Pathology Wbc Disorders

Front 1

What is the normal active volume of red marrow in the adult?

Back 1

500mL

Front 2

Where is a bone marrow sample taken after 18 to 20 years?

Back 2

iliac crest

Front 3

As you age, does your bone marrow get fatter or more cellular?

Back 3

fatter

Front 4

The pluripotent hematopoietic stem cell will diverage into what 2 lineages?

Back 4

multipotent lymphoid stem cell and multipotent myeloid stem cell

Front 5

The earliest recognizable granulocytic precursor is the _____

Back 5

myeloblast

Front 6

What are the first three steps of granulocyte maturation starting from myeloblast?

Back 6

myeloblast, promyelocyte, and myelocyte stages

Front 7

Classically the promyelocyte has been defined by the appearance of coarse ____ (what color) primary or azurophilic granules in the cytoplasm. These granules are loaded with lysosomal enzymes including _____

Back 7

reddish purple, myeloperoxidase

Front 8

Myelocytes are differentiated from ______ by the appearance of secondary or neutrophilic granules. These may appear as distinct tan granules or sometimes as a pink-tan hue to the cytoplasm

Back 8

promyelocytes

Front 9

The postmitotic compartment begins with the metamyelocyte stage. True or false?

Back 9

true

Front 10

Smaller than myelocytes, ______ are characterized by nuclear indentation, denser nuclear chromatin clumping, and a cytoplasm filled with neutrophilic granules.

Back 10

metamyelocytes

Front 11

Are Myeloblasts and promyelocytes motile or nonmotile?

Back 11

nonmotile

Front 12

There are actually far more neutrophils and bands awaiting entry into the blood stream than are circulating in the peripheral blood at any given time. This points to a separate function of the postmitotic compartment, that of a ______, potentially capable of rapidly accelerating the release of neutrophils into the circulation in the face of an inflammatory/infectious stimulus

Back 12

cell reserve

Front 13

Circulating neutrophils are divided into two pools of about equal size. What two pools are these?

Back 13

circulating granulocyte pool and marginal granulocyte pool.
The neutrophilic proportion of the white blood cell count (WBC) represents only the cells in the circulating granulocyte pool;

Front 14

What is the most common leukocyte in the circulation of adults?

Back 14

neutrophils

Front 15

The absolute neutrophil count normally varies from 1,500-7,500 neutrophils/uL or as a percentage 40-80%.True or False?

Back 15

True

Front 16

The characteristic large bright orange eosinophil granules initially appear at the _____ stage

Back 16

myelocyte

Front 17

What cell is the least common of the circulating leukocytes?

Back 17

basophils

Front 18

Promonocytes are large cells with folded nuclei and blue-grey cytoplasm as opposed to the pink-tan color of the cytoplasm of myelocytes and metamyelocyte. True or False?

Back 18

True

Front 19

The average macrophage can survive up to how many days?

Back 19

60 days

Front 20

In the peripheral blood, the absolute ____ count normally varies from 200-1,000 _____/uL or as a percentage 2-12%.

Back 20

monocytes

Front 21

Infection by pyogenic bacteria typically calls forth an elevation of the ______ count

Back 21

neutrophil

Front 22

Causes of _____ (increase in a certain population of leukocytes) include: tissue damage such as surgery, myocardial infarction, or thermal burn, labor and delivery, sickle cell crisis, systemic vasculitis, bleeding, and treatment with certain drugs eg, glucocorticoids or lithium

Back 22

neutrophilila

Front 23

Morphologic evidence of a shortened transit time through the marrow may be identified as _____ due to a lack of time for decolorization of primary reddish-purple granules in the neutrophils

Back 23

toxic granulation

Front 24

Dohle body formation, an ill-defined small area of blue cytoplasmic staining often in the periphery of the ______ cytoplasm, and cytoplasmic vacuolization are additional morphologic clues suggesting infection

Back 24

neutrophil

Front 25

A leukemoid reaction is defined as a reactive leukocytosis composed primarily of ______ with a WBC>50,000 cells/uL

Back 25

neutrophils

Front 26

The leukoerythroblastic reaction is characterized by circulating immature granulocytic elements (typically myelocytes) and nucleated red blood cells (NRBC's). It usually suggests what condition?

