Question 1

The diagnosis of multiple myeloma (MM) depends on

Accepted Answer

A) more than 10% plasma cells in the bone marrow. 
B) a decreased concentration of B lymphocytes. 
C) excretion of Bence Jones protein. 
D) increased albumin concentration in serum protein. 
A) more than 10% plasma cells in the bone marrow. 
B) a decreased concentration of B lymphocytes. 
C) excretion of Bence Jones protein. 
D) increased albumin concentration in serum protein. A

Question 2

Patients with Waldenström's macroglobulinemia (WM) exhibit abnormally large amounts of

Accepted Answer

A) IgM. 
B) IgG. 
C) IgE. 
D) IgA. 
A) IgM. 
B) IgG. 
C) IgE. 
D) IgA. A

Question 3

The difference in antibody class between multiple myeloma (MM) and Waldenström's macroglobulinemia (WM) is that the most common form of MM displays _________, but WM displays ____________.

Accepted Answer

A) IgG; IgM 
B) IgG; IgD 
C) IgM; IgG 
D) IgA; IgM 
A) IgG; IgM 
B) IgG; IgD 
C) IgM; IgG 
D) IgA; IgM A

Question 4

Match the types of cryoglobulin with the correct description.
-Type II

Accepted Answer

A) Mixed cryoglobulins in which both constituent immunoglobulins are polyclonal. More than 90% contain IgM rheumatoid factor and IgG. These cryoglobulins are seen in a variety of autoimmune, systemic rheumatic diseases and persistent infections with immune complexes (e.g., bacterial endocarditis). 
B) Cryoglobulins composed of a single class; IgM and IgG classes most common; IgA or light-chain, single cryoglobulins seen less frequently. This type constitutes about 25% of cryoglobulins and is generally associated with multiple myeloma, macroglobulinemia, and other, rarer neoplastic proliferations of plasma cells and lymphocytes. 
C) Cryoglobulins consist of two forms. The monoclonal form always has rheumatoid factor activity and usually is an IgM with $\kappa$ light chains. The second form is polyclonal IgG, which reacts with the monoclonal IgM rheumatoid factor. 
A) Mixed cryoglobulins in which both constituent immunoglobulins are polyclonal. More than 90% contain IgM rheumatoid factor and IgG. These cryoglobulins are seen in a variety of autoimmune, systemic rheumatic diseases and persistent infections with immune complexes (e.g., bacterial endocarditis). 
B) Cryoglobulins composed of a single class; IgM and IgG classes most common; IgA or light-chain, single cryoglobulins seen less frequently. This type constitutes about 25% of cryoglobulins and is generally associated with multiple myeloma, macroglobulinemia, and other, rarer neoplastic proliferations of plasma cells and lymphocytes. 
C) Cryoglobulins consist of two forms. The monoclonal form always has rheumatoid factor activity and usually is an IgM with $\kappa$ light chains. The second form is polyclonal IgG, which reacts with the monoclonal IgM rheumatoid factor.

Question 5

When an M spike is observed on serum protein electrophoresis, the suggested sequence of testing includes testing by

Accepted Answer

A) immunoelectrophoresis. 
B) immunofixation. 
C) flow cytometry. 
D) Both A and B. 
A) immunoelectrophoresis. 
B) immunofixation. 
C) flow cytometry. 
D) Both A and B.

Question 6

Cryoglobulins are proteins that precipitate at

Accepted Answer

A) -18° C 
B) -4° C 
C) 0° C 
D) 4° C 
A) -18° C 
B) -4° C 
C) 0° C 
D) 4° C

Question 7

An automated nephelometric assay allows for the quantitation of:

Accepted Answer

A) ($\kappa$ free light chains.) 
B) ($\lambda$ free light chains.) 
C) light chains on automated instruments. 
D) All of the above. 
A) ($\kappa$ free light chains.) 
B) ($\lambda$ free light chains.) 
C) light chains on automated instruments. 
D) All of the above.

