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HEMA-13

Total questions: 90

Worksheet time: 45mins

Name
Class
Date
1.
Overproduction of various types of immature or mature cells in the bone marrow and/or peripheral blood
a)
Leukemia
b)
Lymphoma
2.
Frequently involves WBCs of the myelogenous or lymphocytic cell types
a)
Leukemia
b)
Lymphoma
3.
Malignant cells easily trespass the blood-brain barrier
a)
Leukemia
b)
Lymphoma
4.
Solid malignant tumors of the lymph nodes and related WBCs in the bone tissue.
a)
Leukemia
b)
Lymphoma
5.
The distinctive cell type is the lymphocyte.
a)
Leukemia
b)
Lymphoma
6.
Malignant cells are initially confined to the organs containing mononuclear phagocytic cells such as lymph nodes, spleen, liver, and bone marrow. Lymphomas can spill over into the circulating blood and demonstrate a leukemic-appearing picture on a peripheral blood film
a)
Leukemia
b)
Lymphoma
7.
Which of the following best defines leukemia?
a)
A. Overproduction of mature lymphocytes in the lymph nodes
b)
B. Overproduction of immature or mature WBCs in the bone marrow and/or peripheral blood
c)
C. Malignant proliferation of red blood cells
d)
D. Hyperplasia of plasma cells in the bone marrow
8.
Leukemia most commonly involves which types of white blood cells?
a)
A. Neutrophils and monocytes
b)
B. Myelogenous and lymphocytic cell types
c)
C. Eosinophils and basophils
d)
D. Plasma cells and macrophages
9.
A key feature of leukemia is that malignant cells:
a)
A. Are confined to the lymph nodes
b)
B. Rarely enter the bloodstream
c)
C. Can cross the blood-brain barrier
d)
D. Are exclusively mature cells
10.
Lymphoma is primarily a malignancy of:
a)
A. Circulating white blood cells
b)
B. Lymph nodes and lymphoid organs
c)
C. The red blood cell line
d)
D. The bone cortex
11.
The distinctive cell type seen in lymphoma is the:
a)
Monocyte
b)
Lymphocyte
c)
Neutrophil
d)
Basophil
12.
In lymphoma, malignant cells are initially confined to:
a)
A. Circulating blood and bone marrow
b)
B. Organs of the mononuclear phagocyte system (e.g., lymph nodes, spleen, liver, bone marrow)
c)
C. Central nervous system only
d)
D. Peripheral tissues
13.
When lymphoma cells enter the bloodstream, the peripheral smear may show:
a)
A. Pancytopenia
b)
B. A leukemic-appearing picture
c)
C. Increased platelets
d)
D. Hypochromic RBCs
14.
The key difference between leukemia and lymphoma is:
a)
Type of malignant cell
b)
Site of origin
c)
Mode of inheritance
d)
Type of anemia associated
15.
Leukemia is best described as:
a)
A. Overproduction of erythrocytes in the bone marrow
b)
B. Neoplastic overproduction of immature or mature WBCs in the bone marrow or peripheral blood
c)
C. A deficiency of mature lymphocytes in the lymphatic tissues
d)
D. Overproduction of platelets in the peripheral blood
16.
In leukemia, a higher number of blast cells generally indicates:
a)
A. Longer survival rate
b)
B. Shorter and more fatal disease course
c)
C. Chronic progression with remission
d)
D. Normal hematopoietic function
17.
A common hematologic finding in leukemia is:
a)
A. Decreased WBC count with right shift
b)
B. Increased WBC count with shift to the left
c)
C. Normal WBC count with anisocytosis
d)
D. Pancytopenia without blasts
18.
The typical Myeloid-to-Erythroid (M:E) ratio in leukemia is approximately:
a)
1:1
b)
3:1
c)
10:1
d)
15:1
19.
The anemia commonly associated with acute leukemia is:
a)
Microcytic, hypochromic
b)
Normocytic, normochromic
c)
Macrocytic, normochromic
20.
Described by symptoms of short duration
a)
Acute leukemia
b)
Chronic leukemia
21.
Numerous immature cell forms in the bone marrow and/or peripheral blood
a)
Acute leukemia
b)
Chronic leukemia
22.
-Increased total WBC count
a)
Acute leukemia
b)
Chronic leukemia
23.
Described by symptoms of long duration
a)
Acute leukemia
b)
Chronic leukemia
24.
-Mostly mature cell forms in the bone marrow and/or peripheral blood
a)
Acute leukemia
b)
Chronic leukemia
25.
Total WBC counts range from extremely elevated to lower than normal
a)
Acute leukemia
b)
Chronic leukemia
26.
•Enzyme found in primary granules of: ▪ Neutrophils and Eosinophils ▪ Monocytes (to a certain extent)
a)
Myeloperoxidase
b)
Sudan Black B
27.
