Practice Test for DelTech Owens Hematology 2 First Test
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| Any abnormal growth of new tissue, whether malignant or benign, is called a __. The term is usually applied to cancerous cells. | neoplasm
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| Leukocyte neoplasms can be acquired __ diseases. | genetic
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| Leukocyte neoplasms are often __ of a __ process. | systemic of a malignant process
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| Leukocyte neoplasms can begin in the __ __ or in the __ system. | bone marrow or in the lymphatic system
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| Since leukocyte neoplasms are often systemic, the treatment is often of a __ type. | systemic
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| If caught early, the odds of treating or curing a leukocyte neoplasm are __ than when it is caught later. | higher
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| A patient with a lymphoma may have __-__ symptoms. | flu-like
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| One in __ people will get cancer in Sussex County, Delaware. | four
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| Patients treated with chemotherapy will often get cancer/leukemia within __ years due to the chemo. | six
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| The causes of leukocyte neoplasms are (list the 6 causes) | 1. Environmental toxins 2. Environmental exposures (like radiation or organic solvents such as benzene) 3. Viruses (like Mono) 4. Familial predispositions 5. Chemotherapy 6. Unknown
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| FAB classification stands for __ __ __ and refers to a methodology for diagnosing leukocyte neoplasms. | French, American, British
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| The FAB classification relies heavily on __ and __ __ preparation. | morphology on histiological stain preparation
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| The FAB classification was devised during the 19__s and 19__s. | 1970s and 1980s
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| The WHO (World Health Organization) published a new set of leukocyte neoplasm classifications in __. | 2001
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| The WHO leukocyte neoplasm classification system relies heavily on __ and __. | chromosomal and immunophenotyping
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| Genes that cause dominant acting cancer mutations are called __. | oncogenes
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| The presence of some oncogenes is believed to have been derived from __viruses. | retroviruses
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| There is no __ that can stop all the retroviruses believed to inject oncogenes into cells. | vaccine
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| What codes for proteins that help cells resist malignant transformation? | Tumor suppressor genes
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| If tumor suppressor genes are missing after a cell mutates, the cell could develop into a __. | malignancy
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| Very high levels of __ are a major cause of cancer. | stress
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| Very high levels of stress can cause __ __ __ to malfunction. | tumor suppressor cells
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| The 5 therapies for leukocyte neoplasms include ? | 1. Chemotherapy 2. Radiation therapy 3. Supportive therapy 4. Targeted therapy 5. Stem cell transplantation
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| If tumor suppressor cells are __ after a cell mutates, the cell could become malignant. | missing
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| Supportive therapy for neoplasms includes __,__, and __ support. | nutrition, counseling, and financial support
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| Targeted therapies for neoplasms include the use of __ to target the growths without damaging other parts of the body. | antibodies
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| Chemotherapy treatments include the use of compounds that have __ properties. | antitumor
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| Chemotherapy is administered to a patient __ or __. | orally or parenterally (parenterally means "in a manner other than through the digestive tract;" intraveneously or through intramuscular injection)
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| Chemotherapies that affect malignant cells during specific phases of the cell cycle are __ __. | phase specific
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| Chemotherapies that affect malignant cells without regard to the cell cycle are __ __. | phase nonspecific
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| Cancer cells often multiply very __. | rapidly
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| Cells that are moving through the cell cycle are also __ or __. | dividing or multiplying
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| Phase nonspecific agents that kill cells that are moving through the cell cycle (dividing) are __ __. | cycle specific
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| Phase nonspecific agents that kill cells that are NOT dividing are called __ __. | cycle nonspecific
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| Examples of cycle specific agents include __ __ and __. | alkylating agents and cisplatin
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| Cisplatin is a chemotherapy drug that triggers __ in cancer cells. | apoptosis (or programmed cell death)
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| Examples of cycle NONspecific agents include __ and __ __. | steroids and antitumor antibiotics
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| Phase specific agents are only effective if presented during a certain __ in the cell cycle. | phase
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| Both normal cells and neoplastic cells are affected by __. | chemotherapy