Question 8

If an IgG spike is observed on a serum electrophoretic pattern, what diagnosis does this suggest?

Accepted Answer

A) Multiple myeloma (MM) 
B) Waldenström's macroglobulinemia (WM) 
C) Acute lymphoblastic leukemia (ALL) 
D) Hypogammaglobulinemia 
A) Multiple myeloma (MM) 
B) Waldenström's macroglobulinemia (WM) 
C) Acute lymphoblastic leukemia (ALL) 
D) Hypogammaglobulinemia

Question 9

Mortality exceeds 50% in patients with multiple myeloma (MM) because of

Accepted Answer

A) sepsis. 
B) renal insufficiency. 
C) aplastic anemia. 
D) bone fractures. 
A) sepsis. 
B) renal insufficiency. 
C) aplastic anemia. 
D) bone fractures.

Question 10

Patients with multiple myeloma (MM) have defects in ______________ but not in _____________.

Accepted Answer

A) cellular immunity; humoral immunity 
B) humoral immunity; cellular immunity 
C) blood cell multiplication; protein synthesis 
D) complement; the structure of other protein molecules 
A) cellular immunity; humoral immunity 
B) humoral immunity; cellular immunity 
C) blood cell multiplication; protein synthesis 
D) complement; the structure of other protein molecules

Question 11

MGUS is characterized by all the following except

Accepted Answer

A) fewer than 10% plasma cells in the bone marrow. 
B) presence of lytic bone lesions. 
C) anemia. 
D) hypercalcemia. 
A) fewer than 10% plasma cells in the bone marrow. 
B) presence of lytic bone lesions. 
C) anemia. 
D) hypercalcemia.

Question 12

Match the types of cryoglobulin with the correct description.
-Type III

Accepted Answer

A) Mixed cryoglobulins in which both constituent immunoglobulins are polyclonal. More than 90% contain IgM rheumatoid factor and IgG. These cryoglobulins are seen in a variety of autoimmune, systemic rheumatic diseases and persistent infections with immune complexes (e.g., bacterial endocarditis). 
B) Cryoglobulins composed of a single class; IgM and IgG classes most common; IgA or light-chain, single cryoglobulins seen less frequently. This type constitutes about 25% of cryoglobulins and is generally associated with multiple myeloma, macroglobulinemia, and other, rarer neoplastic proliferations of plasma cells and lymphocytes. 
C) Cryoglobulins consist of two forms. The monoclonal form always has rheumatoid factor activity and usually is an IgM with $\kappa$ light chains. The second form is polyclonal IgG, which reacts with the monoclonal IgM rheumatoid factor. 
A) Mixed cryoglobulins in which both constituent immunoglobulins are polyclonal. More than 90% contain IgM rheumatoid factor and IgG. These cryoglobulins are seen in a variety of autoimmune, systemic rheumatic diseases and persistent infections with immune complexes (e.g., bacterial endocarditis). 
B) Cryoglobulins composed of a single class; IgM and IgG classes most common; IgA or light-chain, single cryoglobulins seen less frequently. This type constitutes about 25% of cryoglobulins and is generally associated with multiple myeloma, macroglobulinemia, and other, rarer neoplastic proliferations of plasma cells and lymphocytes. 
C) Cryoglobulins consist of two forms. The monoclonal form always has rheumatoid factor activity and usually is an IgM with $\kappa$ light chains. The second form is polyclonal IgG, which reacts with the monoclonal IgM rheumatoid factor.