Back 26

malignancy, whereas leukemoid reaction suggests infection

Front 27

Eosinophilia can be defined as an elevation in the absolute eosinophil count above ____ eosinophils/uL.

Back 27

400

Front 28

Some skin diseases may be accompanied by _____philia such as atopic dermatitis, acute urticaria, pemphigus, and bullous pemphigoid

Back 28

eosinophilia

Front 29

Neoplastic diseases associated with _____hilia include Hodgkin lymphoma and occasional mucin-producing adenocarcinomas

Back 29

eosinophilia

Front 30

When considering the diseases associated with eosinophilia, _____ infection often comes to mind

Back 30

parasite

Front 31

In the first five years of life what is the predominating circulating white cell?

Back 31

lymphocytes

Front 32

in infants and young children, the normal bone marrow may demonstrate up to 70% _____ whereas this drops to 15% as an upper limit in adults.

Back 32

lymphocytes

Front 33

_____ infection is classically associated with reactive lymphocytosis an example of which is infectious mononucleosis

Back 33

viral

Front 34

it is the heterogeneity of the reactive lymphocytes which helps to differentiate between benign and neoplastic proliferations of lymphocytes. True or False?

Back 34

True

Front 35

Other types of infection which may be associated with reactive _____ include: toxoplasmosis, brucellosis, congenital and secondary syphilis, and Bordetella pertussis (whooping cough) infection.

Back 35

lymphocytosis

Front 36

Transient neutropenia is typical of many ____ infections and lymphopenia is often seen with _____ infection

Back 36

viral, bacterial

Front 37

Today the cancer patient undergoing chemotherapy and/or radiation therapy represents the most common cause of leukopenia, particularly neutropenia. True or False?

Back 37

True

Front 38

______ i.e., decreased granulopoiesis as well as decreased red cell and platelet production, is the most serious toxic side effect of chemotherapy

Back 38

Myelosuppression

Front 39

Most chemotherapeutic drugs are cycle active agents which destroy cells undergoing cell division. Thus the _____ compartment of granulopoiesis is primarily affected resulting in elimination of many committed progenitor cells, myeloblasts, promyelocytes, and myelocytes

Back 39

mitotic

Front 40

With chemotherapy and radiation therapy are the noncycling stem cells or the cycling stem cells most affected?

Back 40

cycling stem cells

Front 41

_____mia is generally divided into two major groups lymphocytic and myeloid (granulocytic).

Back 41

leukemia

Front 42

The combination of anemia, thrombocytopenia, and neutropenia is termed ______.

Back 42

pancytopenia

Front 43

One may see a leukoerythroblastic reaction (the presence of circulating immature granulocytes and nucleated RBC's in the peripheral blood) due to bone marrow infiltration by the blast cells in acute leukemia. True or False?

Back 43

True

Front 44

____ are large, immature white blood cells, often with punched out nucleoli

Back 44

Blasts

Front 45

Are lymphoblasts or myeloblasts have more prominent nucleoli?

Back 45

Myeloblasts

Front 46

Auer rods are found in lymphoblasts or myeloblasts?

Back 46

myeloblasts

Front 47

_____ is the most common malignancy of childhood in the U.S.

Back 47

Acute lymphoblastic leukemia

Front 48

Are the lymphocytes seen in burkitt's leukemia of small, medium, or large size?

Back 48

large

Front 49

With Burkitt lymphoma the lymphocytes have moderately abundant cytoplasm with intense basophilia and clear sharply demarcated vacuoles. True or False?

Back 49

True

Front 50

What markers are present on precursor B-cell Acute Lymphoblastic Leukemia?

