21

Question 1

1. Which of the following are typical characteristics of an acute leukemia?

A. Replacement of normal marrow elements by leukocytic blasts and bleeding episodes
B. Blasts and immature leukocytes in the peripheral blood and anemia
C. Leukocytosis
D. All of the above

Answer 1

D. All of the above

Question 2

2. Myeloid and monocytic acute leukemias are classified as FAB
   A. M1
   B. M4
   C. M5
   D. L1

Answer 2

B. M4

Question 3

3. Monocytic acute leukemia is classified as FAB
   A. M1
   B. M4
   C. M5
   D. L1

Answer 3

C. M5

Question 4

4. Myeloid without maturation acute leukemias is classified as FAB
   A. M1
   B. M4
   C. M5
   D. L1

Answer 4

A. M1

Question 5

5. Lymphoblastic (one cell population) acute leukemias are classified as FAB
   A. M1
   B. M4
   C. M5
   D. L1

Answer 5

D. L1

Question 6

6. Characteristics of FAB M1 include
   A. leukocytosis with maturation of the myeloid cell line in the peripheral blood
   B. leukocytosis with maturation of the lymphocytic cell line in the peripheral blood
   C. leukocytosis without maturation of the myeloid cell line in the peripheral blood
   D. leukocytosis with many mature leukocytes in the peripheral blood

Answer 6

C. leukocytosis without maturation of the myeloid cell line in the peripheral blood

Question 7

7. The incidence of FAB M1 is
   A. high in children younger than 18 months of age
   B. high in children between 1.5 and 12 years of age
   C. high in middle-aged adults
   D. both A and C

Answer 7

D. both A and C

Question 8

8. A mixture of myeloid and monocytic blasts predominate in
   A. FAB M2
   B. FAB M3
   C. FAB M4
   D. FAB M6

Answer 8

C. FAB M4

Question 9

9. Blasts of the monocytic type predominate in
   A. FAB M2
   B. FAB M3
   C. FAB M4
   D. FAB M5

Answer 9

D. FAB M5

Question 10

10. Many coarsely granular promyelocytes with dumbbell-shaped or bilobed nuclei predominate in
    A. FAB M2
    B. FAB M3
    C. FAB M4
    D. FAB M6

Answer 10

B. FAB M3

Question 11

11. Myeloblasts, promyelocytes, and myelocytes predominate in

A. FAB M2
B. FAB M3
C. FAB M4
D. FAB M6

Answer 11

A. FAB M2

Question 12

Which cytochemical stain will demonstrate lysosomal enzyme activity in primary azurophilic granules?

A. Prussian Blue
B. Sudan Black B
C. Periodic acid–Schiff (PAS)
D. Myeloperoxidase

Answer 12

D. Myeloperoxidase

Question 13

Multinucleated (3–5) erythroid precursors are usually seen in
A. acute myeloblastic leukemia without maturation
B. chronic myeloid leukemia
C. myelofibrosis
D. acute lymphoblastic leukemia

Answer 13

A. acute myeloblastic leukemia without maturation

Question 14

The M:E ratio in acute erythroid leukemia is usually
A. high
B. normal
C. variable
D. low

Answer 14

D. low

Question 15

Auer rods are
A. an aggregation of lysosomes or primary granules
B. peroxidase negative
C. LAP positive
D. associated with lymphoblasts

Answer 15

A. an aggregation of lysosomes or primary granules

Question 16

One cytochemical stain that can differentiate most cases of precursor lymphoblastic leukemia from other fomrs of leukemia is
A. peroxidase
B. alkaline phosphatase
C. nonspecific esterease
D. TdT terminal deoxynucleotidyla transferase

Answer 16

D. TdT terminal deoxynucleotidyla transferase

Question 17

Which cellular series can be identified by a positive Sudan Black B reaction?
A. Lymphocytic
B. Monocytic
C. Myelocytic
D. Erythrocytic

Answer 17

C. Myelocytic

Question 18

Which type of cell demonstrates the most intense peroxidase reaction?

A. neutrophil, expect blast forms
B. Basophil
C. Lymphocyte
D. Monocyte

Answer 18

A. neutrophil, expect blast forms

Question 19

Which cytochemical stain is associated with selectively identifying lipoproteins in the cellular membranes of myelogenous cells and mitochrondria?

