Deck 29: Alterations of Leukocyte, Lymphoid, and Hemostatic Function

Question 1

Which proinflammatory cytokines are responsible for the development and maintenance of disseminated intravascular coagulation (DIC)?

A) Granulocyte colony-stimulating factor (G-CSF); interleukin (IL)-2, IL-4, and IL-10; and tumor necrosis factor-gamma (IFN-g)
B) Granulocyte-macrophage colony-stimulating factor (GM-CSF); and IL-3, IL-5, IL-9, and IFN-g
C) Macrophage colony-stimulating factor (M-CSF); IL-7, IL-11, and IL-14; and PAF
D) Tumor necrosis factor-alpha (TNF-a); IL-1, IL-6, and IL-8; and platelet-activating factor (PAF)

Answer 1

Tumor necrosis factor-alpha (TNF-a); IL-1, IL-6, and IL-8; and platelet-activating factor (PAF)

Question 2

What change is observed in leukocytes during an allergic disorder (type I hypersensitivity)often caused by asthma,hay fever,and drug reactions?

A) Neutrophilia
B) Basophilia
C) Eosinophilia
D) Monocytosis

Answer 2

Eosinophilia

Question 3

Which description is consistent with chronic lymphocytic leukemia (CLL)?

A) Defects exist in the ras oncogene, TP53 tumor-suppressor gene, and INK4A, the gene encoding a cell-cycle regulatory protein.
B) Leukocytosis and a predominance of blast cells characterize the bone marrow and peripheral blood. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
C) B cells fail to mature into plasma cells that synthesize immunoglobulins.
D) The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL.

Answer 3

B cells fail to mature into plasma cells that synthesize immunoglobulins.

Question 4

What is the most common cause of vitamin K deficiency?

A) Administration of warfarin (Coumadin)
B) Total parenteral nutrition with antibiotic therapy
C) An immunoglobulin G-mediated autoimmune disorder
D) Liver failure

Question 5

Which virus is associated with Burkitt lymphoma in African children?

A) Cytomegalovirus
B) Adenovirus
C) Human papillomavirus
D) Epstein-Barr virus

Question 6

Which electrolyte imbalance accompanies multiple myeloma (MM)?

A) Hyperkalemia
B) Hypercalcemia
C) Hyperphosphatemia
D) Hypernatremia

Question 7

Local signs and symptoms of Hodgkin disease-related lymphadenopathy are a result of which of the following?

A) Pressure and ischemia
B) Pressure and obstruction
C) Inflammation and ischemia
D) Inflammation and pressure

Question 8

Which term is used to describe a red-purple discoloration caused by diffuse hemorrhage into the skin tissue?

A) Petechiae
B) Hematoma
C) Ecchymosis
D) Purpura

Question 9

Reed-Sternberg (RS)cells represent malignant transformation and proliferation of which of the following?

A) Interleukin (IL)-1, IL-2, IL-5, and IL-6
B) Tumor necrosis factor-beta
C) B cells
D) T cells

Question 10

Which description is consistent with chronic myelogenous leukemia (CML)?

A) Defects exist in the ras oncogene, TP53 tumor-suppressor gene, and INK4A, the gene encoding a cell-cycle regulatory protein.
B) Leukocytosis and a predominance of blast cells characterize the bone marrow and peripheral blood. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
C) B cells fail to mature into plasma cells that synthesize immunoglobulins.
D) The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL1.

Question 11

In disseminated intravascular coagulation (DIC),what activates the coagulation cascade?

A) Cytokines, such as platelet-activating factor (PAF), and tumor necrosis factor- alpha (TNF-a)
B) Thromboxane A, causing platelets to aggregate and consume clotting factors
C) Tissue factor (TF) located in the endothelial layer of blood vessels and subcutaneous tissue
D) Endotoxins from gram-negative and gram-positive bacteria circulating in the bloodstream

Question 12

Immune thrombocytopenia (ITP)is a(n)_____ condition in adults and a(n)_____ condition in children.

A) Acute; acute
B) Chronic; chronic
C) Acute; chronic
D) Chronic; acute

Question 13

In infectious mononucleosis (IM),what does the Monospot test detect?

A) Immunoglobulin E (IgE)
B) Immunoglobulin M (IgM)
C) Immunoglobulin G (IgG)
D) Immunoglobulin A (IgA)

Question 14

What is the most reliable and specific test for diagnosing disseminated intravascular coagulation (DIC)?

A) Prothrombin time (PT)
B) Activated partial thromboplastin time (aPTT)
C) Fibrin degradation products (FDP)
D) D-dimer

Question 15

Which statement best describes heparin-induced thrombocytopenia (HIT)?

A) Immunoglobulin G immune-mediated adverse drug reaction that reduces circulating platelets
B) Hematologic reaction to heparin in which the bone marrow is unable to produce sufficient platelets to meet the body's needs
C) Immunoglobulin E-mediated allergic drug reaction that reduces circulating platelets
D) Cell-mediated drug reaction in which macrophages process the heparin and platelet complexes that are then destroyed by activated cytotoxic T cells.

Question 16

What term is used to identify thrombi that occlude arterioles and capillaries and are made up of platelets with minimal fibrin and erythrocytes?