Back 50

CD10, CD19, CD20

Front 51

B-lineage surface antigens plus monoclonal surface IgM signifies what type of leukemia?

Back 51

Burkitt Leukemia

Front 52

CD7, CD5, CD2 are expressed on what type of leukemias?

Back 52

Precursor T-cell Acute Lymphoblastic Leukemia

Front 53

Early thymocytes are characterized by the presence of CD___ on the cell surface

Back 53

CD7

Front 54

Common thymocytes are characterized by the additional presence of CD1, CD4, and CD8. Mature or late thymocytes can be identified as being of either CD4 (helper) or CD8 (suppressor) phenotype. True or False?

Back 54

True

Front 55

The incidence of Precursor T ALL increases with age. True or False?

Back 55

True

Front 56

Which one out of the three has the best prognosis? worst prognosis? Precursor B ALL, Precursor T ALL and Burkitt Leukemia

Back 56

best = precursor B ALL
worst = precursor T ALL

Front 57

With ALL is being hyperdipoid a good or bad prognostic factor?

Back 57

good

Front 58

A karyotypic abnormality seen in 16 to 29% of ____ associated with a favorable prognosis is t(12;21) (TEL/AML1 fusion) which requires molecular techniques for detection.

Back 58

Acute lymphoblastic leukemia

Front 59

What translocation defines the philadelphia chromosme?

Back 59

9:22

Front 60

An t(8:14) translocation is commonly associated with ____

Back 60

Burkitt Lymphoma

Front 61

The typical patient with Precursor T Acute Lymphoblastic Leukemia is an adolescent male with a somewhat lymphomatous presentation (mediastinal mass--> thymic origin and/or peripheral lymphadenopathy) and a high WBC. These features are usually lacking in Precursor B Acute Lymphoblastic Leukemia. True or False?

Back 61

True

Front 62

vincristine, prednisone, and L-asparaginase are used to treat what leukemia?

Back 62

ALL

Front 63

Chronic lymphocytic leukemia (CLL) is the most common leukemia in the United States. True or False? What is the median age of diagnosis?

Back 63

True, 60

Front 64

_____ is defined as a hemoglobin <10g/dL and ______ is defined by a platelet count <100,000 per uL

Back 64

anemia, thrombocytopenia

Front 65

Smudge cells are seen on peripheral smears of what leukemia?

Back 65

chronic lymphocytic leukemia

Front 66

Involvement of lymph nodes leads to generalized lymphadenopathy and is called small lymphocytic lymphoma. True or False?

Back 66

True

Front 67

What is the major reason for death in CLL?

Back 67

infection

Front 68

What tumor antigens are expressed on CLLs?

Back 68

Cd5 and CD20, also may nclude CD19 and CD23

Front 69

Deletion of 13q14.3 is the most frequent single chromosomal abnormality and is seen in about 50% of ___

Back 69

CLL

Front 70

Expression of CD38 n CLL correlates, although not perfectly, with a lack of mutations of the immunoglobulin genes and thus a more or less favorable prognosis.

Back 70

less

Front 71

Transformation in CLL is heralded by fever, progressive asymmetric lymphadenopathy, and organomegaly. Histologically the lymph nodes show conversion from an infiltration by small lymphocytes to large cell lymphoma. This phenomenon has been termed _____

Back 71

Richter syndrome

Front 72

Autoimmune hemolytic anemia can be a complication of CLL. True or False?

Back 72

True

Front 73

______ is an uncommon form of chronic leukemia characterized by an insidious onset, massive splenomegaly without lymphadenopathy, pancytopenia, dry bone marrow aspiration, and the presence of abnormal circulating mononuclear cells

Back 73

Hairy cell leukemia

Front 74

Why is there a dry tap of the bone marrow in hairy cell leukemia?