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| The damage done by chemotherapy to normal cells is most pronounced in cells that divide __. | rapidly
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| Rapidly dividing cells that are especially affected by chemotherapy include those found in the __ tract and the __. | GI tract and the mucosa
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| The cells that line the mucous membrane, also known as the thin layer which lines body cavities and passages, are called the __. | mucosa
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| The 5 categories of chemotherapies are: | 1. Alkylating agents 2. Plant alkaloids 3. Antitumor antibiotics 4. Antimetabolites 5. Glucocorticoids
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| The __ category of chemotherapy agents work well on neoplastic lymphocytes. | gluccocorticoid
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| A synthetic THC, called __ is used to treat nausea and vomiting in chemotherapy patients. | Zofran
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| THC occurs naturally in __. | marijuana
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| Chemotherapeutic __ agents ionize within the cells, forming highly reactive free radicals that damage DNA and are phase nonspecific. | alkylating agents
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| Chemotherapeutic __ alkaloids affect microtubules and interrupt the process of mitotic spindle formation. | plant alkaloids
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| Cyclophosphamide, chlorambucil, busulfan, and melphalan are all examples of chemo __ agents. | alkylating agents
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| Vincrisitine and vinblastine are examples of chemo __ alkaloids. | plant alkaloids
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| Antitumor __ are derived from living microorganisms, inhibit RNA and DNA synthesis, and interfere with the G phase of the cell cycle. | Antitumor antibiotics
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| Chemotherapeutic __ interfere with the normal function of essential metabolites. | antimetabolites
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| Chemotherapeutic __ affect nonproliferating cells and have a lympholytic effect. | glucocorticoids
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| __ treatment, a non-chemotherapeutic treatment for cancer, kills cells by producing unstable ions that damage DNA. | Radiation treatment
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| Radiation treatment may cause instant or __ death of a cell. | delayed
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| These three areas of the body are most affected by radiation treatment, but the harmful effects are reversible. | GI tract, skin, hematopoietic system (or bone marrow)
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| The better a patient's __, the better his or her odds of making it through chemotherapy. | outlook
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| Shots of Neupogen and Neulasta increase the number of __, but can also spread leukemia faster. | granulocytes (which are WBCs)
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| Shots of Epogen and Procrit raise a patient's __ count. | RBC
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| Fun fact: Neulasta is basically Neupogen with propyline glycol. The latter is better known as __ __. | radiator fluid
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| Cancer therapies that specifically hit tumor cells while leaving normal cells untouched are known as __ therapies. | targeted therapies
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| Targeted therapies include __ and __. | Gleevec and Rituximab
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| Four sources of stem cell transplantation for patients with cancer include: | 1. Umbilical cord blood 2. An identical twin (called a syngeneic transplant) 3. an allogeneic transplant (from a donor who is genetically different from the patient) 4. An autologous transplant (from the patients own marrow or peripheral blood).
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| A stem cell transplant from an identical twin is called a __ transplant. | syngeneic
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| A stem cell transplant from a donor who is genetically different from the recipient is called a __ transplant. | allogeneic
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| A stem cell transplant from the patient's own marrow or peripheral blood is called an __ transplant. | autologous
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| Locally, __ Hospital does stem cell transplants on cancer patients. | Christiana
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| The study of the chemical elements found in cells is called __. | cytochemistry
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| The chemical elements found in cells may be __ or __. | enzymatic or non-enzymatic
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| Cytochemical __ of cells can be used for the differentiation of acute or chronic leukemias. | staining
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| The use of cytochemical staining of cells is going out of __ as other, more accurate and efficient processes continue to be developed. | use
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| Cytochemistry is used in conjuction with flow __ and __. | flow cytometry and Cytogenetics
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| In cytomchemistry, __ __ smears are used most often as test samples. | bone marrow
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| Smears and imprints made from __ __, __ __, the __, or the __ __ are all acceptable specimens for cytochemical procedures. | bone marrow, lymph nodes, the spleen, or the peripheral blood
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| __ smears are best to ensure optimal enzyme activity. | Fresh
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| PAS stands for __ __ __. | Periodic Acid Schiff
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| SBB stands for __ __ _. | Susan Black B
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| Proper fixatives for cytochemical smears include these 5 answers. | methanol, ethanol, acetone, formaldehyde, or a combo of these