A) Essential (primary) thrombocythemia (ET)
B) Acute idiopathic thrombotic thrombocytopenic purpura
C) Thrombotic thrombocytopenic purpura (TTP)
D) Immune thrombocytopenic purpura (ITP)

Question 17

Which disorder is described as an unregulated release of thrombin with subsequent fibrin formation and accelerated fibrinolysis?

A) Disseminated intravascular coagulation (DIC)
B) Immune thrombocytopenic purpura (ITP)
C) Heparin-induced thrombocytopenia (HIT)
D) Essential thrombocythemia (ET)

Question 18

Vitamin _____ is required for normal clotting factor synthesis by the _____.

A) K; kidneys
B) D; kidneys
C) K; liver
D) D; liver

Question 19

Which description is consistent with acute lymphocytic leukemia (ALL)?

A) ALL is a progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood.
B) Leukocytosis and a predominance of blast cells characterize the bone marrow and peripheral blood. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
C) B cells fail to mature into plasma cells that synthesize immunoglobulins.
D) The translocation of genetic material from genes 9 and 22 create an abnormal, fused gene identified as BCR-ABL.

Question 20

In disseminated intravascular coagulation (DIC),what are the indications of microvascular thrombosis?

A) Reduced amplitude in peripheral pulses
B) Symmetric cyanosis of fingers and toes
C) Numbness and tingling in fingers and toes
D) Bilateral pallor and edema of fingers and toes

Question 21

When the demand for mature neutrophils exceeds the supply,immature neutrophils are released indicating:

A) A shift to the right
B) A shift to the left
C) Leukocytosis
D) Leukemia

Question 22

Match the causes or diagnostic tests with the hematologic disorders.
Multiple myeloma

A)Epstein-Barr virus
B)Bence Jones protein
C)Diagnosed by the Reed-Sternberg cell
D)Diagnosed by the Philadelphia chromosome

Question 23

Which classic clinical manifestations are symptoms of IM? (Select all that apply.)

A) Lymph node enlargement
B) Hepatitis
C) Pharyngitis
D) Edema in the area of the eyes
E) Fever

Question 24

Match the causes or diagnostic tests with the hematologic disorders.
Chronic myelogenous leukemia

A)Epstein-Barr virus
B)Bence Jones protein
C)Diagnosed by the Reed-Sternberg cell
D)Diagnosed by the Philadelphia chromosome

Question 25

Which statement relates to immune thrombocytopenic purpura (ITP)?

A) ITP is formed in conditions of low flow and is made up of mostly red cells with larger amounts of fibrin and few platelets.
B) An alteration of multipotent stem cells, resulting in an excess production of platelets, causes ITP.
C) Mononuclear phagocytes in the spleen remove antibody-coated platelets from circulation.
D) Arterial clots are made up of mostly platelet aggregates held together by fibrin strands.

Question 26

Match the causes or diagnostic tests with the hematologic disorders.
Infectious mononucleosis

A)Epstein-Barr virus
B)Bence Jones protein
C)Diagnosed by the Reed-Sternberg cell
D)Diagnosed by the Philadelphia chromosome

Question 27

Match the causes or diagnostic tests with the hematologic disorders.
Hodgkin lymphoma

A)Epstein-Barr virus
B)Bence Jones protein
C)Diagnosed by the Reed-Sternberg cell
D)Diagnosed by the Philadelphia chromosome

Question 28

The two major forms of leukemia,acute and chronic,are classified by which criteria? (Select all that apply.)

A) Predominant cell type
B) Rate of progression
C) Age of individual when cells differentiation occurs
D) Stage of cell development when malignancy first occurs
E) Serum level of leukocytes

Question 29

What are the most significant risk factors for the development of thrombus formation as referred to by the Virchow triad? (Select all that apply.)

A) Endothelial injury to blood vessels
B) Turbulent arterial blood flow
C) Rapid coagulation of the blood
D) Stagnant venous blood flow
E) History of obesity

Question 30

Hodgkin disease is characterized by the presence of which of the following?

A) Philadelphia chromosome
B) Virchow triad
C) Microvascular thrombi
D) Reed-Sternberg (RS) cells

Question 31

Early detection of acute leukemia would include which of the following symptoms? (Select all that apply.)

A) Dizziness
B) Paresthesia
C) Anorexia
D) Bruising
E) Bone pain

Question 32

Which statements are true regarding leukemias? (Select all that apply.)

A) A single progenitor cell undergoes a malignant change.
B) Leukemia is a result of uncontrolled cellular proliferation.
C) Bone marrow becomes overcrowded.
D) Leukocytes are under produced.
E) Hematopoietic cell production is decreased.

Question 33

Which of the following is characterized by what is referred to as pathognomonic pentad of symptoms?

A) Acute idiopathic thrombotic thrombocytopenic purpura
B) Essential (primary) thrombocythemia (ET)
C) Immune thrombocytopenic purpura (ITP)
D) Thrombotic thrombocytopenic purpura (TTP)

Question 34

What are the clinical manifestations of advanced non-African Burkitt lymphoma? (Select all that apply.)

A) Abdominal swelling
B) Night sweats
C) Fever
D) Weight gain
E) Dementia