Question 1

A clinical laboratory scientist sees unusual darkly stained cytoplasmic inclusions in leukocytes that she has not seen before. She should:

Accepted Answer

A)   Ignore them; they probably are not significant.
B)   Report that the patient has Alder-Reilly anomaly.
C)   Report toxic granulation if the patient is known to have an infection.
D)   Have a supervisor or pathologist look at the cells. D

Question 2

A patient has 20% eosinophils. Which of the following can probably be eliminated?

Accepted Answer

A)   Allergy
B)   Parasitic infection
C)   Pertussis
D)   Chronic myelogenous leukemia C

Question 3

Nuclear hyposegmentation and denser than normal chromatin clumping are features of:

Accepted Answer

A)   Alder-Reilly anomaly
B)   Chédiak-Higashi syndrome
C)   May-Hegglin anomaly
D)   Pelger-Huët anomaly D

Question 4

Neutrophilia and a left shift are most often found in patients with:

Accepted Answer

A)   Autoimmune disorder
B)   Acute bacterial infection
C)   Hemolytic anemia
D)   Acute viral infection

Question 5

The Epstein-Barr virus is the causative agent for:

Accepted Answer

A)   Infectious mononucleosis
B)   Infectious lymphocytosis
C)   Lymphocytic leukemia
D)   Monocytic leukemia

Question 6

Gaucher cells and Niemann-Pick cells are found in:

Accepted Answer

A)   Peripheral blood
B)   Bone marrow only
C)   Spleen only
D)   Bone marrow and spleen

Question 7

A patient has a white count of 15.0 *109/L. What is the correct interpretation?

Accepted Answer

A)   Normal for an infant, leukocytosis for an adult
B)   Normal for an infant, leukemoid reaction for an adult
C)   Leukocytosis for any patient
D)   Normal for any patient

Question 8

Nonmalignant disorders of leukocytes are:

Accepted Answer

A)   Inherited and cause no symptoms
B)   Acquired and cause serious disease
C)   Acquired and affect the nuclei of cells
D)   Acquired or inherited and range from benign to life threatening

Question 9

Which of the following is the poorest prognostic sign for a patient with a bacterial infection?

Accepted Answer

A)   High white count with mature neutrophils
B)   High white count with immature neutrophils
C)   High white count with few toxic changes in neutrophils
D)   Low white count with immature neutrophils and toxic changes

Question 10

Neutrophilia accompanied by immature granulocytes and nucleated red cells is what kind of reaction?

Accepted Answer

A)   Leukoerythroblastic
B)   Leukemoid
C)   Myelophthisic
D)   Myeloproliferative

Question 11

What is the correct interpretation of the absolute neutrophil count in the chemotherapy patient in Question 1?

Accepted Answer

A)   Normal
B)   Neutrophilia
C)   Neutropenia
D)   Qualitative neutrophil disorder

Question 12

A patient has a white count of 15.0 *109/L. What is the best test to determine the reason for the leukocyte count?

Accepted Answer

A)   Bacterial cultures
B)   White cell differential
C)   Bone marrow aspirate
D)   Serologic test for infectious mononucleosis

Question 13

Most often the clinician makes a diagnosis of infectious mononucleosis by which of the following findings?

Accepted Answer

A)   Significant lymphocytosis, with reactive lymphocytes predominating
B)   Presence of mild thrombocytopenia, with a significant lymphocytosis
C)   Demonstration of the presence of the heterophil antibody
D)   Demonstration of the presence of cytomegalovirus antibody

Question 14

A patient has a white count of 8.3*109/L and 65% lymphocytes. What is the correct interpretation?

Accepted Answer

A)   Depends on the patient's age
B)   Lymphocytosis
C)   Lymphopenia
D)   Patient probably has infectious mononucleosis

Question 15

The abnormal granules seen in Alder-Reilly anomaly could be confused for:

Accepted Answer

A)   Toxic granulation
B)   Intracellular bacteria
C)   Döhle bodies
D)   Intracellular yeasts

Question 16

What are the abnormal cytoplasmic inclusions in Chédiak-Higashi?

Accepted Answer

A)   Nuclear fragments that prevent cell division
B)   Ribosomal material that looks like Döhle bodies
C)   Fused granules that inhibit bactericidal functions
D)   Mucopolysaccharide lipids that disrupt cell function

Question 17

A college student seeks medical care for extreme fatigue and swollen lymph nodes in the neck. The WBC count is 11.3 *109/L. The differential shows a relative and absolute lymphocytosis. Many of the lymphocytes are larger than normal, with a basophilic cytoplasm indented by the red blood cells (RBCs). The nuclei are less clumped than normal and some have nucleoli. The rest of the complete blood count (CBC) is normal. What is the most likely diagnosis?

Accepted Answer

A)   Infectious lymphocytosis
B)   Infectious mononucleosis
C)   Lymphoma
D)   Lymphocytic leukemia

Question 18

A chemotherapy patient's WBC is count is 1.0 *109 /L. There are 60% segmented neutrophils, 38% lymphocytes, and 2% monocytes. What is the absolute neutrophil count?

Accepted Answer

A)   60 * 109/L
B)   6 * 109/L
C)   0.6 * 109/L
D)   0.16* 109/L

Question 19

What abnormal findings are found in May-Hegglin anomaly?

Accepted Answer

A)   Toxic granulation and vacuoles
B)   Fused primary and secondary granules
C)   Hypersegmented neutrophils and twinning
D)   Döhle body-like cytoplasmic inclusions and thrombocytopenia

Question 20

The lymphocytes in the student in Question 22 are most likely:

Accepted Answer

A)   Differentiated T cells
B)   Lymphoblasts
C)   Plasma cells
D)   B cells

Exam 28: Nonmalignant Leukocyte Disorders