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| __ is an enzyme found in the primary granules of neutrophils, eosinophils, and to some extent, monocytes. | Myeloperoxidase (MPO)
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| When myeloperoxidase (also called MPO)is present in a cell, it oxidizes dye substrates, creating a __ to __-__ stain depending on the substrate used. | black to red-brown
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| Leukemic __ are usually positive for MPO. | myeloblasts
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| What inclusions found in leukemic blasts and promyelocytes test strongly MPO positive? | auer rods
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| __ do not show MPO positive when tested. | Lymphocytes
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| Myeloperoxidase (MPO) stain is used to differentiate what 2 forms of leukemia? | AML and ALL (Acute myeloid leukemia and acute lymphoblastic leukemia)
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| Monocytes are peroxidase __ to __ or diffusely positive. | negative to weak
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| Lymphoblasts and lymphocytes are always peroxidase __. | negative
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| When testing for leukemia in WBCs, only the __ cells can be used as the determining factor for differentiating acute leukemias. | blast
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| Auer rods are actually __ granules stuck together in the cell. | primary
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| Sudan Black B stains cell __ because of the solubility of the dye in that kind of particle. | lipids
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| Lipids, like those stained with Sudan Black B, are found in the primary or secondary granules of __. | segs
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| Lipids, like those stained with Sudan Black B, are found in the lysosomal granules of __. | moncytes
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| Sudan Black B staining is used for differentiating __ from __. | AML from ALL
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| Sudan Black B staining is slightly more sensitive than __ staining. | peroxidase
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| When staining with Sudan Black B, lymphoid cells are usually __. | negative
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| Granulocytes are Sudan Black B positive from the __ stage through the rest of the cell maturation sequence. | myeloblast
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| __ stains are used to differentiate myeloid cells from those of monocytic origin. | Esterase
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| M1, M2, and M3 leukemias are __ in origin and can be differentiated from M5 leukemias using an esterase stain. | myeloid
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| M5 leukemias are __ in origin and can be differentiated using an esterase stain. | monocytic
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| PAS stands for __ __ __. | periodic acid schiff
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| The intensity of the stain called PAS depends on the number of __ groups that are liberated by periodic acid. | aldehyde
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| The stain pattern of PAS may be __. | highly varied (fine, diffuse, coarse, granular, and mix)
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| PAS stains __, __, and __ positive. | lymphocytes, granulocytes, and megakaryocytes
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| PAS is helpful in diagnosing __ where there is a strong reactivity in normoblasts. | erythroleukemia
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| PAS does not stain __ precursors. | RBC (Hence, the test on RBC precursors will be negative)
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| PAS does not stain __ (WBCs). | monocytes
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| TRAP stands for __ __ __ __. | Acid Phosphate (Tartrate Resistant)
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| TRAP stains cells with __ __ __. This is all it is used for. | Hairy Cell Leukemia
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| Cells that get a low score with the TRAP test have __. | leukemia
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| Cells that get a high score with the TRAP test are __. | infected
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| If hairy cells are present, the TRAP test remains positive after the addition of __ __ to the incubation mixture. | tartaric acid
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| TDT stands for __ __ __. | Terminal Deoxynucleotidyl Transferase
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| TDT is a DNA polymerase that is present in __ __. | lymphocytic cells
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| A polymerase takes __ apart. | DNA
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| When staining for cancer detection, a __ __ __ is used as a negative control. | normal blood smear
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| When staining for cancer detection, a __ __ should be used as well as a negative control. | positive control
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| The study of chromosomes is called __. | cytogenetics
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| Chromosome disorders are either __ or __. | structural or numerical
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| Chromosome disorders involve the __ or __ of a piece of chromosome or even the loss of the __ chromosome. | loss or gain, entire
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| There are approximately __ genes in the human genome. | 25,000
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| Chromosome analysis is also called __. | karyotyping
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| A chromosome's structure is made of a single, long strand of __ that contains a series of genes. | DNA
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| The movement of DNA from one chromosome to another is called __. | translocation
