Chapter 3: Hematopoietic function

von Willebrand factor is directly involved in:

• platelet adhesion and aggregation.

• platelet production.

• formation of the fibrin clot.

• clot dissolution.

A 50-year-old man is having an acute myocardial infarction and will be administered recombinant tissue plasminogen activator (t-PA). The medication activates plasminogen in order to:

• decrease platelet adhesion.

• increase clotting time.

• promote fibrinolysis.

• promote coronary vasodilation.

A 25-year-old woman comes in complaining of night sweats and at times gets chills. She is losing weight unintentionally. She has no other complaints. A lymph node in her neck that measures 3 cm and is painless is palpated. The most likely diagnosis is:

• non-Hodgkin lymphoma.

• Hodgkin lymphoma.

• Burkitt lymphoma.

• multiple myeloma.

In Hodgkin lymphoma, B cells can become defective as a result of:

• T-cell inactivation of B cells.

• premature apoptosis due to lack of differentiation.

• errors in immunoglobulin gene arrangements.

• enhanced conversion into plasma B memory cells.

A 30-year-old man is complaining of cough, difficulty breathing, and fatigue that he has had for about a month. The cough is nonproductive and he denies fever. He attributes his symptoms to his asthma, which he had as a child. He borrowed an inhaler like he would use for his asthma but he states it doesn't seem to be working. A chest X-ray reveals a mediastinal mass and mediastinal nodes. Based on these findings, which type of cancer is the most likely diagnosis?

• Hodgkin lymphoma

• Non-Hodgkin lymphoma

• Myelodysplastic syndrome

• Ewing sarcoma

Which of the following is a characteristic of non-Hodgkin lymphoma in comparison to Hodgkin lymphoma?

• It accounts for only 10% of all lymphomas.

• Reed-Sternberg cells are generally present.

• Multiple lymph nodes are usually involved.

• Incidence is higher in young adults.

A mother brings in her 7-year-old son for an evaluation. The mother states her son has not been eating well. When questioned, the boy states he is not eating because he feels "bumps" in his neck and like his face is getting big. The mother notes that his face looks different. The family just moved from Africa. The vital signs are normal and his height and weight are appropriate for his age. Physical exam findings are unremarkable except for enlarged tonsils and asymmetrical facial bone distortion and nontender, enlarged lymph nodes palpated in his head and neck region. Based on these findings, which type of childhood lymphoma is the most likely diagnosis?

• Burkitt lymphoma

• Large-cell lymphoma

• Lymphoblastic lymphoma

• Hodgkin lymphoma

Abnormal immunoglobulins known as M proteins and free light chains produced by plasma cells are characteristic of:

• non-Hodgkin lymphoma.

• multiple myeloma.

• myelodysplastic syndrome.

• acute myelogenous leukemia.

Most lymphomas arise in:

• T cells.

• Reed-Sternberg cells.

• B cells.

• NK cells.

A 66-year-old black man comes in complaining of back pain. Diagnostic tests are done and include an X-ray, a complete blood count with differential, and a comprehensive metabolic panel (e.g., glucose, potassium, calcium, albumin). Which findings are consistent with multiple myeloma?

• Hypocalcemia

• High platelet level

• High neutrophil count

• Diffuse well-defined "punched out" lytic lesions