Question 13

Fluorescent in situ hybridization (FISH) testing of a bone marrow aspirate in patients with multiple myeloma should include the following:

Accepted Answer

A) t(4;14)(p16;q32) 
B) t(14;16)(q32;q23) 
C) 17p13 deletions 
D) A, B and C 
A) t(4;14)(p16;q32) 
B) t(14;16)(q32;q23) 
C) 17p13 deletions 
D) A, B and C

Question 14

Match the terms with the appropriate definition.
-Polyclonal gammopathy

Accepted Answer

A) Benign or malignant condition that results from a single clone of lymphoid-plasma cells producing elevated levels of a single class and type of immunoglobulin 
B) Condition characterized by the elevation of two or more immunoglobulins by several clones of plasma cells 
A) Benign or malignant condition that results from a single clone of lymphoid-plasma cells producing elevated levels of a single class and type of immunoglobulin 
B) Condition characterized by the elevation of two or more immunoglobulins by several clones of plasma cells

Question 15

Monoclonal gammopathy of undetermined significance (MGUS) represents (a)

Accepted Answer

A) monoclonal protein in patients with no features of multiple myeloma (MM) or related malignant disorders. 
B) disorder that can evolve into a malignant monoclonal gammopathy. 
C) serum monoclonal protein concentration less than 3 g/dL. 
D) All of the above. 
A) monoclonal protein in patients with no features of multiple myeloma (MM) or related malignant disorders. 
B) disorder that can evolve into a malignant monoclonal gammopathy. 
C) serum monoclonal protein concentration less than 3 g/dL. 
D) All of the above.

Question 16

Match the terms with the appropriate definition.
-Monoclonal gammopathy

Accepted Answer

A) Benign or malignant condition that results from a single clone of lymphoid-plasma cells producing elevated levels of a single class and type of immunoglobulin 
B) Condition characterized by the elevation of two or more immunoglobulins by several clones of plasma cells 
A) Benign or malignant condition that results from a single clone of lymphoid-plasma cells producing elevated levels of a single class and type of immunoglobulin 
B) Condition characterized by the elevation of two or more immunoglobulins by several clones of plasma cells

Question 17

What is the M component in a monoclonal gammopathy?

Accepted Answer

A) Excessive IgM antibody 
B) Monoclonal antibody or cell line 
C) Excessive number of macrophages 
D) Proliferation of malignant cells 
A) Excessive IgM antibody 
B) Monoclonal antibody or cell line 
C) Excessive number of macrophages 
D) Proliferation of malignant cells

Question 18

More than one-third of patients with Waldenström's macroglobulinemia (WM) display

Accepted Answer

A) hepatomegaly and splenomegaly. 
B) lymphadenopathy. 
C) Raynaud's phenomenon. 
D) all of the above. 
A) hepatomegaly and splenomegaly. 
B) lymphadenopathy. 
C) Raynaud's phenomenon. 
D) all of the above.

Question 19

The most consistent immunologic feature of multiple myeloma (MM) is

Accepted Answer

A) constant synthesis of a dysfunctional single monoclonal protein. 
B) incessant synthesis of immunoglobulin chains of fragments. 
C) suppression of the synthesis of normal functional antibody. 
D) All of the above. 
A) constant synthesis of a dysfunctional single monoclonal protein. 
B) incessant synthesis of immunoglobulin chains of fragments. 
C) suppression of the synthesis of normal functional antibody. 
D) All of the above.