•Used in differentiating blasts of AML from those of ALL
a)
Myeloperoxidase
b)
Sudan Black B
28.
•Reactions parallel those of the MPO’s [in most cases]
a)
Myeloperoxidase
b)
Sudan Black B
29.
most sensitive stain for granulocytic precursors.
a)
Myeloperoxidase
b)
Sudan Black B
30.
Stains sterols, neutral fats, phospholipids (found in the primary and secondary granules of neutrophils and lysosomal granules of monocytes)
a)
Myeloperoxidase
b)
Sudan Black B
31.
Which cytochemical stain is typically strongly positive in neutrophilic granulocytes, eosinophils, and Auer rods, but weakly positive or negative in monocytes and lymphocytes?
a)
A. Periodic Acid-Schiff (PAS) reaction, for glycogen detection
b)
B. Nonspecific esterase stain, for monocytic differentiation
c)
C. Myeloperoxidase stain, for myeloid enzyme activity
d)
D. Acid phosphatase reaction, for lysosomal enzyme localization
32.
The Sudan Black B stain demonstrates strong positivity in mature granulocytic cells, such as metamyelocytes and segmented neutrophils, because it primarily stains:
a)
A. Nuclear chromatin and nucleoproteins
b)
B. Neutral fats, phospholipids, and sterols within cytoplasmic granules
c)
C. Glycogen and mucopolysaccharide components of cytoplasm
d)
D. Sulfhydryl groups present in membrane proteins
33.
A negative reaction for both Myeloperoxidase and Sudan Black B stains would most likely be seen in:
a)
A. Myeloblasts exhibiting early granulocytic differentiation
b)
B. Monocytes containing weakly lipid-rich lysosomes
c)
C. Lymphoblasts of acute lymphoblastic leukemia
d)
D. Eosinophilic myelocytes with dense primary granules
34.
A positive Myeloperoxidase stain in leukemic blast cells indicates that the leukemia is of:
a)
A. Lymphoid origin, characteristic of Acute Lymphoblastic Leukemia (ALL)
b)
B. Myeloid origin, consistent with Acute Myelogenous Leukemia (AML)
c)
C. Monocytic origin, typical of Chronic Monocytic Leukemia (CMML)
d)
D. Megakaryocytic origin, as seen in primary myelofibrosis
35.
Both Myeloperoxidase and Sudan Black B stains highlight Auer rods as positive structures. This finding supports a diagnosis of:
a)
A. Lymphoid leukemia due to enzyme accumulation
b)
B. Myeloid leukemia due to presence of primary azurophilic granules
c)
C. Monocytic leukemia due to lysosomal enzyme activity
d)
D. Erythroleukemia due to cytoplasmic vacuolation
36.
(+) Peroxidase stain rules out
a)
AML
b)
ALL
37.
Lymphocytic leukemias in myeloperoxidase
a)
Positive
b)
Negative
38.
Lymphocytic leukemias in Sudan Black B
a)
Positive
b)
Negative
39.
Lymphocytic leukemias in both MPO and Sudan Black B
a)
Positive
b)
Negative
40.
Most common form of childhood leukemia
a)
Acute lymphocytic leukemia (ALL)
b)
Chronic lymphocytic leukemia
41.
Most common form of elderly leukemia
a)
Acute lymphocytic leukemia (ALL)
b)
Chronic lymphocytic leukemia
42.
Examples: Hairy-cell leukemia ➢ Lymphosarcoma cell leukemia ➢ Prolymphocytic leukemia
a)
Acute lymphocytic leukemia (ALL)
b)
Chronic lymphocytic leukemia
43.
Characterized by persistent lymphocytosis
a)
Acute lymphocytic leukemia (ALL)
b)
Chronic lymphocytic leukemia
44.
70% of childhood ALL
a)
L1
b)
L2
c)
L3
45.
70% of adult ALL
a)
L1
b)
L2
c)
L3
46.
Rare in children and adults
a)
L1
b)
L2
c)
L3
47.
aka burkitt type of leukemia
a)
L1
b)
L2
c)
L3
48.
Immunologic markers: CALLA (CD10), TdT, CD19, CD20
a)
L1
b)
L2
c)
L3
49.
Cell size: Homogeneous population of small blasts
a)
L1
b)
L2
c)
L3
50.
Nucleus: Uniformly round small
a)
L1
b)
L2
c)
L3
51.
Chromatin: Slightly reticulated with perinucleolar clumping
a)
L1
b)
L2
c)
L3
52.
Cytoplasm: Scant, blue
a)
L1
b)
L2
c)
L3
53.
Cytoplasm: Moderate, pale
a)
L1
b)
L2
c)
L3
54.
Cell size: Heterogenous population of large blasts
a)
L1
b)
L2
c)
L3
55.
