Hematology What is the first type of cell produced by the developing embryo? 1 point Erythrocyte Granulocyte Lymphocyte Thrombocyte Distinguished from other lymphomas by the presence of REED-STERNBERG CELLS 1 point Non-hodgkin's lymphoma Hodgkin's lymphoma Sezary Syndrome Hairy Cell Leukemia In leukemia, which term describes a peripheral blood finding of leukocytosis with a shift to the left, accompanied by nucleated red cells? 1 point Megaloblastosis Myelophthisis Dysplasia Leukoerythroblastosis What influence does the Philadelphia (Ph1)chromosome have on the prognosis of patients with chronic myelocytic leukemia? 1 point It is not predictive The prognosis is worse if Ph1 is present The prognosis is better if Ph1 is present The disease usually transforms into AML when Ph1 is present Rare disorder generally found only as an acute terminal stage in MM 1 point Plasma Cell leukemia CML AML Hodgkin's lymphoma ALL What is the mean N:C ratio of a pronormoblast? 1 point 8:1 6:1 10:1 1:6 All of the following are true about chronic myelogenous leukemia, EXCEPT? 1 point There is a presence of a chimeric BCR-ABL gene derived from portions of the BCR gene on chromosome 22 and the ABL gene on chromosome 9. BCR-ABL is created by a reciprocal (9; 22) (q34; q11) translocation of the so-called Philadelphia chromosome. This disorder is a type of Myeloproliferative Disorders. Presence of scattered macrophages with abundant wrinkled, green-blue cytoplasm a so-called sea-blue histiocytes. AOTA NOTA Dohle Bodies: 1 point Represent aggregation of Smooth ER They are similar with Alder-reilly bodies Both are Correct Neither is Correct A characteristic starry-sky pattern is commonly seen in what precursor B-cell neoplasm? 1 point Follicular Lymphoma Burkitt’s Lymphoma Diffuse Large B-cell Lymphoma Small Lymphocytic Lymphoma Erythropoietin 1 point Produced by the kidneys Has direct effect to erythrocyte Colony Forming Units (CFU-E) Both are correct Neither is correct T-Lymphocytes constitute _________-% of the Blood Lymphocyte pool in adults 1 point 0-20% 20-40 40-60% 60-80 Accumulation of degraded mucopolysaccharides. 1 point Auer Rods Pelger-Huet Alder Reilly Toxic Granules The erythroid precursor can be described as follows: the cell is of medium size compared with other normoblasts,with an N:C ratio of nearly 1:1. The nuclear chromatin is condensed and chunky throughout the nucleus. No nucleoli are seen. The cytoplasm is a muddy, blue-pink color. 1 point Reticulocyte Pronormoblast Orthochromic normoblast Polychromatic normoblast In addition to morphology, cytochemistry, and immunophenotyping, the WHO classification of myelo- and lymphoproliferative disorders is based upon which characteristics? 1 point Cytogenetic abnormalities Proteomics Carbohydrate-associated tumor antigen production Cell signaling and adhesion markers The following are compounds formed in the synthesis of heme: 1. coproporphyrinogen 3. uroporphyrinogen 2. porphobilinogen 4. protoporphyrinogen Which of the following responses lists these compounds in the order in which they are formed? 1 point 4,3,1,2 2,3,1,4 2,4,3,1 2,1,3,4 Which of the following can differentiate metamyelocytes from other stages of granulocyte maturation? 1 point Presence of specific granules Absence of nucleoli Color of the cytoplasm Indentation of the Nucleus Neutrophils and monocytes are direct descendants of a common progenitor known as: 1 point CLP GMP MEP HSC Changes in the nucleus: 1 point Decrease in basophilia increased diameter of the nucleus as it matures Both are correct Neither is correct Which of the following types of Hodgkin's lymphoma has the best prognosis? 1 point Nodular Sclerosis Lymphocyte predominant mixed cellularity lymphocyte depletion A 50-year-old woman who has been receiving busulfan for 3 years for chronic myelogenous leukemia becomes anemic. Laboratory tests reveal: Thrombocytopenia, Many peroxidase-negative blast cells in the peripheral blood, Bone marrow hypercellular in blast transformation, and Markedly increased bone marrow TdT Which of the following complications is this patient most likely to have? 1 point acute lymphocytic leukemia acute myelomonocytic leukemia acute myelocytic leukemia busulfan toxicity Which of the following is not associated with hereditary spherocytosis? 