)  t(9;22) BCR-ABL 
D)  t(15;17) PML-RARF1F1F1S1F1F1F10 
E)  t(22;9) MDR1 
A)  t(8;21) AML1-ETO 
B)  t(4;11) AF4-MLL 
C)  t(9;22) BCR-ABL 
D)  t(15;17) PML-RARF1F1F1S1F1F1F10 
E)  t(22;9) MDR1

Question 9

A 49-year-old woman was admitted to the hospital for easy bruising and menorrhagia. She had evidence of disseminated intravascular coagulation. Her white blood cell count is 3 F1F1F1S1F1F1F10 109/L with 95% large, atypical mononuclear cells and some atypical bilobed cells. Many of these cells are packed with larger, purple-staining granules; some have multiple Auer rods; and all are strongly peroxidase-positive. What is the diagnosis?

Accepted Answer

A)  AML, FAB M2 
B)  AML, FAB M3 
C)  AML, FAB M4 
D)  AML, FAB M5 
E)  AML, FAB M6 
A)  AML, FAB M2 
B)  AML, FAB M3 
C)  AML, FAB M4 
D)  AML, FAB M5 
E)  AML, FAB M6

Question 10

The most common acute leukemia FAB classification diagnosed is __________.

Accepted Answer

A)  M2 
B)  M4 
C)  M5 
D)  M6 
E)  None of the above 
A)  M2 
B)  M4 
C)  M5 
D)  M6 
E)  None of the above

Question 11

The most common structural chromosomal abnormalities in acute leukemia are __________.

Accepted Answer

A)  Duplications 
B)  Inversions 
C)  Translocations 
D)  Deletions 
E)  None of the above 
A)  Duplications 
B)  Inversions 
C)  Translocations 
D)  Deletions 
E)  None of the above

Question 12

The objective in treatment of leukemia is to:

Accepted Answer

A)  Eradicate the leukemic cell mass 
B)  Provide supportive care 
C)  Lower the WBC count 
D)  All of the above 
E)  None of the above 
A)  Eradicate the leukemic cell mass 
B)  Provide supportive care 
C)  Lower the WBC count 
D)  All of the above 
E)  None of the above

Question 13

Which definitive laboratory findings in acute myelomonocytic leukemia aid in the differentiation of M4 and M2?

Accepted Answer

A)  Increased serum lysozyme level 
B)  Negative SBB stain 
C)  Positive peroxidase 
D)  WBC count 
E)  Hematocrit 
A)  Increased serum lysozyme level 
B)  Negative SBB stain 
C)  Positive peroxidase 
D)  WBC count 
E)  Hematocrit

Question 14

A clinical feature of acute leukemia is:

Accepted Answer

A)  Sudden onset 
B)  Untreated course < 6 months 
C)  Presence of immature leukemic cells 
D)  All of the above 
E)  None of the above 
A)  Sudden onset 
B)  Untreated course < 6 months 
C)  Presence of immature leukemic cells 
D)  All of the above 
E)  None of the above

Question 15

A positive myeloperoxidase or SBB stain indicates __________ differentiation.

Accepted Answer

A)  Myeloid 
B)  Lymphoid 
C)  Megakaryocytoid 
D)  Plasmacytoid 
E)  None of the above 
A)  Myeloid 
B)  Lymphoid 
C)  Megakaryocytoid 
D)  Plasmacytoid 
E)  None of the above

Question 16

Which precursor B-cell marker is used exclusively in the work-up of acute leukemia in studying B lineage ALL?

Accepted Answer

A)  Mu (µ) heavy chain 
B)  Epsilon (F1F1F1S1F1F1F10) heavy chain 
C)  Lambda (F1F1F1S1F1F1F10) heavy chain 
D)  Delta (F1F1F1S1F1F1F10) heavy chain 
E)  None of the above 
A)  Mu (µ) heavy chain 
B)  Epsilon (F1F1F1S1F1F1F10) heavy chain 
C)  Lambda (F1F1F1S1F1F1F10) heavy chain 
D)  Delta (F1F1F1S1F1F1F10) heavy chain 
E)  None of the above

Question 17

Which type of ALL occurs primarily in adults?

Accepted Answer

A)  L1 
B)  L2 
C)  L3 
D)  L4 
E)  None of the above 
A)  L1 
B)  L2 
C)  L3 
D)  L4 
E)  None of the above

Question 18

In leukemia, the presence of predominantly mature malignant cells is classified as: __________.

Accepted Answer

A)  Chronic 
B)  Myeloid 
C)  Acute 
D)  Lymphoid 
E)  Myeloid metaplasia 
A)  Chronic 
B)  Myeloid 
C)  Acute 
D)  Lymphoid 
E)  Myeloid metaplasia

Question 19

Leukemia of the myeloid lineage may include:

Accepted Answer

A)  Granulocytic leukemia 
B)  Monocytic leukemia 
C)  Megakaryocytic leukemia 
D)  All of the above 
E)  None of the above 
A)  Granulocytic leukemia 
B)  Monocytic leukemia 
C)  Megakaryocytic leukemia 
D)  All of the above 
E)  None of the above

Question 20

When a leukemia is suspected in a patient, what laboratory test should be required for the initial diagnosis?

Accepted Answer

A)  CBC, differential, platelet count 
B)  Cytochemical stains 
C)  Immunologic surface markers 
D)  All of the above 
E)  None of the above 
A)  CBC, differential, platelet count 
B)  Cytochemical stains 
C)  Immunologic surface markers 
D)  All of the above 
E)  None of the above

Exam 16: Introduction to Leukemia and the Acute Leukemias

Which of the following indicators correlate to children with a poor prognosis for ALL?

The FAB classification M7 in acute leukemia is characterized by the extensive proliferation of __________.

L3 acute lymphoblastic leukemia is referred to as __________ type.

The SBB stain is the most sensitive stain for granulocytic precursors with a staining pattern which parallels the __________ stain.

Surface marker studies must use fresh specimens from either peripheral blood or bone marrow aspirates with __________ cells.

In acute monocytic leukemia (M5a), which cell predominates in the bone marrow and peripheral blood?

Which translocation and associated hybrid gene formation is exclusively found in acute promyelocytic leukemia?

The most common acute leukemia FAB classification diagnosed is __________.

The most common structural chromosomal abnormalities in acute leukemia are __________.

The objective in treatment of leukemia is to:

Which definitive laboratory findings in acute myelomonocytic leukemia aid in the differentiation of M4 and M2?

A clinical feature of acute leukemia is:

A positive myeloperoxidase or SBB stain indicates __________ differentiation.

Which precursor B-cell marker is used exclusively in the work-up of acute leukemia in studying B lineage ALL?

Which type of ALL occurs primarily in adults?

In leukemia, the presence of predominantly mature malignant cells is classified as: __________.

Leukemia of the myeloid lineage may include:

When a leukemia is suspected in a patient, what laboratory test should be required for the initial diagnosis?

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

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

Multiple Myeloma and Related Plasma Cell Disorders

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

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