Hematology TB Flashcards Unit 3
1) The cell line committed to developing into a myeloblast is / CFU-GM2) Cells committed to differentiate as granulocytes are dependent on __(A)__ and __(B)__ to differentiate further. / a. Colony-stimulating factor (CSF)
b. Interleukins
3) Arrange the cells in granulocytic series into the correct order of maturation.
A) Promyelocyte
B) Myeloblast
C) Metamyelocyte
D) Myelocyte
E) Band neutrophil
F) Segmented polymorphonuclear neutrophil (PMN) / B, A, D, C, E, F
4) What is the length of time that myeloblasts reside in the bone marrow? / 15 hours
5) What is the length of time that promyelocytes reside in the bone marrow? / 24 hours
6) What is the length of time myelocytes spend maturing in the bone marrow? / 4.3 hours
7) The predominant cell type found in the maturation storage compartment is / Segmented polymorphonuclear neutrophil (PMN)
The marrow reserve contains mature cells with variable life spans. Match the cell type with the expected length of time in the marrow reserve.
8) Polymorphonuclear segmented neutrophils (PMNs)
9) Eosinophils
10) Basophils
11) Monocytes / 7) 7–10 days
8) 2.5 days
9) 12 hours
10) No large reserve
12) Match the proportion of cells to the concentration in the bone marrow.
Myeloblast / 1%
Myelocyte / 3%
Promyelocyte / 12%
13) Match the relative proportion of leukocytes with the cell type.
Metamyelocytes / 45%
Band neutrophils / 35%
PMNs / 20%
14) Once mature granulocytes migrate to the tissues, their life span is considered to be / Several days
15) Eosinophilic granules differ from neutrophilic granules because they / Lack lysozyme
16) Monocytes have an estimated half-life in the circulating blood of / 8.5 hours
17) Eosinophils have a well-documented daily fluctuation; the quantity of circulating eosinophils tends to be highest ____. / At night (when sleeping)
18) The total leukocyte count is highest and is at a peak at ____. / Early morning
In women, the number of circulating eosinophils __(18)__ at the time of ovulation and __(19)__ at the time of menstruation. / 18. Drop
19. Rise
20) The most frequent cause of a nonmalignant increase in total WBC count is an increase in ____. / Neutrophils
21) Eosinophilia is associated with / Active allergies (hay fever)
22) Neutropenia can result from ____ / Entrapment of PMNs in the spleen
23) Basophilia can be observed in / Chronic sinusitis
24) Significant eosinophilia (20%–70%) can be seen in / Hookworm
25) Monocytosis can be associated with / Infections, e.g., tuberculosis
26) Monocytopenia can be associated with / No known conditions
27) Döhle bodies may be seen in patients with ___. / Burns and Viral infections
28) Toxic granulation may
A) Represent metabolic toxicity in cells
B) Represent precipitation of ribosomal protein (RNA)
C) Be most frequently associated with infectious states
D) All of the above / D
29) In May-Hegglin anomaly, patients may demonstrate / Abnormal bleeding tendencies
30) Patients with Chediak-Higashi syndrome / Demonstrate delayed killing of ingested bacteria by PMNS
31) Alder-Reilly inclusions are most commonly seen in patients with / Hurler syndrome
32) True or false? H. capsulatum is a fungus. / True
33) True or false? H. capsulatum can be recovered from body fluids, e.g., CSF. / True
34) True or false? H. capsulatum can be observed in phagocytic cells / True
35) Ehrlichia characteristics include / A Gram-negative bacteria
36) Patients with type I diabetes exhibit a defect in / Cellular response to chemotaxis
37) CGD patients demonstrate a defect in / Microbicidal activity
38) The absence of the enzyme myeloperoxidase is not manifested in / Eosinophils
39) Qualitative disorders of monocytes-macrophages are manifested as ____ storage diseases. / Lipid
40) Gaucher disease represents / A deficiency of β-glucocerebrosidase
41) Niemann-Pick disease is an abnormality of ____ metabolism. / Lipid
42) Transient neutropenia can be caused by / Viral infection
43) True or false? Neutrophils are functionally defective in Pelger-Huet anomaly. / False
44) Pseudohypersegmentation can be seen in / Old segmented neutrophils
45) Eosinophilia is not a characteristic of a(n) ____ infection. / Protozoan
46) Myelokathexis is ____. / The ability to release mature granulocytes into the blood
47) Grading of toxic granulation is dependent on the __ (1)__ and the __(2)__ of granulation within the cellular cytoplasm. / 1. Coarseness
2. Amount
48) A characteristic of lazy leukocyte syndrome is defective ____. / Locomotion
49) Lymphocyte life span disorder involving dysregulation of the apoptotic pathway include / Chronic lymphocytic leukemia and Autoimmune lymphoproliferative syndrome
50) The lymphocyte pool is of crucial importance to / Adaptive immunity
51) Antigen-specific T lymphocytes expand in a primary immune response but ____ % survive in the memory pool. / Less than 10
52) After the peak of an immune response and the immune response diminishes, it has been observed that ____. / Antigen-presenting cells decrease
53) Homeostatic proliferation refers to ____. / Control of T lymphocytes in secondary lymphoid organs and circulating blood
54) At any one time, approximately ____% of the total body lymphocytes mass is present in the circulating blood. / 5
55) The blood lymphocyte pool in adults is distributed with approximately ____% of T lymphocytes. / 80
56) The blood lymphocyte pool in adults is distributed with approximately ____ % B lymphocytes. / 20
57) The dominant type of leukocyte in a baby who is a few days old is / Lymphocytes
58) What is the correct definition of the term “absolute number of lymphocytes?” / Total number of lymphocytes compared with the total number of leukocytes
59) What is the correct definition of the term “relative number of lymphocytes?” / Percentage of lymphocytes in relationship to the total population of leukocytes
60) What is the correct description for the lymphoblast stage of development? / Nucleoli may be present; delicate chromatin pattern.