1 point Extravascular hemolysis Intravascular hemolysis An MCHC greater than 36% Increased osmotic fragility What single feature of the normal RBCs is most responsible for limiting their life span? 1 point Loss of mitochondria Increased flexibility of the cell membrane Reduction of hemoglobin iron Loss of the nucleus What would be the most likely designation by the WHO for the FAB AML M2 by the French-American-British classification? 1 point AML with t(15;17) AML with inv(16) AML with mixed lineage AML with t(8;21) All of the following are synthesized in the Mitochondria, EXcept: 1 point Heme Protoporphyrin Succinyl CoA + D-ALA Uroporphyrinogen III The chromosomal abnormality found in patients with AML M3 is found in chromosomes ____ and ____: 1 point 15 and 19 13 and 17 15 and 17 8 and 21 8 and 14 The Hematopoietic stem cell is a _________ stem cell. 1 point Totipotent Multipotent Progenitor Myeloid Blast cell Which of the following is the earliest recognizable stage in Granulopoiesis? 1 point Myelocyte Promyelocyte Myeloblast Juvenile Cells Which of the following types of Non-hodgkin's lymphoma has better prognosis? 1 point Well-Differentiated True Histiocytic Follicular Mycosis Fungoides Acute Lymphoblastic Leukemias: Burkitt type 1 point L1 L2 L3 Pelger-Huet Anomaly 1 point Autosomal Dominant trait Acquired or pseudo-Pelger-Huet Anomaly is most often seen in Acute Myelogenous leukemia Both are correct Neither is correct One Pronormoblast can give rise to______erythrocytes. 1 point 8 16 32 24 Manifestations: Visceral involvement, hepatic bone marrow, pulmonary, disseminated bony involvement, skin 1 point Hodgkin's lymphoma Stage 1 Hodgkin's lymphoma Stage 2 Hodgkin's lymphoma Stage 3 Hodgkin's lymphoma Stage 4 Non-Hodgkin's lymphoma Stage 3 Non-Hodgkin's lymphoma Stage 2 Many microspherocytes and schistocytes and budding off of spherocytes can be seen on peripheral blood smears of patients with: 1 point hereditary spherocytosis acquired autoimmune hemolytic anemia disseminated intravascular coagulation (DIC) extensive burns During the second trimester of fetal development, the primary site of blood cell production is the: 1 point Bone marrow Spleen Lymph nodes Liver Erythropoiesis: 1 point It takes approximately 3 days for the pronormoblast to develop into orthochromic normoblast Reticulocytes are held within the bone marrow for an additional 24 hours before it is released into the peripheral blood Both are correct Neither is correct Leukemic lymphoblasts reacting with anti-CALLA are characteristically seen in: 1 point Null-cell ALL T-cell ALL Common ALL B-cell ALL Small to moderate amount of grayish cytoplasm that has hairlike projections around the outer border of the cell 1 point Plasma Cell leukemia Chronic Myelogenous Leukemia Leukemic Reticuloendotheliosis ALL Burkitt's Lymphoma Naegeli's Syndrome 1 point AML M3 AML M4 AML M5a AML M5b AML M6 The esterase cytochemical stains are useful to differentiate: 1 point Granulocytic from monocytic leukemias Lymphocytic leukemias from myelocytic leukemias Monocytic leukemias from megakaryocytic leukemias Lymphocytic leukemias from monocytic leukemias A 15-year-old girl is taking primaquine for parasitic infection and notices her urine is a brownish color. A CBC shows mild anemia. The laboratorian performing the reticulocyte count notices numerous irregular shaped granules near the periphery of the RBC. These cellular inclusions are most likely: 1 point Howell-Jolly bodies basophilic stippling Heinz bodies Pappenheimer bodies The predominant cell is a poorly differentiated myeloblast without any granulation; nuclear chromatin is fine with one or more distinct nucleoli; cytoplasm is moderate and amount, and Auer rods are rare 1 point AML M1 AML M2 AML M3 AML M4 Nucleus has brainlike convolution, and has a ground-glass appearance. 1 point plasma cell Lymphocyte Basophil Monocyte Which of the following disorders is associated with ineffective erythropoiesis? 1 point G6PD deficiency Liver disease Hgb C disease Megaloblastic anemia Rieder cells are similar to Normal lymphocytes except that the nucleus is notched, lobulated, and cloverleaf-like. They occur in: 1 point Niemann-pick and Burkitt’s lymphoma CLL Lymphosarcoma Natural artifact Which AML cytogenetic abnormality is associated with acute myelomonocytic leukemia with marrow eosinophilia under the WHO classification of AML with recurrent genetic abnormalities? 1 point AML with t(15;17) AML with inv(16) AML with mixed lineage AML with t(8;21) AML M5 1 point Exists in 2 forms: Differentiated (M5b) and Poorly differentiated (M5a) Also known as Di Guglielmo's Syndrome Both are correct Neither is correct A differential was performed on an asymptomatic patient. The differential included 60% neutrophils: 55 of which had 2 lobes and 5 had 3 lobes. There were no other abnormalities. This is consistent with which of the following anomalies? 