Question 1

A patient presents with 25% blasts (nonerythroid) , 34% monocytic cells, and 31% granulocytic cells in the bone marrow. The peripheral blood smear has 10% monocytes. The alpha-naphthyl esterase and chloroacete esterase are positive. What is the probable diagnosis based on these findings?

Accepted Answer

A)   Acute monocyte leukemia
B)   Acute monoblastic leukemia
C)   Acute myelomonocytic leukemia
D)   Acute erythroid leukemiaE) A) and D)
F) None of the above C

Question 2

Which of the following does not fall into the category of AML as defined by the WHO classification?

Accepted Answer

A)   AML with recurrent genetic abnormalities
B)   Therapy-related myeloid neoplasms
C)   MDS with excess blasts
D)   Myeloid proliferations related to Down syndromeE) All of the above
F) A) and C)

Question 3

All of the following AML subtypes have positive reactivity with myeloperoxidase stain except:

Accepted Answer

A)   Acute monocytic leukemia
B)   AML with maturation
C)   Acute erythroid leukemia
D)   AML minimally differentiatedE) B) and C)
F) A) and C) D

Question 4

What is the definition of acute leukemia, according to the World Health Organization?

Accepted Answer

According to WHO, acute leukem...

Question 5

Which of the following markers are positive for monoblasts?

Accepted Answer

A)   HLA-DR
B)   CD33
C)   CD14
D)   All of the aboveE) B) and D)
F) A) and C)

Question 6

How is erythrocyte morphology likely to be described in patients with AML?

Accepted Answer

A)   Normocytic normochromic
B)   Microcytic hypochromic
C)   Microcytic normochromic
D)   Variable with anisocytosisE) A) and B)
F) B) and C)

Question 7

What is the most likely diagnosis?

Accepted Answer

A)   Acute erythroid leukemia
B)   Acute megakaryoblastic leukemia
C)   AML with maturation
D)   AML minimally differentiatedE) A) and B)
F) C) and D)

Question 8

The WHO classification system of AML incorporates which of the following?

Accepted Answer

A)   Morphology of the proliferating cells
B)   Immunophenotyping
C)   Cytogenetic analysis
D)   All of the aboveE) A) and B)
F) A) and D)

Question 9

A PAS stain is ordered on a leukemic patient. The test is performed, and the technologist confirms that the PAS stain is positive with coarse granularity. Based on these findings, from what is the patient most likely suffering?

Accepted Answer

A)   Acute myelomonocytic leukemia
B)   Acute erythroleukemia
C)   Acute megakaryoblastic leukemia
D)   AML with minimal differentiationE) B) and C)
F) B) and D)

Question 10

Which of the following confirms that a blast of unknown lineage is myeloid?

Accepted Answer

A)   Toxic granulation
B)   Leukocytosis
C)   Auer rod
D)   BasophiliaE) A) and B)
F) C) and D)

Question 11

A laboratory professional is reviewing a peripheral blood smear of a 10-year-old patient and notes that 35% blasts are present. Which of the following diagnoses is likely based on these findings?

Accepted Answer

A)   Myelodysplastic syndrome
B)   Acute leukemia
C)   Chronic myeloid leukemia
D)   Aplastic anemiaE) A) and C)
F) All of the above

Question 12

Traditional therapy in APL includes pharmacological concentration of retinoic acid (ATRA)  and chemotherapy. What is the function of the chemotherapy component in this treatment protocol?

Accepted Answer

A)   Induces maturation of the promyelocytes to mature granulocytes
B)   Binds with the target PML/RARA gene and represses gene transcription
C)   Eradicates the leukemic stem cells
D)   Induces cytolysis of the malignant promyelocytesE) B) and D)
F) A) and C)

Question 13

A patient presents with bleeding and is found to be in DIC. The peripheral smear contains hypergranular promyelocytes. The white count is slightly elevated. The bone marrow contains cells with multiple Auer rods with a clear blue cytoplasm. What is the probable type of AML?

Accepted Answer

A)   AML with 11q23 abnormalities
B)   AML with t(15;17)  q22;q12) 
C)   Microgranular APL variant
D)   AML with multilineage dysplasiaE) B) and C)
F) A) and D)

Question 14

List the common cytochemical stains used in the detection of AML and predict their results in AML.

Accepted Answer

Myeloperoxidase (MPO): positive
Sudan Bl...

Question 15

A patient presents with acute leukemia with blasts identified by a positive CD34, CD13, and CD33. Less than 3% of the blasts stain positive for MPO and SBB. Which category of AML is the most likely diagnosis for this patient?

