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Exam 2 Advanced Hematology

Total questions: 46

Worksheet time: 25mins

Name
Class
Date
1.

How many blast cells in a bone marrow aspirate smear are necessary for a diagnosis of acute myeloid leukemia using the WHO criteria?

a)

20%

b)

15%

c)

25%

d)

30%

2.

What cytochemical stain is best for differentiating AML from ALL?

a)

Alpha-napthyl acetate

b)

Nonspecific esterase

c)

Myeoperoxidase

d)

Periodic acid Schiff

3.

Which peripheral blood morphology is associated with dysmyelopoieisis?

a)

Hyposegmentation

b)

Hypogranulation

c)

Schistocytes

d)

Presence of Heinz Bodies

4.

Which Leukemia is more common in Children?

a)

Acute myelomonocytic leukemia

b)

Acute Lymphoblastic leukemia

c)

Acute Myelogenous leukemia

d)

Acute myeloid leukemia with minimal maturation

5.

Which chromosome abnormality is associated with mantle cell lymphoma?

a)

t(11;14)

b)

t(16;16)

c)

t(14;18)

d)

Trisomy 8

6.

Which of the following pairs of cytochemical stains provide essentially the same information with regard to blast cell identity in acute leukemia cases?

a)

chloroacetate esterase and Sudan Black B

b)

acid phosphatase and myeloperoxidase

c)

Periodic acid-Schiff and alkaline phosphatase

d)

 

alpha napthyl acetate esterase and myeloperoxidase

7.

Which of the following is a key marker for Chronic Lymphocytic Leukemia (CLL)?

a)

CD5+ and CD23+

b)

CD10+ and BCL2+

c)

CD19+ and CD20-

d)

CD15+ and CD30+

8.

Which lymphoma subtype is characterized by Reed-Sternberg cells?

a)

Diffuse Large B-Cell Lymphoma

b)

Hodgkin Lymphoma

c)

Follicular Lymphoma

d)

Burkitt Lymphoma

9.

Which B-cell neoplasm is associated with an aggressive clinical course and CD10 positivity?

a)

Chronic Lymphocytic Leukemia

b)

Burkitt Lymphoma

c)

Plasma Cell Myeloma

d)

Mycosis Fungoides

10.

Which of the following phenotypes is characteristic of hairy cell leukemia?

a)

 

CD11c+, CD19+, CD103+

b)

 

CD3+, CD4+, CD7+

c)

CD11c+, CD3+, CD10+

d)

CD13+, CD19+, CD25+

11.

Polycythemia vera can be differentiated from secondary polycythemia by measuring:

a)

erythropoeitin

b)

hematocrit

c)

plasma volume

d)

hemoglobin

12.

Which of the following is a hallmark finding in Myelodysplastic Syndromes (MDS)?

a)

Presence of Reed-Sternberg cells

b)

Ineffective hematopoiesis and increased apoptosis

c)

Presence of Auer rods in peripheral blood

d)

t(9;22) translocation

13.

Pseudo–Pelger–Huët anomaly is a characteristic finding in which condition?

a)

Acute Myeloid Leukemia

b)

Myelodysplastic Syndrome

c)

Chronic Myeloid Leukemia

d)

Follicular Lymphoma

14.

Which immunophenotypic marker is most characteristic of B-cell Acute Lymphoblastic Leukemia (B-ALL)?

a)

CD34+, CD19+, TdT+

b)

CD3+, CD4+, CD8+

c)

CD33+, MPO+

d)

CD15+, CD30+

15.

The presence of Auer rods is a defining feature of which leukemia subtype?

a)

ALL

b)

CLL

c)

AML

d)

MDS

16.

Which cytogenetic abnormality is associated with a poor prognosis in Acute Lymphoblastic Leukemia (ALL)?

a)

t(12;21)(p13;q22)

b)

t(9;22)(q34;q11)

c)

inv(16)(p13;q22)

d)

t(8;21)(q22;q22)

17.

Which genetic mutation is most commonly associated with Polycythemia Vera (PV)?

a)

BCR-ABL1

b)

JAK2 V617F

c)

CALR mutation

d)

MPL mutation

18.

Chronic Myeloid Leukemia (CML) is characterized by which chromosomal translocation?

a)

t(9;22)(q34;q11)

b)

t(15;17)(q24;q21)

c)

t(11;14)(q13;q32)

d)

t(8;14)(q24;q32)

19.

Which of the following poikilocytes is a characteristic finding in primary myelofibrosis (PM)?

a)

teardrop cell

b)

schistocyte

c)

spherocyte

d)

target cell

20.

Which stain is used to identify the presence of fibrosis in the bone marrow?

(a)  

21.

In which category does Refractory Anemia (RA) fall according to the WHO classification of Myelodysplastic Syndromes (MDS)?

a)

MDS with excess blasts (MDS-EB)

b)

MDS with single lineage dysplasia (MDS-SLD)

c)

MDS with multilineage dysplasia (MDS-MLD)

d)

MDS with isolated del(5q)

22.