Nucleus: Irregular
a)
L1
b)
L2
c)
L3
56.
Nucleolus: Single to several
a)
L1
b)
L2
c)
L3
57.
Chromatin: Fine
a)
L1
b)
L2
c)
L3
58.
Immunologic markers: TdT
a)
L1
b)
L2
c)
L3
59.
Nucleolus: Single
a)
L1
b)
L2
c)
L3
60.
Immunologic markers: sIg, CD19, CD20, CD22, CD24
a)
L1
b)
L2
c)
L3
61.
Cell size: Homogenous population of large blasts with nuclear and cytoplasmic vacuoles
a)
L1
b)
L2
c)
L3
62.
Nucleus: Round to oval
a)
L1
b)
L2
c)
L3
63.
Nucleolus: Two to five
a)
L1
b)
L2
c)
L3
64.
Chromatin: Coarse with clear parachromatin
a)
L1
b)
L2
c)
L3
65.
Cytoplasm: Moderate, blue, prominently vacuolated
a)
L1
b)
L2
c)
L3
66.
Which of the following is Periodic acid-Schiff (PAS) NEGATIVE?
a)
L1
b)
L2
c)
L3
67.
Which of the following is Periodic acid-Schiff (PAS) POSITIVE?
a)
L1
b)
L2
c)
L3
68.
Which of the following is Methyl Green Pyronine NEGATIVE?
a)
L1
b)
L2
c)
L3
69.
Only sometimes positive in Oil Red O (ORO)
a)
L1
b)
L2
c)
L3
70.
Always positive in Oil Red O (ORO)
a)
L1
b)
L2
c)
L3
71.
Periodic Acid-Schiff (PAS): L1
a)
Positive
b)
Negative
72.
Periodic Acid-Schiff (PAS): L3
a)
Positive
b)
Negative
73.
Methyl Green Pyronine L1
a)
Positive
b)
Negative
74.
Methyl Green Pyronine L2
a)
Positive
b)
Negative
75.
Methyl Green Pyronine L3
a)
Positive
b)
Negative
76.
Periodic Acid-Schiff (PAS): L2
a)
Positive
b)
Negative
77.
Which of the following is Methyl Green Pyronine POSITIVE?
a)
L1
b)
L2
c)
L3
78.
E-rosettes = Negative Surface Ig = Negative Serum Anti-ALL = Negative
a)
T-ALL
b)
B-ALL
c)
Common ALL
d)
Null ALL
79.
E-rosettes = Negative Surface Ig = Negative Serum Anti-ALL = Positive
a)
T-ALL
b)
B-ALL
c)
Common ALL
d)
Null ALL
80.
E-rosettes = Negative Surface Ig = Positive Serum Anti-ALL = Negative
a)
T-ALL
b)
B-ALL
c)
Common ALL
d)
Null ALL
81.
E-rosettes = Positive Surface Ig = Negative Serum Anti-ALL = Negative
a)
T-ALL
b)
B-ALL
c)
Common ALL
d)
Null ALL
82.
Which of the following is the only surface immunoglobulin positive?
a)
T-ALL
b)
B-ALL
c)
Common ALL
d)
Null ALL
83.
Which of the following is the only E rosettes positive?
a)
T-ALL
b)
B-ALL
c)
Common ALL
d)
Null ALL
84.
Which of the following is the only serum anti-ALL positive?
a)
T-ALL
b)
B-ALL
c)
Common ALL
d)
Null ALL
85.
What is the solid tumor counterpart of Acute lymphoblastic leukemia (ALL)?
a)
Lymphoma, poorly differentiated; lymphocytic
b)
Lymphoma, well-differentiated; lymphocytic
c)
Reticulum cell sarcoma
d)
Chloroma
86.
What is the solid tumor counterpart of Chronic lymphocytic leukemia?
a)
Lymphoma, poorly differentiated; lymphocytic
b)
Lymphoma, well-differentiated; lymphocytic
c)
Reticulum cell sarcoma
d)
Chloroma
87.
What is the solid tumor counterpart of monocytic leukemia?
a)
Lymphoma, poorly differentiated; lymphocytic
b)
Lymphoma, well-differentiated; lymphocytic
c)
Reticulum cell sarcoma
d)
Chloroma
88.
What is the solid tumor counterpart of acute myelogenous granulocytic leukemia?
a)
Lymphoma, poorly differentiated; lymphocytic
b)
Lymphoma, well-differentiated; lymphocytic
c)
Reticulum cell sarcoma
d)
Chloroma
89.
What is the solid tumor counterpart of plasma cell leukemia?
a)
Myeloma
b)
Lymphoma, undifferentiated
90.
What is the solid tumor counterpart of stem cell leukemia?
a)
Myeloma
b)
Lymphoma, undifferentiated