Deck 11: Hematopoietic and Lymphoid Systems

Question 1

The deletion of two α -globin chains of hemoglobin is the cause of

A) α -thalassemia trait
B) α -thalassemia minor
C) salient carrier state
D) hemoglobin H disease
E) hydrops fetalis

Answer 1

α -thalassemia trait

Question 2

The most common cause of myelophthisic anemia is

A) metastatic carcinoma to the bones
B) multiple myeloma
C) lymphoma
D) leukemia
E) osteosclerosis

Answer 2

metastatic carcinoma to the bones

Question 3

Severe hemophilia develops in patients who have factor VIII reduced below

A) 1%
B) 5%
C) 10%
D) 20%
E) 25%

Answer 3

1%

Question 4

The most common form of autosomal dominant hereditary spherocytosis is caused by a mutation of the gene encoding which of the following proteins?

A) Ankyrin
B) Spectrin
C) Protein 4.1
D) Hemoglobin A
E) Transferrin

Question 5

Hemolytic uremic syndrome (HUS) shares many features with thrombotic thrombocytopenic purpura (TTP), but in contrast with patients with TTP, those with HUS do NOT have

A) anemia
B) renal failure
C) neurologic deficits
D) fever
E) thrombocytopenia

Question 6

Which is the most common histologic form of Hodgkin disease?

A) Lymphocyte predominance
B) Nodular sclerosis
C) Mixed cellularity
D) Lymphocyte depletion
E) Nodular lymphocyte predominance

Question 7

Which is the most common cause of microcytic hypochromic anemia in American women aged 20 to 50 years?

A) Autoimmune hemolysis
B) Iron deficiency
C) Vitamin B₁₂ deficiency
D) Thalassemia minor
E) Viral infection

Question 8

Terminal deoxynucleotidyltransferase is a marker of

A) B cells
B) T cells
C) Precursors of B and T lymphocytes
D) Plasma cells
E) Natural killer cells

Question 9

The monoclonal immunoglobulin, the so-called M protein of multiple myeloma, belongs to which class of immunoglobulins?

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

Question 10

Which of the following bleeding tests is abnormal in patients with von Willebrand disease?

A) Prolonged bleeding time
B) Thrombocytopenia
C) Prolonged prothrombin time
D) Shortened partial thromboplastin time
E) Increased levels of factor VIII in plasma

Question 11

Transformation of chronic lymphocytic leukemia or small cell lymphocytic lymphoma into a large B-cell lymphoma is called

A) Burkitt lymphoma
B) Waldenstrom macroglobulinemia
C) Richter syndrome
D) myelodysplastic syndrome
E) mycosis fungoides

Question 12

Which of the following is the most common aggressive form of non-Hodgkin lymphoma in the United States?

A) Follicular lymphoma
B) Diffuse large B-cell lymphoma
C) Mantle cell lymphoma
D) Peripheral T-cell lymphoma
E) Angiocentric lymphoma

Question 13

Aplastic crisis, which can be encountered in patients with hereditary spherocytosis or sickle cell anemia, is most often precipitated by

A) deficiency of erythropoietin
B) negative feedback inhibition by bilirubin
C) adverse effect of iron released from hemolyzed erythrocytes
D) autoimmune mechanisms
E) parvovirus infection

Question 14

Which test is abnormal in hemophilia A?

A) Bleeding
B) Platelet count
C) Prothrombin time
D) Partial thromboplastin time
E) Clot retraction

Question 15

Which form of lymphoma tends to arise in the gastrointestinal tract at the site of chronic inflammation, such as chronic sialadenitis in Sjögren disease or chronic gastritis caused by Helicobacter pylori?

A) Pre-B, pre-T lymphoblastic lymphoma
B) Mantle cell lymphoma
C) Marginal cell lymphoma
D) Peripheral T-cell lymphoma
E) Burkitt lymphoma

Question 16

What is the most common form of non-Hodgkin lymphoma in the United States?

A) Follicular lymphoma
B) Diffuse large B-cell lymphoma
C) Mantle cell lymphoma
D) Peripheral T-cell lymphoma
E) Angiocentric lymphoma

Question 17

Normocytic normochromic anemia, associated with low serum iron, reduced total-iron binding capacity, and abundant iron stores, as seen in the bone marrow biopsy, are laboratory findings typically found in anemia of

A) iron deficiency
B) chronic disease
C) thalassemia minor
D) thalassemia trait
E) vitamin B₁₂ deficiency

Question 18

What are the mechanisms of thrombocytopenia in patients who have giant hemangiomas?

A) Autoimmune destruction of platelets
B) Inhibition of bone marrow
C) Mechanical destruction of platelets
D) Increased consumption of platelets in peripheral blood vessels
E) Disseminated intravascular hemolysis

Question 19

A 15-year-old boy developed generalized lymphadenopathy, accompanied by fever and malaise. A lymph node biopsy specimen showed that the architecture of the lymph nodes was erased and the nodes were infiltrated with moderately large lymphoid cells. There were numerous mitoses and apoptotic bodies. Between the B lymphocytes, there were phagocytic macrophages, imparting a "starry-sky" appearance to the lymph node. Which of the following is the most likely diagnosis?

A) Follicular lymphoma
B) Large B-cell lymphoma
C) Chronic lymphocytic leukemia/small lymphocytic lymphoma
D) Burkitt lymphoma
E) Multiple myeloma

Question 20

A 20-year-old woman was diagnosed with Hodgkin disease involving the mediastinum. Which would be the most common histologic form of Hodgkin disease to occur at this site?

A) Lymphocyte predominance
B) Nodular sclerosis
C) Mixed cellularity
D) Lymphocyte depletion
E) Nodular lymphoid predominance

Question 21

Peripheral blood cytopenia is a feature of

A) chronic myelogenous leukemia
B) chronic myeloproliferative disorders
C) myelodysplastic syndrome
D) polycythemia vera
E) essential thrombocytopenia