Back 74

fibrosis of the bone marrow

Front 75

The splenomegaly seen in hairy cell leukemia is due to expansion of the _____ by a diffuse infiltration of hairy cells similar in appearance to the bone marrow

Back 75

red pulp

Front 76

The classic cytochemical test used to confirm the presence of _____ leukemia is the tartrate resistant acid phosphatase (TRAP) reaction.

Back 76

hairy cell

Front 77

Hairy Cell leukemia is a ___- cell leukemia

Back 77

B-cell

Front 78

CD19, CD20, CD22, CD11c, CD25, FMC7, and CD103 are expressed on what type of leukemia?

Back 78

Hairy Cell

Front 79

This type of leukemia has an excellent response rate to cladribine, an adenosine deaminase inhibitor

Back 79

hairy cell leukemia

Front 80

Follicular and diffuse are two ways to classify non-Hodgkin's lymphoma. True or False?

Back 80

True

Front 81

________ (small cleaved cells), found in Non-Hodgkin's lymphoma, have elongated, twisted, angulated, club-shaped nuclear contours with absent or inconspicuous nucleoli and clumped darkly-staining nuclear chromatin.

Back 81

Centrocytes

Front 82

______ (large noncleaved cells) have oval to round large nuclei with easily identified often multiple nucleoli typically situated peripherally near the nuclear membrane in a background of pale dispersed chromatin.

Back 82

centroblasts

Front 83

Is stage the strongest predictor of prognosis in Hodgkins or Non-Hodgkin's lymphoma?

Back 83

Hodgkins

Front 84

Stage I is involvement of one lymph node group. Stage II is involvement of two or more lymph node groups on one side of the diaphragm. Stage III is involvement above and below the diaphragm. Stage IV is disseminated disease exemplified by bone marrow involvement and/or liver involvement. True or False?

Back 84

True

Front 85

Small lymphocytic lymphoma express what B cell markers?

Back 85

CD19, CD20, and CD23, also CD5

Front 86

Small lymphocytic lymphoma commonly presents at what stage?

Back 86

Stage IV

Front 87

The markers CD19, CD20, CD22, and CD10 are present on ____ lymphomas

Back 87

follicular

Front 88

The majority of follicular lymphomas have what chromosomal translocation?

Back 88

t (14:18)

Front 89

With follicular lymphoma there is overproduction of the anti-apoptotic ____ if the translocation occurs

Back 89

BCL-2

Front 90

The neoplastic follicles of follicular lymphoma contain mainly centoblasts or centrocytes?

Back 90

centrocytes

Front 91

What can you used to treat follicular lymphoma?

Back 91

slowly progressive disease that isn't really cured by conventional chemotherapy

Front 92

Positive immunohistochemical staining for CD20 performed on a routine tissue section is confirmatory of the diagnosis of a ____ malignancy

Back 92

B-cell

Front 93

Does the geminal center or non-geminal center origin diffuse, large B-cell lymphoma have a better prognosis?

Back 93

germinal center origin has better prognosis

Front 94

What is the most common type of non-Hodgkin lymphoma?

Back 94

Diffuse, large B cell lymphoma

Front 95

What is the treatment of Diffuse B-Cell Lymphoma?

Back 95

40-50% of patients cured with Chop-R

Front 96

Markers such as CD2, CD3, CD4, CD5, CD7, and CD8 are B or T cell markers?

Back 96

T cell markers

Front 97

The majority of lymphoblastic lymphomas are of Precursor ___ origin with a minority of Precursor ___ type

Back 97

T, B

Front 98

When is the peak incidence of Precursor T or B lymphoblastic lymphoma/leukemia?

Back 98

second decade

Front 99

Precursor T or B lymphoblastic lymphoma/leukemia is primarily ___diaphragmatic at presentation with significant peripheral adenopathy and/or mediastinal mass

Back 99

supra

Front 100

An aggressive B-cell lymphoma commonly occurring in children with an extranodal abdominal presentation often involving the ileocecal area

Back 100

Burkitt lymphoma

Front 101

The translocation 11:14 is seen in mantle cell lymphoma. True or Fales?