Question 20

Match the types of cryoglobulin with the correct description.
-Type I

Accepted Answer

A) Mixed cryoglobulins in which both constituent immunoglobulins are polyclonal. More than 90% contain IgM rheumatoid factor and IgG. These cryoglobulins are seen in a variety of autoimmune, systemic rheumatic diseases and persistent infections with immune complexes (e.g., bacterial endocarditis). 
B) Cryoglobulins composed of a single class; IgM and IgG classes most common; IgA or light-chain, single cryoglobulins seen less frequently. This type constitutes about 25% of cryoglobulins and is generally associated with multiple myeloma, macroglobulinemia, and other, rarer neoplastic proliferations of plasma cells and lymphocytes. 
C) Cryoglobulins consist of two forms. The monoclonal form always has rheumatoid factor activity and usually is an IgM with $\kappa$ light chains. The second form is polyclonal IgG, which reacts with the monoclonal IgM rheumatoid factor. 
A) Mixed cryoglobulins in which both constituent immunoglobulins are polyclonal. More than 90% contain IgM rheumatoid factor and IgG. These cryoglobulins are seen in a variety of autoimmune, systemic rheumatic diseases and persistent infections with immune complexes (e.g., bacterial endocarditis). 
B) Cryoglobulins composed of a single class; IgM and IgG classes most common; IgA or light-chain, single cryoglobulins seen less frequently. This type constitutes about 25% of cryoglobulins and is generally associated with multiple myeloma, macroglobulinemia, and other, rarer neoplastic proliferations of plasma cells and lymphocytes. 
C) Cryoglobulins consist of two forms. The monoclonal form always has rheumatoid factor activity and usually is an IgM with $\kappa$ light chains. The second form is polyclonal IgG, which reacts with the monoclonal IgM rheumatoid factor.

Exam 26: Immunoproliferative Disorders

The diagnosis of multiple myeloma (MM) depends on

Patients with Waldenström's macroglobulinemia (WM) exhibit abnormally large amounts of

The difference in antibody class between multiple myeloma (MM) and Waldenström's macroglobulinemia (WM) is that the most common form of MM displays _________, but WM displays ____________.

Match the types of cryoglobulin with the correct description. -Type II

When an M spike is observed on serum protein electrophoresis, the suggested sequence of testing includes testing by

Cryoglobulins are proteins that precipitate at

An automated nephelometric assay allows for the quantitation of:

If an IgG spike is observed on a serum electrophoretic pattern, what diagnosis does this suggest?

Mortality exceeds 50% in patients with multiple myeloma (MM) because of

Patients with multiple myeloma (MM) have defects in ______________ but not in _____________.

MGUS is characterized by all the following except

Match the types of cryoglobulin with the correct description. -Type III

Fluorescent in situ hybridization (FISH) testing of a bone marrow aspirate in patients with multiple myeloma should include the following:

Match the terms with the appropriate definition. -Polyclonal gammopathy

Monoclonal gammopathy of undetermined significance (MGUS) represents (a)

Match the terms with the appropriate definition. -Monoclonal gammopathy

What is the M component in a monoclonal gammopathy?

More than one-third of patients with Waldenström's macroglobulinemia (WM) display

The most consistent immunologic feature of multiple myeloma (MM) is

Match the types of cryoglobulin with the correct description. -Type I

An Overview of Immunology

Antigens and Antibodies

Cells and Cellular Activities of the Immune System: Granulocytes and Mononuclear Cells

Cells and Cellular Activities of the Immune System: Lymphocytes and Plasma Cells

Soluble Mediators of the Immune System

Safety in the Immunology-Serology Laboratory

Quality Assurance and Quality Control

Basic Serologic Laboratory Techniques

Rapid Testing

Precipitation and Particle Agglutination Methods

Electrophoresis Techniques

Labeling Techniques in Immunoassay

Flow Cytometry

Molecular Laboratory Techniques

Infectious Diseases: Traditional and Alternate Diagnostic Techniques

Streptococcal Infections

Syphilis

Vector-Borne Diseases

Toxoplasmosis

Cytomegalovirus

Infectious Mononucleosis

Viral Hepatitis

Rubella and Rubeola Infections

Primary and Acquired Immune Deficiency Syndromes

Hypersensitivity Reactions

Tolerance, Autoimmunity, and Autoimmune Diseases

Systemic Lupus Erythematosus

Rheumatoid Arthritis

Transplantation: Hla, Solid Organ, and Hematopoietic Stem Cells

Tumor Immunology and Up-To-Date Applications of Next-Generation Sequencing

Primer on Vaccines

Filters

The difference in antibody class between multiple myeloma (MM) and Waldenström's macroglobulinemia (WM) is that the most common form of MM displays _, but WM displays ____.

Patients with multiple myeloma (MM) have defects in __ but not in _.