A. Sudan Black B
B. LAP
C. Nonspecific esterease
D. Acid phosphatase

Answer 19

A. Sudan Black B

Question 20

Which cytochemical stain is associated with staining glycogen and related mucopolysaccharides?
A. Sudan Black B
B. LAP
C. Periodic acid Schiff stain (PAS)
D. Acid phosphatase

Answer 20

C. Periodic acid Schiff stain (PAS)

Question 21

25. Leukemia secondary to Burkitt’s lymphoma is classified as
    A. FAB M1
    B. FAB L1
    C. FAB L2
    D. FAB L3

Answer 21

D. FAB L3

Question 22

26. Childhood lymphoblastic leukemia is classified as
    A. FAB M1
    B. FAB L1
    C. FAB L2
    D. FAB L3

Answer 22

B. FAB L1

Question 23

27. Older children and adults are typically classified with
    A. FAB M1
    B. FAB L1
    C. FAB L2
    D. FAB L3

Answer 23

C. FAB L2

Question 24

Chloromas are associated with

A. FAB M1
B. FAB M3
C. FAB M4
D. FAB M5

Answer 24

A. FAB M1

Question 25

A common characteristic of ALL is A. bone and joint pain B. many blast cells with Auer rods C. leukocytopenia D. a leukemia of older persons

Answer 25

A. bone and joint pain

Question 26

Specific nature B-cell surface marker(s) membrane is A. CD 79a B. CD19 C. CD 20 D. ALL OF THE ABOVE

Answer 26

B. CD19

Question 27

Patients with AML have a good prognosis if A. less than 45 years of age B. Auer rods are present in blast cells C. Ph chromosome D. all of the above

Answer 27

A. less than 45 years of age

Question 28

Which of the following classification systems delineates each subtype of acute leukemia on immunophenotyping and cytogenetic analysis as well as morphology? A. REAL B. WHO C. FAB D. EYE

Answer 28

B. WHO

Question 29

A medical laboratory scientist is reviewing a patient’s peripheral blood smear and notices many eosinophils in addition to two different populations of blasts—myeloid and monocytic. Immunophenotyping revealed blasts were positive for CD14 and CD33. Which of the following cytogenetic abnormalities would be an expected finding with this picture? A. t (9, 22) (q34; q11.2) B. del (5q) (31) C. 11q23 D. inv (16)9p13q22

Answer 29

D. inv (16)9p13q22

Question 30

A 27-year-old woman presents with acute bleeding to the emergency department and is found to have a white count of 25.7 × 109L with pancytopenia: hematocrit 27%, platelet count 35 × 109/L, and absolute neutrophil count 0.8 × 109/L. She has a combination of 97% blasts and abnormal promyelocytes in her peripheral blood; some of these cells contain stacked Auer rods. What form of leukemia does she most likely have? A. acute myeloid with t (15; 17) (q22:q12) B. chronic myeloid leukemia C. acute monoblastic leukemia D. acute myeloid with t (8; 21) (q33:q22)

Answer 30

A. acute myeloid with t (15; 17) (q22:q12)

Question 31

A confirmed ALL patient was also positive for the Philadelphia chromosome. What conclusions can you make from this? A. the patient has a better prognosis B. the patient has a poorer prognosis C. the patient’s treatment regimen is effective D. the wrong patient was analyzed

Answer 31

B. the patient has a poorer prognosis

Question 32

A diagnosis of an acute leukemia according to the World Health Organization is defined by: A. a high WBC count B. blasts in the peripheral blood C. >20% non-erythroid blasts in the bone marrow D. hepatosplenomegaly

Answer 32

C. >20% non-erythroid blasts in the bone marrow

Question 33

An unknown blast is positive for CD34, CD19, CD10 (CALLA), CD22 and TdT. Using WHO guidelines, this immunophenotyping profile is consistent with which classification of ALL? A. early pre-B cell B. common ALL C. pre-B cell ALL D. T-cell ALL

Answer 33

B. common ALL

Question 34

ALL Prognosis is NOT dependent on which of the following? A. tumor burden B. immunophenotype C. genetic abnormalities D. morphology of the blasts

Answer 34

D. morphology of the blasts

Question 35

Patients with Down Syndrome are predisposed to developing ALL due to what genetic alteration? A. Philadelphia chromosome B. GATA1 mutation C. deletion of 5q D. no genetic alterations have been seen

Answer 35

B. GATA1 mutation