Back 101

True

Front 102

Does marginal zone lymphoma, follicular lymphoma, or mantle cell lymphoma have the worst prognosis?

Back 102

mantle cell lymphoma

Front 103

Compared to CLL, do diffuse large B cell lymphomas and Burkitt lymphomas have a better or worse prognosis?

Back 103

worse

Front 104

Do B-cell lymphomas have higher or lower grade malignancy compared to T-cell lymphomas?

Back 104

lower grade

Front 105

Is elevated LDH levels good or bad for lymphoma prognoisis?

Back 105

bad

Front 106

Compared to Hodgkin's lymphoma is non-Hodgkins lymphoma more or less common in old age?

Back 106

more common

Front 107

Does Hodgkins or non-hodgkins lymphoma usually present with localized lymph node involvement (stage I or II) and spreads in a contiguous manner from one lymph node group to an adjacent lymph node group

Back 107

Hodgkin's

Front 108

_____ lymphoma virtually always presents within lymph nodes not as extranodal disease

Back 108

Hodgkin

Front 109

The malignant cell involved in nodular lymphocyte predominant Hodgkin lymphoma is the ___ cell or ___ cell

Back 109

LP, popcorn cell

Front 110

LP cells are negative for CD30 and CD15 but positive for CD20 and CD45. True or False?

Back 110

True

Front 111

The Reed-Sternberg cell is the neoplastic cell of ____

Back 111

Hodgkin lymphoma

Front 112

R-S cell are positive for what two cell markers frequently?

Back 112

CD30 and CD15

Front 113

Most RS cells are derived from B or T cells?

Back 113

B cells

Front 114

CD30 is a member of the TNF receptor superfamily. Constitutively active CD30 signaling induces activation of ____

Back 114

NF-KB

Front 115

Is nodular sclerosis, mixed cellularity, lymphocyte depleted, or lymphocyte rich the most common subtype of classical hodgkin lymphoma?

Back 115

nodular sclerosis

Front 116

Does Nodular lymphocyte Predominant Hodgkin have a favorable or not favorable prognosis?

Back 116

favorable

Front 117

People with nodular sclerosis Hodgkin Lymphoma usually present at stage ____ with a mediastinal mass

Back 117

II

Front 118

Does lymphocyte depleted Hodgkin's Lymphoma have a good or bad prognosis?

Back 118

bad

Front 119

What is the most common therapy related malignancy for Hodgkin's lymphoma?

Back 119

acute myeloid leukemia (AML)

Front 120

When is the peak incidence of Multiple Myeloma?

Back 120

70

Front 121

Hypercalcemia, renal insufficiency, anemia, lytic bone lesions, hyperviscosity, amyloidosis, and recurrent infections are characteristics of what immunoproliferative disorder?

Back 121

multiple myeloma

Front 122

With multiple myeloma one might see ___chain in the urine

Back 122

light

Front 123

____ protein is the traditional term for free immunoglobulin light chain in the urine

Back 123

Bence Jones

Front 124

Macroglobulinemia of Waldenstrom is a B-cell lymphoma with monoclonal ____ production

Back 124

IgM

Front 125

Are lytic bone lesions present or absent in Macroglobulinemia of Waldenstrom?

Back 125

absent

Front 126

Is lymphadenopathy, hepatosplenomegaly and hyperviscosity syndrome seen in Macroglovulinemia of Waldenstrom?

Back 126

Yes

Front 127

Hodgkin's lymphoma is a disease or the white or red pulp of the spleen?

Back 127

red pulp

Front 128

Is the bone marrow involved with plasmacytoma?

Back 128

No, unlike multiple myeloma

Front 129

The promyelocyte contains ___ granules while the myeloctye contains ___ granules

Back 129

primary, secondary

Front 130

Does a band neutrophil occur after or before a segmented neutrophil?

Back 130

before

Front 131

What is the most common cause of neutropenia?