61) What is the correct description for the prolymphocyte stage of development? / Slightly condensed cytoplasm chromatin pattern; small amount of medium blue color cytoplasm with a thin, darker blue rim
62) What is the correct description for the mature lymphocyte stage of development? / Dense, clumped-appearing chromatin; light sky blue cytoplasm, very scanty
63) The average lymphocyte values in peripheral blood are __(1)__% at birth, __(2)__% at six months of age, and approximately __(3)__% after the age of ten years. / 1. 31
2. 61
3. 38
64) Small, sensitized and committed lymphocytes are called / Memory cells
65) A smudge cell is produced because the cell is / Old and fragile
66) A major category of functionally active lymphocytes is
A) T cells
B) B cells
C) NK lymphocytes
D) All of the above / D
67) True or false? Sensitized T lymphocytes protect humans against viral infection. / True
68) True or false? T lymphocytes are responsible for chronic rejection in organ transplantation. / True
69) True or false? B lymphocytes reorganize foreign antigens. / False
70) Monoclonal antibodies are produced by fusing __(Choice X)__ and __(Choice Y)__. / X = A plasma cell derived from a malignant tumor
Y = A lymphocyte activated by a specific antigen
71) Match the antigen designation with the appropriate distribution cluster.
1. CD4
2. CD10 (CALLA)
3. CD19 / 1. 35%–55% mature T cells
2. 90% all common ALLs
3. 5%–15% B cells
72) The cell membrane marker ____ is lost during early maturation of T and B cells. / TDT
73) B cells are recognized by the cell surface (CD) molecules such as
A) CD19
B) CD20
C) CD22
D) All of the above / D
74) Calculate the absolute lymphocytes count using the following data: Total leukocyte count = 16.0 × 109/L; relative number of lymphocytes = 71% / 11.36 × 109/L
75) What is the most common nonmalignant cause of lymphocytosis in adolescence and adulthood? / Acute viral infection
76) Which particular leukocyte is affected in patients with infectious mononucleosis? / B lymphocytes
77) During what stage of life do most people seroconvert after exposure to Epstein-Barr virus? / Late adolescent
78) The symptoms of infectious mononucleosis include all of the following except
A) Extreme fatigue
B) Malaise
C) Trunk rash
D) Fever / C
79) In addition to hematological studies to determine an infection with Epstein-Barr virus, what other definitive test can be performed? / Epstein-Barr virus (EBV) antibody testing
80) The most common modes of transmission for cytomegalovirus (CMV) include all of the following except
A) Close contact with infected secretions
B) Blood transfusions
C) Intact skin contact
D) Intimate sexual contact / C
81) When examining a peripheral blood smear of a patient suspected of having a cytomegalovirus infection, what would be observed? / A slight lymphocytosis with more than 20% variant lymphocytes
82) The definitive diagnosis of cytomegalovirus infection is the presence of CMV-specific ____ or increasing CMV-specific _____. / IgM; IgG
83) Human infection with toxoplasmosis is prevalent because of the definitive host. What is the host? / Cat
84) The clinical manifestations of an infection with toxoplasmosis include all of the following except
A) Chills
B) Fever
C) Fatigue
D) Diarrhea / D
85) Infectious lymphocytosis is most common in what population? / Children
86) A peripheral blood smear from a 6-year-old boy with a leukocyte count of 49 x 109/L shows an increase in small, mature normal-looking lymphocytes; an increase in eosinophils; and no lymphoblasts. What is the most probable diagnosis for this patient? / Infectious lymphocytosis
87) A child presents to the physician with a sputum producing cough with pain over the trachea. The complete blood count indicates an increased leukocyte count with a high absolute lymphocyte count. On peripheral smear, small mature lymphocytes are seen. What is this child’s condition? / Bordetella pertussis infection
88) All of the following conditions may cause lymphocytopenia, except
A) Decreased production
B) Increased destruction
C) Blood donation
D) Cytotoxic drugs / C
89) Patients with diagnosed DiGeorge syndrome show a decrease in which cell population? / Total T lymphocytes
