Question 1

Which of the following subtypes is associated with adult-onset ALL?

Accepted Answer

A) L1 
B) L2 
C) L3 
D) Burkitt's lymphoma 
A) L1 
B) L2 
C) L3 
D) Burkitt's lymphoma

Question 2

B-lymphoblasts in ALL exhibit which of the following markers on their surface that is also helpful in their identification?

Accepted Answer

A) CD4 
B) CD2 
C) CD10 
D) HLA-DR 
A) CD4 
B) CD2 
C) CD10 
D) HLA-DR

Question 3

Which of the following markers would be helpful in differentiating cortical T cell ALL from medullary T cell ALL?

Accepted Answer

A) HLA-DR 
B) TdT 
C) CD2 
D) CD1a 
A) HLA-DR 
B) TdT 
C) CD2 
D) CD1a

Question 4

Explain how ALL and Burkitt-type ALL are different morphologically.

Accepted Answer

ALL:
a.Small or large, homogeneous/heter

Question 5

As part of their disease progression, ALL patients are at risk for developing which of the following?

Accepted Answer

A) Recurrent infections 
B) Bleeding episodes 
C) Fatigue 
D) All of the above 
A) Recurrent infections 
B) Bleeding episodes 
C) Fatigue 
D) All of the above

Question 6

The most common form of ALL relapse in children is:

Accepted Answer

A) CNS leukemia. 
B) BM relapse. 
C) Relapse in extramedullary hematopoietic organs. 
D) Relapse in the lymphatic system. 
A) CNS leukemia. 
B) BM relapse. 
C) Relapse in extramedullary hematopoietic organs. 
D) Relapse in the lymphatic system.

Question 7

The technologist is reviewing a blood smear of a patient.He notices many immature blasts exhibiting prominent cytoplasmic basophilia and vacuolization.Cytogenetic analysis performed on this patient identified a translocation between chromosomes 8 and 14.Based on this information, what is the patient most likely suffering from?

Accepted Answer

A) Precursor B cell ALL 
B) Precursor T cell ALL 
C) ALL - Burkitt type 
D) Cannot be determined based on the information given 
A) Precursor B cell ALL 
B) Precursor T cell ALL 
C) ALL - Burkitt type 
D) Cannot be determined based on the information given

Question 8

Which of the following is a classic morphologic finding in the peripheral blood in ALL?

Accepted Answer

A) Increased WBC and platelets with increased lymphoblasts 
B) Lymphoblasts, decreased platelets and decreased neutrophils 
C) Lymphoblasts, increased platelets and increased neutrophils 
D) Increased WBC, platelets, and neutrophils 
A) Increased WBC and platelets with increased lymphoblasts 
B) Lymphoblasts, decreased platelets and decreased neutrophils 
C) Lymphoblasts, increased platelets and increased neutrophils 
D) Increased WBC, platelets, and neutrophils

Question 9

A 5-year-old patient has been diagnosed with Pre-B cell ALL.Routine cytogenetic analysis confirms the presence of the Philadelphia chromosome.What does this mean for the patient?

Accepted Answer

A) The patient is in remission. 
B) The patient has relapsed. 
C) The patient has a poor prognosis. 
D) More aggressive treatment is needed. 
A) The patient is in remission. 
B) The patient has relapsed. 
C) The patient has a poor prognosis. 
D) More aggressive treatment is needed.

Question 10

A patient 2 years of age presents with general fatigue, pallor, fever, and weight loss.The morphological exam reveals a normal leukocyte count, marked neutropenia and thrombocytopenia, with 35% blasts.A bone marrow smear reveals hypercellularity with neoplastic lymphoid cells.What cytochemical stains should be performed on the peripheral blood?

Accepted Answer

A) PAS, TdT 
B) Iron stain and Wright-Giemsa 
C) Sudan Black B, myeloperoxidase, and nonspecific esterase 
D) PAS and acid phosphatase 
A) PAS, TdT 
B) Iron stain and Wright-Giemsa 
C) Sudan Black B, myeloperoxidase, and nonspecific esterase 
D) PAS and acid phosphatase

Question 11

Use the case below to answer the following questions:
A mother takes her 6-year-old boy to see the pediatrician because of tiny pinpoint spots that appeared on his upper torso 3 days prior. The pediatrician orders a CBC, and it comes back abnormal. There are 70% blasts present, with a platelet count of 18 x 10⁹/L. A bone marrow aspirate and biopsy are performed, and confirm ALL. Cytogenetic and molecular testing was also ordered, but no results were present yet.
-Which of the following sets of markers would be useful in differentiating B cell ALL from T cell ALL?