Back 131

drug-induced

Front 132

Basophilia can occur in CML and AML. True or False?

Back 132

True

Front 133

Acute viral infections are more likely to cause an increase in lymphocytes whereas an acute bacterial infection is more likely to cause an increase in neutrophils. True or False?

Back 133

True

Front 134

Toxic granulation is persistent ____ granules

Back 134

primary

Front 135

Dohle bodies are denatured aggregates of endoplasmic reticulum and free ribosomes. They stain ___ due to residual RNA

Back 135

blue

Front 136

Acute myeloid leukemia can be associated with Down's syndrome. True or False?

Back 136

True

Front 137

Myelodysplastic syndrome can evolve into AML. True or False?

Back 137

True

Front 138

The 15:17 translocation occurs in what type of WBC disorder?

Back 138

Acute myeloid leukemia

Front 139

For AML there must be more than 0% blasts in the bone marrow. True or False?

Back 139

True

Front 140

Distention of pulmonary capillaries, arterioles and small arteries are common in AML or ALL

Back 140

AML

Front 141

Can auer rods be found in AML or ALL?

Back 141

AML

Front 142

CD34, CD117, CD13, and CD33 is associated with what myeloid disorder?

Back 142

AML

Front 143

8:21, 15:17, inverted (16) and 9:11 are all balanced translocations associated with the development of de novo ___

Back 143

AML

Front 144

Monosomy or deletions of chromosomes ___ and ____ is seen with AML genetic abnormalities

Back 144

5 and 7

Front 145

Acute monocytic leukemia (a subclass of AML) is characterized by hypertrophic ____

Back 145

gums

Front 146

Granulocytic sarcoma can be the first manifestation of relapse of ___

Back 146

AML

Front 147

As you get older does the prognosis for AML get better or worse?

Back 147

worse

Front 148

t(15:17), t (8:21), inv (16) for AML has a favorable, intermediate, or unfavorable prognosis?

Back 148

favorable

Front 149

Acute promyelocytic leukemia has a ___ translocation and people have an increased risk of DIC

Back 149

t (15:17)

Front 150

What type of cancer could go into remission with the administration of all-trans retinoic acid?

Back 150

acute promyelocytic leukemia

Front 151

For acute promyelocytic leukemia (AML-M3), all trans retinoic acid must be given in combination with chemotherapy or ____ for a durable remission

Back 151

arsenic trioxide

Front 152

Myelodysplastic syndromes are caused by an increased degree of ___ which contributes to peripheral blood cytopenias

Back 152

apoptosis

Front 153

What can cause secondary myelodysplastic syndrome?

Back 153

prior treatment with DNA damaging drug radiation, and previous exposure to toxic substance

Front 154

Ringed sideroblasts can be seen in myelodysplastic syndrome. True or False?

Back 154

True

Front 155

Pseudo-Pelger-Huet cells are ___segmented neutrophils

Back 155

hyposegmented

Front 156

Ringed sideroblasts are a result of accumulation of ___ in mitochondria that in their abnormal state localize around the nucleus of the erythroblast

Back 156

iron

Front 157

Myeloproliferative disorders are usually seen in adults with the exception of CML which is seen more in children. True or False?

Back 157

True

Front 158

The 9:22 BCR-ABL translocation is associated with ___

Back 158

CML

Front 159

The JAK2 kinase mutation is associated with ____

Back 159

poolycythemia vera

Front 160

Myelofibrosis is proliferation of mature myeloid cells, especially ____

Back 160

megakaryocytes

Front 161

Is basophilia seen in CML?

Back 161

yes

Front 162

Is the clinical course of CML fast or slow?

Back 162

slowly progressive

Front 163

Imatinib or Gleevac is used to treat ____

Back 163

CML

Front 164

Is it in CML or the Leukemoid reaction where one would have a positive leukocyte alkaline phosphatase stain?

Back 164

leukemoid reaction