Which of the following best describes the bone marrow findings in Refractory Anemia (RA)?

a)

Dysplasia affecting multiple cell lineages

b)

Presence of >5% blasts in the bone marrow

c)

Dysplasia limited to the erythroid lineage with <5% blasts

d)

Increased megakaryocytes with abnormal morphology

23.

What is the blast percentage cutoff in the peripheral blood for diagnosing Refractory Anemia (RA)?

a)

<1%

b)

5-10%

c)

10-20%

d)

>20%

24.

Which of the following is NOT a typical characteristic of Refractory Anemia (RA)?

a)

Anemia as the primary cytopenia

b)

Ringed sideroblasts present in all cases

c)

No Auer rods in peripheral blood or bone marrow

d)

Low risk of progression to acute leukemia

25.

Which chromosomal translocation is most commonly associated with Acute Promyelocytic Leukemia (APL)?

a)

t(8;21)

b)

t(15;17)

c)

t(9;22)

d)

t(11;14)

26.

Which immunophenotypic marker is most characteristic of B-cell Acute Lymphoblastic Leukemia (B-ALL)?

a)

CD3+, CD4+, CD8+

b)

CD33+, MPO+

c)

CD15+, CD30+

d)

CD34+, CD19+, TdT+

27.

Myeloblasts are ( positive or negative) for Myeloperoxidase stain? write the correct answer below

(a)  

28.

Nonspecific esterae Alpha-Naphthyl acetate separates monoblasts from myeloblasts. Monoblasts stain ( positive or negative)

(a)  

29.

What is the genetic alteration for Chronic Eosinophilic leukemia?

a)

BCR/ABL1

b)

JAK2

c)

Trisomy 8

d)

CSFR3r

30.

What is the genetic alteration for PMF

a)

JAK2

b)

CALR

c)

MPL

d)

BCR/ABL1

31.

Which genetic mutation is most commonly associated with Polycythemia Vera (PV)?

a)

BCR-ABL1

b)

JAK2 V617F

c)

CALR mutation

d)

MPL mutation

32.

The key characteristic for distinguishing between myelodysplastic syndrome and acute leukemia is:

a)

percent of bone marrow blasts

b)

bone marrow cellularity

c)

Plasma cell infiltrate

d)

None of these

33.

Which chromosome abnormality is specifically associated with myelodysplastic syndrome?

a)

translocation between chromosomes 17 and 22

b)

loss of the Y chromosome

c)

addition of chromosome 7

d)

deletion of long arm of chromosome 5

34.

Which chromosome abnormality gives rise to the hybrid gene, MYC/IGH?

a)

t(8;21)

b)

t(9;22)

c)

t(15;17)

d)

t(8;14)

35.

The cytochemical stain, chloroacetate (specific) esterase is useful for identifying blast cells of:

a)

lymphoid lineage

b)

monocytic lineage

c)

erythroid lineage

d)

myeloid lineage

36.

Which genetic abnormality gives rise to the hybrid gene CBFB/SMMHC

a)

t(12;21)

b)

t(8;21)

c)

t(9;11)

d)

t(16;16)

37.

Malignancies associated with which genetic mutation can be successfully treated with Gleevec?

a)

JAK2(V617F)

b)

BCR/ABL

c)

RAR/PML

d)

FRK(K423W)

38.

Which laboratory tests would help distinguish myelodysplastic syndrome from megaloblastic anemia?

a)

reticulocyte count

b)

myeloperoxidase stain

c)

serum folate and vitamin B12

d)

lactate dehydrogenase

39.

What cytochemical stain is used to help differentiate a leukemoid reaction from CML?

a)

Myeloperoxidase

b)

New Methylene Blue

c)

Leukocyte Alkaline Phosphatase

d)

Perl's Prussian Blue

40.

Which of the following markers is expressed in most cases of AML?

a)

 

CD2

b)

CD10

c)

CD11b

d)

CD117

41.

What is the typical M:E ratio in patients with CML (chronic myelogenous leukemia)? Select the best answer.

a)

1:10

b)

1:5

c)

15:1

d)

3:1

42.

Which of the following is consistent with leukemoid reaction?

a)

Low WBC Count

b)

Basophilia

c)

Presence of ph chromosome

d)

High LAP

43.

Which phase of CML carries the worst prognosis and is generally unresponsive to treatment?

a)

Chronic

b)

Accelerated

c)

Blastic

d)

Refractory

44.

Which of the following myeloproliferative disorders is characterized by a decreased LAP score?

a)

CML

b)

PMF

c)

ET

d)

PV

45.

Review the attachment and answer the following question:

What is the probable diagnosis based on the result?

a)

ALL

b)

CML

c)

CLL

d)

AML

46.

Review the attachment and answer the following question:

Which lab result is most helpful in obtaining a diagnosis?

a)

The identification of the BCR/ABL1 is most helpful in offering a diagnosis.

b)

The identification of the Myeoblast is most helpful in offering a diagnosis.

c)

PLT Count of 70

d)

None of the choices listed