Deck 13: Lymphoproliferative Disorders and Related Plasma Cell Disorders

Question 1

Hypogammaglobulinemia is a significant feature in half of patients with CLL.This complication can lead to:

A) Refractory anemia
B) Essential thrombocytosis
C) Autoimmune hemolytic anemia
D) Pernicious anemia

Answer 1

C

Question 2

The most characteristic change seen in the peripheral smear of a patient with multiple myeloma is the presence of:

A) Microcytic hypochromic cells
B) Intracellular inclusion bodies
C) Rouleaux
D) Agglutination

Answer 2

C

Question 3

Reed Sternberg cells are associated with:

A) Sézary syndrome
B) CLL
C) Hodgkin's lymphoma
D) Multiple myeloma

Answer 3

C

Question 4

All of the following are related to the pathophysiology of multiple myeloma except:

A) Acceleration of plasma cells in the bone marrow
B) Increased levels of tyrosine kinase activity
C) Activation of osteoclasts
D) Production of an abnormal monoclonal protein

Question 5

A peripheral blood picture dominated by cells that appear convoluted with an ovoid nucleus and clefting would most likely be seen in:

A) Sézary syndrome
B) Burkitt's lymphoma
C) CLL
D) Infectious mononucleosis

Question 6

The CD markers associated with CLL include all of the following except:

A) CD 4
B) CD 15
C) CD 19
D) CD 20

Question 7

The cells at the tip of the pointer are most frequently associated with:

A) CLL
B) Hairy cell leukemia
C) Sézary syndrome
D) Multiple myeloma

Question 8

An abnormal proliferation of dysfunctional B lymphocytes is commonly associated with:

A) Acute lymphocytic leukemia
B) Chronic lymphocytic leukemia
C) Infectious mononucleosis
D) Hodgkin's disease

Question 9

The protein electrophoresis pattern pictured above is most frequently associated with:

A) Hodgkin's lymphoma
B) Multiple myeloma
C) Thalassemia major
D) Essential thrombocytopenia

Question 10

A significant feature of hairy cell leukemia not seen is other acute leukemias is:

A) Panmyelosis
B) Pancytosis
C) Pancytopenia
D) Panhyperplasia

Question 11

Russell bodies are associated with:

A) Multiple myeloma
B) Hodgkin's lymphoma
C) Non-Hodgkin's lymphoma
D) Waldenström's macroglobulinemia

Question 12

A new treatment for multiple myeloma that was once banned from use in pregnant women is:

A) EPO
B) Thalidomide
C) Demerol
D) Interferon

Question 13

The TRAP stain is useful in the diagnosis of:

A) CLL
B) PLL
C) Hairy cell leukemia
D) Hodgkin's lymphoma

Question 14

Which of the following genetic alterations is associated with a poor prognosis in CLL?

A) Trisomy 13
B) Trisomy 12
C) t(15:17)
D) t(9:21)

Question 15

The phenomenon pictured above is known as rouleaux and is frequently associated with:

A) An increased red cell count
B) A decreased MCV and MCHC
C) An elevated ESR
D) All of the above

Question 16

The immunoglobulin responsible for secondary immunological response is:

A) Ig A
B) Ig M
C) Ig D
D) Ig G

Question 17

All of the following are consistent with the clinical and pathological picture of Waldenström's macroglobulinemia except:

A) M spike due to Ig M
B) Lymphadenopathy and splenomegaly
C) Proliferation of lymphocytes and plasmacytoid lymphocytes
D) Destructive bone lesions

Question 18

An increase in plasma cells can be seen in all the following except:

A) Epstein-Barr virus
B) Collagen vascular disease
C) Tuberculosis
D) Sézary syndrome

Question 19

Which of the following statements about Hodgkin's disease is false?

A) The peak incidence for the disease is 15 to 40 years of age.
B) The disease occurs more frequently in males.
C) It is a precursor to T-cell lymphoma
D) Individuals who have been exposed to the Epstein-Barr virus may be more vulnerable to Hodgkin's lymphoma.

Question 20

Patients with CLL (chronic lymphocytic leukemia):

A) Die most often of blast crisis
B) Are usually younger than 40 years
C) May develop monoclonal spikes
D) Often are immunocompromised