90) The original designation for the human immunodeficiency virus (HIV) was HTLV. What was the predominant cell line responsible for the naming at the time of discovery? / Lymphocytes
91) Besides T lymphocytes, CD4 antigen is expressed on all of the following except
A) Macrophages/monocytes
B) B lymphocytes
C) Granulocytes
D) Lymph nodes / C
92) The human immunodeficiency virus (HIV) can remain dormant in ______until the late stage infection/disease manifestation? / T lymphocytes
93) What opportunistic infection is considered the hallmark of later phase HIV infection? / Pneumocystis carinii pneumonia
94) Which subset of lymphocytes is decreased in a patient with HIV infection? / T lymphocytes; CD4+ subset
95) What is the ratio of CD4+ to CD8+ cells in a non–HIV-infected individual? / 2:1
96) The progressive decline in CD4+ cells leads to what overall condition for the patient? / Decrease in immune function
97) When performing confirmatory testing for HIV infection, which glycoprotein is detected consistently during the infection stages? / Glycoprotein 41
98) Systemic lupus erythematosus (SLE) is more common in females than in males by what ratio? / 8:1
99) Clinical symptoms for SLE include all of the following, except
A) Arthralgia
B) Arthritis
C) Erythematosus rash over the bridge of the nose
D) Trunk rash / D
100) What is the most common screening test for SLE? / Antinuclear antibodies (ANA) test
101) High titers of ______are seen in patients with SLE? / Double-stranded DNA
102) The presence of ANA titer of greater than ______is considered substantial in indicating an immune response. / 1:32
103) Which lymphocyte subset is disturbed in patients with SLE? / T lymphocytes; helper cells
104) The difference between leukemia and lymphoma is / Myeloma is tumor in bone marrow
105) Chronic leukemias have ____ prognosis of survival than acute leukemias. / Several months to several years (treated)
106) Myelomas differ from both leukemias and lymphomas because they involve the overproduction of __(1)__ with concurrent production of __(2)__ / 1. Plasma cells
2. Antibodies
107) The type of cell that is diagnostic of Hodgkin-type lymphoma is / Reed-Sternberg
108) In lymphomas, malignant cells are confined to / Organs with mononuclear phagocytes e.g., liver
109) The French-American-British classification separates ____ into one of the broad leukocyte groups.
A) Myelogenous
B) Monocytic
C) Lymphocytic
D) All of the above / D
110) The newest WHO lineage classification includes / Histiocytic/dendritic
111) Using the WHO 2008 classification, mature myeloid neoplasms are stratified according to / Genetic features
112) The newest leukemia/lymphoma treatment is / Molecule level drugs
113) A predisposing factor for Fanconi anemia is / Genetic
114) Describe each genetic term.
1. Translocation
2. Deletion
3. Inversion / 1.Most common type of DNA change
2. Part of a chromosome is lost
3.Part of a chromosome is reversed
115) Protooncogenes / Are antecedents of oncogenes
116) Oncogenes are
A) Central regulators of growth in normal cells
B) Genetic targets of carcinogens
C) Altered versions of normal genes
D) Both B and C / D
117) Tumor-suppressing genes
A) Are called antioncogenes
B) Appear to regulate the proliferation of cell growth in normal cells
C) Stimulate mitosis
D) Both A and B / D
118) Chemical exposure is more strongly linked to an increased risk of __(1)__ leukemia than __(2)__ leukemia. / 1. Acute myelogenous
2. Acute lymhoblastic
119) The most common genetic translocation in adults with chronic myelogenous leukemia (CML) is / t(9;22)
120) A ubiquitous virus associated with leukemia/lymphoma is / HBV
121) Secondary leukemia can emerge from / Platinum-based therapy
122) Leukemia, lymphomas, and multiple myeloma represent about ____% of cancer deaths in the United States. / 10
123) The total annual number of newly diagnosed patients with lymphoma in the United States is ____ compared to the total number of patients with leukemia. / Greater
124) Among lymphoma patients, the prognosis is ____ for those with non-Hodgkin’s compared to those with Hodgkin’s. / Poorer
125) Among leukemia patients, the most programs are for those with ____ leukemia. / Acute myeloid
126) Seventy five percent of leukemia in children (ages 0–14 years) is diagnosed as / Acute lymphoblastic