Accepted Answer

A)   AML minimally differentiated
B)   AML without maturation
C)   Acute myelomonocytic leukemia
D)   Acute erythroid leukemiaE) B) and C)
F) A) and C)

Question 16

According to the WHO classification, when differentiating myelodysplastic syndromes and acute leukemia, acute leukemia's:

Accepted Answer

A)   Blasts must be >20% in the bone marrow
B)   Blasts must be >20% in the bone marrow and contain Auer rods
C)   Bone marrow must contain fibrosis
D)   Blast count is close to 100%E) None of the above
F) A) and D) A

Question 17

The M:E ratio of a patient with AML typically displays which of the following?

Accepted Answer

A)   Myeloid hyperplasia
B)   Erythroid hyperplasia
C)   Both myeloid and erythroid hyperplasia
D)   NothingE) B) and D)
F) None of the above

Question 18

What is the most likely diagnosis?

Accepted Answer

A)   AML without maturation
B)   AML minimally differentiated
C)   APL
D)   AMMLE) All of the above
F) B) and C)

Question 19

A major complication of APL is DIC, explain why that occurs.

Accepted Answer

The release of procoagulant material fro...

Question 20

Predict the results of the immunophenotyping panel based on the information already given.

Accepted Answer

A)   Positive reactions with CD13, CD33, and CD34
B)   Positive reactions with CD41, CD42, and CD61
C)   Positive reactions with HLA-DR and CD13
D)   Positive reactions with CD11b and CD14E) A) and B)
F) A) and C)

Exam 26: Acute Myeloid Leukemias

A patient presents with 25% blasts (nonerythroid) , 34% monocytic cells, and 31% granulocytic cells in the bone marrow. The peripheral blood smear has 10% monocytes. The alpha-naphthyl esterase and chloroacete esterase are positive. What is the probable diagnosis based on these findings?

Correct AnswerverifiedC

Which of the following does not fall into the category of AML as defined by the WHO classification?

Correct AnswerverifiedShow Answer

All of the following AML subtypes have positive reactivity with myeloperoxidase stain except:

Correct AnswerverifiedD

What is the definition of acute leukemia, according to the World Health Organization?

Correct AnswerverifiedAccording to WHO, acute leukem...View AnswerShow Answer

Which of the following markers are positive for monoblasts?

Correct AnswerverifiedShow Answer

How is erythrocyte morphology likely to be described in patients with AML?

Correct AnswerverifiedShow Answer

What is the most likely diagnosis?

Correct AnswerverifiedShow Answer

The WHO classification system of AML incorporates which of the following?

Correct AnswerverifiedShow Answer

A PAS stain is ordered on a leukemic patient. The test is performed, and the technologist confirms that the PAS stain is positive with coarse granularity. Based on these findings, from what is the patient most likely suffering?

Correct AnswerverifiedShow Answer

Which of the following confirms that a blast of unknown lineage is myeloid?

Correct AnswerverifiedShow Answer

A laboratory professional is reviewing a peripheral blood smear of a 10-year-old patient and notes that 35% blasts are present. Which of the following diagnoses is likely based on these findings?

Correct AnswerverifiedShow Answer

Traditional therapy in APL includes pharmacological concentration of retinoic acid (ATRA) and chemotherapy. What is the function of the chemotherapy component in this treatment protocol?

Correct AnswerverifiedShow Answer

A patient presents with bleeding and is found to be in DIC. The peripheral smear contains hypergranular promyelocytes. The white count is slightly elevated. The bone marrow contains cells with multiple Auer rods with a clear blue cytoplasm. What is the probable type of AML?

Correct AnswerverifiedShow Answer

List the common cytochemical stains used in the detection of AML and predict their results in AML.

Correct AnswerverifiedMyeloperoxidase (MPO): positiveSudan Bl...View AnswerShow Answer

A patient presents with acute leukemia with blasts identified by a positive CD34, CD13, and CD33. Less than 3% of the blasts stain positive for MPO and SBB. Which category of AML is the most likely diagnosis for this patient?

Correct AnswerverifiedShow Answer

According to the WHO classification, when differentiating myelodysplastic syndromes and acute leukemia, acute leukemia's:

Correct AnswerverifiedA

The M:E ratio of a patient with AML typically displays which of the following?

Correct AnswerverifiedShow Answer

What is the most likely diagnosis?

Correct AnswerverifiedShow Answer

A major complication of APL is DIC, explain why that occurs.

Correct AnswerverifiedThe release of procoagulant material fro...View AnswerShow Answer

Predict the results of the immunophenotyping panel based on the information already given.

Correct AnswerverifiedShow Answer

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D

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According to WHO, acute leukem...
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Myeloperoxidase (MPO): positive
Sudan Bl...
View Answer

Correct Answer
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A

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The release of procoagulant material fro...
View Answer

Correct Answer
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