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Pathologic basis of disease (9th) - test bank - chapter 13
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Transcript
Kumar: Robbins and Cotran Pathologic Basis of Disease, 9th Edition
Chapter 13: WBCS
Test Bank
MULTIPLE CHOICE
1. A 15-year-old boy developed generalized lymphadenopathy, accompanied by fever and malaise. A lymph node biopsy specimen showed that the architecture of the lymph nodes was erased and the nodes were infiltrated with moderately large lymphoid cells. There were numerous mitoses and apoptotic bodies. Between the B lymphocytes, there were phagocytic macrophages, imparting a "starry-sky" appearance to the lymph node. Which of the following is the most likely diagnosis?
a. Follicular lymphoma
b. Large B-cell lymphoma
c. Chronic lymphocytic leukemia/small lymphocytic lymphoma
d. Burkitt lymphoma
e. Multiple myeloma
ANS: D, Burkitt lymphoma presents with diffuse infiltration of the lymph nodes. There are many mitoses, apoptotic bodies, and macrophages that impart a starry-sky appearance to the lymph node.
2. Terminal deoxynucleotidyltransferase is a marker of
a. B cells
b. T cells
c. Precursors of B and T lymphocytes
d. Plasma cells
e. Natural killer cells
ANS: C, Terminal deoxynucleotidyltransferase, a specialized DNA polymerase, is expressed on undifferentiated pre-B and pre-T lymphoblasts. It is typically found in more than 95% of cases of acute lymphoblastic leukemia of the precursor B-cell and T-cell type.
3. Transformation of chronic lymphocytic leukemia or small cell lymphocytic lymphoma into a large B-cell lymphoma is called
a. Burkitt lymphoma
b. Waldenstrom macroglobulinemia
c. Richter syndrome
d. myelodysplastic syndrome
e. mycosis fungoides
ANS: C, Terminal transformation of low-grade lymphoma/leukemia into high-grade lymphoblastic lymphoma is called Richter syndrome. It occurs in 10% of patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).
4. What is the most common form of non-Hodgkin lymphoma in the United States?
a. Follicular lymphoma
b. Diffuse large B-cell lymphoma
c. Mantle cell lymphoma
d. Peripheral T-cell lymphoma
e. Angiocentric lymphoma
ANS: A, Follicular lymphoma accounts for 45% of all non-Hodgkin lymphomas and is the most common lymphoma in the United States.
5. Which of the following is the most common aggressive form of non-Hodgkin lymphoma in the United States?
a. Follicular lymphoma
b. Diffuse large B-cell lymphoma
c. Mantle cell lymphoma
d. Peripheral T-cell lymphoma
e. Angiocentric lymphoma
ANS: B, Diffuse large B-cell lymphomas account for 60% to 70% of all aggressive forms of lymphoma. These tumors thus form the largest group of high-grade malignant lymphomas in the United States.
6. The monoclonal immunoglobulin, the so-called M protein of multiple myeloma, belongs to which class of immunoglobulins?
a. IgA
b. IgD
c. IgE
d. IgG
e. IgM
ANS: D, The M protein, which is found in 55% of patients with multiple myeloma, belongs to the IgG class.
7. Which form of lymphoma tends to arise in the gastrointestinal tract at the site of chronic inflammation, such as chronic sialadenitis in Sjögren disease or chronic gastritis caused by Helicobacter pylori?
a. Pre-B, pre-T lymphoblastic lymphoma
b. Mantle cell lymphoma
c. Marginal cell lymphoma
d. Peripheral T-cell lymphoma
e. Burkitt lymphoma
ANS: C, Marginal cell lymphomas, also known as mantle cell lymphomas, are low-grade lymphomas that occur at the site of chronic inflammation in the gastrointestinal tract.
8. Which is the most common histologic form of Hodgkin disease?
a. Lymphocyte predominance
b. Nodular sclerosis
c. Mixed cellularity
d. Lymphocyte depletion
e. Nodular lymphocyte predominance
ANS: B, Nodular sclerosis is the most common histologic form of Hodgkin disease and accounts for approximately 70% of all cases.
9. A 20-year-old woman was diagnosed with Hodgkin disease involving the mediastinum. Which would be the most common histologic form of Hodgkin disease to occur at this site?
a. Lymphocyte predominance
b. Nodular sclerosis
c. Mixed cellularity
d. Lymphocyte depletion
e. Nodular lymphoid predominance
ANS: B, Nodular sclerosis most often affects young women and presents with mediastinal involvement.
10. Peripheral blood cytopenia is a feature of
a. chronic myelogenous leukemia
b. chronic myeloproliferative disorders
c. myelodysplastic syndrome
d. polycythemia vera
e. essential thrombocytopenia
ANS: C, Myelodysplastic syndrome is a clonal stem cell disorder characterized by maturation defects of hematopoietic cells leading to pancytopenia.
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