1 point Pelger-Huet May-Hegglin Alder-Reilly Chediak-Higashi Which of the following reactions are often positive in ALL but are negative in AML? 1 point Terminal deoxynucleotidyl transferase and PAS Chloroacetate esterase and nonspecific esterase Sudan Black B and peroxidase New methylene blue and acid phosphatase A MedTech intern saw a mixture of Megalocytes, microcytes, and immature RBCs on the Blood smear of a patient. Which of the following values will likely reflect the status of the patient? 1 point RDW value of 15.5 % MCHC value of 37 RDW value of 14.3% B and C Compared to a rubricyte, a metarubricyte looks different because of its: 1 point Dark blue cytoplasm Larger size Pyknotic nucleus Nucleoli Quiz in Hematology (Seminar 1 and Seminar 2) Hemolytic uremic syndrome is characterized by all of the following except; 1 point Hemorrhage Thrombocytopenia Hemoglobinuria Reticulocytopenia The autohemolysis test is positive in all the following areas except: 1 point G6PD deficiency Hereditary Spherocytosis Pyruvate Kinase deficiency Paroxysmal Nocturnal Hemoglobinuria G6PD deficiency is a disorder with a (an) 1 point A structural membrane defect B erythrocytic enzyme defect C defect of the hemoglobin molecule D defect in heme synthesis A hemolytic crisis may be precipitated in 10% of American Black males suffering from G6PD deficiency 1 point A fava beans B primaquine C quinine D quinidine All of the following are usually found in Hgb C disease, Except; 1 point Bar of Gold crystals Codocytes Lysine substituted for Glutamic acid at the sixth position of the alpha chain Fast mobility of Hgb C at pH 8.6 Which of the following tests is not useful in determining increased erythrocyte destruction? 1 point A Reticulocyte count B Total leukocyte count C Serum haptoglobin D Unconjugated bilirubin All of the Following are deficient in Hereditary Spherocytosis, Except: 1 point Protein 4.1R Ankyrin Band 3 Beta Spectrin The characteristic hemoglobin concentration in a patient's silent state with heterozygous ß thalassemia 1 point A Hb A level normal B Hb A2 increased C Hb A2 level decreased D Hb F level increased In warm-type autoimmune hemolytic anemia (AIHA) 1 point A IgM usually anti-1, is present B Rh antibodies are the most frequent cause C IgM usually occurs in newborn infants D autoantibodies are present A patient hematocrit from a morning specimen was 0.35 L/L; later that afternoon it was 0.40 L/L. Both specimens were collected in an EDTA evacuated tube. Assuming that there should not have been any significant change in the hematocrit, what is one possible explanation for the discrepancy? 1 point a. The correct order of draw was not followed b. The tourniquet was applied too long during the first collection c. The tourniquet was applied too long during the second collection d. An improper anticoagulant was used Which of the following is most true of paroxysmal nocturnal hemoglobinuria? 1 point It is an acquired hemolytic anemia It is inherited as a sex-linked trait It is inherited as an autosmal dominant trait It is inherited as an autosmal recessive trait Autosplenectomy is characteristic of; 1 point Sickle Cell trait Homogenous Hgb C disease Thalassemia major Sickle Cell anemia Heterogenous Hgb C disease When the bone marrow temporarily ceases to produce cells in a sickle cell patient, a/an __________ crisis has occurred 1 point Aplastic Hemolytic Vaso-occlusive Painful Myelofibrotic In which of the ff. conditions: is Hgb A2 elevated? 1 point Hgb H Hgb SC disease B-thalassemia minor Hgb S trait Thalassemia Major B and D What estimated percentage of black Americans are heterozygous for Hb S 1 point A 4% B 8% C12% D More than 25 What factors contribute to the sickling of erythrocytes in sickle cell disease crisis? 1 point A Increase in blood pH and increase in oxygen B Extremely hot weather C Extremely reduced oxygen and increased acidity in the blood D Sickling is spontaneous Although there are many complications in individuals with thalassemia major, which of the following is the leading cause of death? 