Accepted Answer

A) CD10, CD4, CD2, CD19, and CD22 
B) HLA-DR, TdT, and CD10 
C) CD34, Ig gene rearrangement, and TCR gene rearrangement 
D) cIg, HLA-DR, and TdT 
A) CD10, CD4, CD2, CD19, and CD22 
B) HLA-DR, TdT, and CD10 
C) CD34, Ig gene rearrangement, and TCR gene rearrangement 
D) cIg, HLA-DR, and TdT

Question 12

The WHO classification of subgroups of ALL uses which criteria to help define the categories?

Accepted Answer

A) Cytochemistry and immunophenotyping 
B) Cytochemistry and molecular analysis 
C) Morphology of the blasts 
D) Morphology, immunophenotyping and molecular analysis 
A) Cytochemistry and immunophenotyping 
B) Cytochemistry and molecular analysis 
C) Morphology of the blasts 
D) Morphology, immunophenotyping and molecular analysis

Question 13

Which of the following is a positive predictive factor in children with precursor B-ALL?

Accepted Answer

A) High leukocyte count; less than 1 year of age 
B) Low leukocyte count; 4-10 years of age 
C) High leukocyte count; PBX/E2A translocation 
D) Hyperdiploid chromosomes, high leukocyte count, less than 1 year of age 
A) High leukocyte count; less than 1 year of age 
B) Low leukocyte count; 4-10 years of age 
C) High leukocyte count; PBX/E2A translocation 
D) Hyperdiploid chromosomes, high leukocyte count, less than 1 year of age

Question 14

Which of the following is an expected finding in the peripheral blood smear of an ALL patient?

Accepted Answer

A) A normal platelet count 
B) The presence of nucleated RBCs 
C) A decreased platelet count 
D) An absolute increase in mature lymphocytes 
A) A normal platelet count 
B) The presence of nucleated RBCs 
C) A decreased platelet count 
D) An absolute increase in mature lymphocytes

Question 15

Explain why acute unclassified leukemias are difficult to identify.

Accepted Answer

They are difficult to identify

Exam 24: Acute Lymphoblastic Leukemias

Which of the following subtypes is associated with adult-onset ALL?

B-lymphoblasts in ALL exhibit which of the following markers on their surface that is also helpful in their identification?

Which of the following markers would be helpful in differentiating cortical T cell ALL from medullary T cell ALL?

Explain how ALL and Burkitt-type ALL are different morphologically.

As part of their disease progression, ALL patients are at risk for developing which of the following?

The most common form of ALL relapse in children is:

Which of the following is a classic morphologic finding in the peripheral blood in ALL?

A 5-year-old patient has been diagnosed with Pre-B cell ALL.Routine cytogenetic analysis confirms the presence of the Philadelphia chromosome.What does this mean for the patient?

The WHO classification of subgroups of ALL uses which criteria to help define the categories?

Which of the following is a positive predictive factor in children with precursor B-ALL?

Which of the following is an expected finding in the peripheral blood smear of an ALL patient?

Explain why acute unclassified leukemias are difficult to identify.

Introduction

Cellular Homeostasis

Hematopoiesis

Structure and Function of Hematopoietic Organs

The Erythrocyte

Hemoglobin

The Leukocyte

Introduction to Anemia

Anemias of Disordered Iron Metabolism and Heme Synthesis

Hemoglobinopaties: Qualitative Defects

Thalassemia

Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Introduction to Hemolytic Anemia

Hemolytic Anemia: Membrane Defects

Hemolytic Anemia: Enzyme Deficiencies

Hemolytic Anemia: Immune Anemias

Hemolytic Anemia: Nonimmune Defects

Nonmalignant Granulocyte and Monocyte Disorders

Nonmalignant Lymphocyte Disorders

Introduction to Hematopoietic Neoplasms

Myeloproliferative Disorders

Myelodysplastic Syndromes

Acute Myeloid Leukemias

Lymphoid Malignancies: Chronic Lymphoid Leukemias, Lymphomas, and Plasma Cell Neoplasms

Hematopoietic Stem Cell Transplantation

Morphologic Analysis of Body Fluids in the Hematology Laboratory

Primary Hemostasis

Secondary Hemostasis and Fibrinolysis

Disorders of Primary Hemostasis

Disorders of Secondary Hemostasis

Thrombophilia

Hematology Procedures and Hemostasis

Bone Marrow Examination

Automation in Hematology and Hemostasis

Flow Cytometry

Chromosome Analysis of Hematopoietic and Lymphoid Disorders

Molecular Analysis of Hematologic Diseases

Laboratory Testing in Coagulation

Quality Assessment in the Hematology Laboratory

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