1 point Splenomegaly Cardiac Complications Autosplenectomy Bone marrow atrophy Hemoglobin Lepore All of the following can lead to Paroxysmal Nocturnal Hemoglobinuria, Except: 1 point Decreased Fixation of C3 Increased complex C5 through c9 Increased ability of complex to penetrate lipid membrane of the cell, which leads to the destruction of RBCs Only choice A can lead to PNH Patients with beta-thalassemia: 1. Normocytic normochromic anemia 3. Decreased hemoglobin F 2. Occasional target cells 4. Increased hemoglobin A2 1 point 1 and 3 2 and 4 1, 2 and 3 1, 2, 3 and 4 All of the following are extrinsic causes of Hemolytic anemia, Except: 1 point Septicemia (e.g Clostridium) Zinc Toxicity Extracoporeal circulation (e.g Open Heart Surgery) Microangiopathic anemia caused by Eclampsia The Benin haplotype of sickle cell disease is prevalent in which country or countries? 1 point Saudi Arabia and Asia Senegal West Africa Central and South Africa North Africa and Arabian Peninsula Cote D'ivoire All of the following statements are true about Hemolytic anemia caused by Hereditary spherocytosis, Except; 1 point Most common type of Hereditary Hemolytic anemia in caucasians Increased autohemolysis in Lab testing; corrected by addition of sucrose It is an intrinsic cause of Hemolytic anemia Small dense staining "Bronze" spherocytes lacking central pallor Which of the following hemoglobin separation methods is used for most newborn hemoglobin screening? 1 point High performance liquid chromatography Alkaline Electrophoresis Isoelectric Focusing Acid Electrophoresis SDS-PAGE Which antibiotic(s) is (are) most often implicated in the development of aplastic anemia? 1 point Penicillin Tetracycline Sulfonamides Chloramphenicol What is the majority Hemoglobin in Thalassemia Major 1 point Hgb A Hgb A2 Hgb F Hgb H All of the following are consistent findings in Intravascular hemolysis, Except: 1 point Increased plasma hemoglobin Hemoglobinuria Increased plasma haptoglobin Methemoglobinemia In sickle cell disease, the cause is 1 point A a change of a single nucleotide (GAT to GTT) B the substitution of valine for glutamic acid at the sixth position on the beta chain of the hemoglobin molecule C not genetic D both A and B E both B and C F none of the statements is correct The abnormally increased hemoglobin electrophoresis value(s) that would usually exclude the possibility of alpha thalassemia is (are):1. HbA2 2. HbH 3. HbF 4. Hb Barts 1 point 1 and 3 2 and 4 1, 2 and 3 4 only One of the two most common monogenic diseases of man is 1 point A sickle cell trait B sickle cell disease C Alpha thalassemia D Hb SC disease Of the four clinical states of alpha-thalassemia, which is incompatible with life? 1 point Alpha thalassemia silent carrier Alpha thalassemia trait Hgb H disease Bart's hydrops fetalis Hemolytic anemia caused by Hereditary Stomatocytosis can be due to: 1 point Increased phosphorylation by ATP in RBCs Decreased red cell K+ and Increased red cell Na+ Rh Null disease B and C All of the above Homozygous Beta thalassemia patients have 1 point A no manifestations of anemia B only mild anemia C moderate anemia D severe transfusion-dependent anemia The Na+ - K+ cation pump is an important mechanism in keeping the red blood cell intact. Its function is to maintain a high level of: 1 point Intracellular Na+ Intracellular K+ Plasma Na+ Plasma K Laboratory findings in acute hemolytic anemia: 1. Hemoglobinemia 2. Inc. plasma haptoglobin 3. Hemoglobinuria 4. Hematuria 1 point 1 and 3 2 and 4 1, 2 and 3 1, 2, 3 and 4 How many amino acids are present in the alpha chain of Hb Constant Spring? 1 point 142 141 172 183 166 A patient with hemolytic-uremic syndrome associated with septicemia has a haptoglobin level that is normal, although the plasma free hemoglobin is elevated and hemoglobinuria is present. Which test would be more appropriate than haptoglobin to measure this patient’s hemolytic episode? 1 point Hemopexin Alpha-1 antitrypsin C-reactive protein Transferrin The osmotic fragility test in patient with thalassemia major would most likely be: 1 point Increased Decreased Normal Increased after incubation at 37 deg C Which of the following conditions is the leading cause of hospitalization for sickle cell patients? 1 point Acute chest Syndrome Priapism Painful Crisis Splenic sequestration Hemolytic anemia is not indicated by a(an): 1 point Positive urine hemosiderin Positive fecal occult blood Increased in plasma unconjugated bilirubin Decreased serum haptoglobin Spur Cell anemia: 1 point Complication of severe liver disease in some patients Due to defect in lipid component of the RBC membrane Both statements are correct Neither is Correct