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| The most common mutations, or chromosomal abnormalities, seen in leukemias and lymphomas include these 5 things: | 1) translocations 2) gain or loss of chromosomes 3) gene deletions 4) point mutations 5) others
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| The cell cycle takes place in __ stages. | four
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| At which stage are chemicals used to arrest cell progression so analysis can be done? | Mitosis
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| When identifying chromosomes, you stain the __ chromosome with a __. | mitotic, dye
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| Q banding is a __ used to distinguish the unique pattern of a chromosome. | process
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| Q banding differentiates the chromosome into bands of differing __ and relative __. | widths, brightness
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| __ banding is the most common method used for staining chromosomes. | G banding (NOT Q banding)
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| Which 4 types of tissue samples can be used for chromosome analysis? | 1. peripheral blood 2. bone marrow 3. amniotic fluid 4. products of conception
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| The primary constriction that separates the long arm from the short arm of a chromosome is called a __. | centromere
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| The short arm of a chromosome is called __. | P
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| The long arm of a chromosome is called __. | Q
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| When under analysis, each chromosome is arranged in pairs according to size and banding pattern into a __. | karyotype
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| Three of the most common structural abnormalities found in chromosomes are: | 1) deletions 2) inversions 3) translocations
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| Chromosome deletions involve... | loss of material from a single chromosome. The effects are usually severe.
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| Chromosome inversions occur... | when there are 2 breaks within a single chromosome and the broken segment flips 180 degrees (inverts) and reattaches to form a chromosome that is structurally out of sequence.
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| Chromosome translocations involve... | exchange of material between 2 or more chromosomes.
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| If a chromosomal translocation is __, the risk for problems to an individual is similar to that with inversions. | reciprocal
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| __ involves altered cellular pathways in self renewal, proliferation, differentiation, and apoptosis. | Leukemogenesis
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| Leukemogenesis involves altered cellular pathways in __ __, __, __, and __. | self renewal, proliferation, differentiation, and apoptosis
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| Some chromosomal alterations result in gene __, gain or loss of __, loss of __, and __. | amplifications, gain or loss of chromosomes, loss of function, and translocations
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| What 3 reasons should we test for chromosomal abnormalities in a patient with cancer? | 1) diagnosis 2) prognosis 3) decision concerning therapy
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| FISH stands for __ __ __ __. | Florescence in situ hybridization (NOTE: in situ is Latin for "in position")
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| A B cell lymphoma that is common in Europe and N. America is called __ __. | Follicular Lymphoma
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| The median age for diagnosis of Follicular Lymphoma is between __ and __ years of age. | 60 and 65
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| The __ protein expression inhibits __; this keeps mutated cells from dieing as they should. These cells can live for years in the body. | BCL2 protein, apoptosis
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| __ __ is the specimen of choice for hematologic malignancy. | Bone marrow
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| __ is the most common leukemia for children. | ALL (Acute Lymphoblastic Leukemia)
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| Molecular biology techniques enhance the diagnostic team's ability to __ or __ an increasing number of diseases in the clinical laboratory. | predict or identify
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| Molecular tests are based on analysis of __ __. | base pairs
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| FISH (flourescence in situ hybridization) detects and localizes the presence or absence of specific abnormal __ __ __ on chromosomes. | base pair sequences
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| When using the FISH test, cells are placed on a slide and the cell membranes are __. | permeabilized
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| When using the FISH test, DNA in the chromosomes is denatured to a __ __ state. | single stranded
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| During FISH, after chromosomes have been denatured to the single stranded state, specific flourescent labeled probes are then __ with the cells. | incubated
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| During Fish, if the complementary sequences are present in the chromosome, the probes will __ to the chromosome. | hybridize
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| During FISH, after the probes have been hybridized, the result is a flourescent signal that is __ by __ microscopy. | detectable by flourescent microscopy
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| FISH is less __, easier to __, and __ than conventional cytogenetic studies. | less expensive, easier to perform, and faster
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| FISH is less labor __ than cytogenetics. | intensive
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| The limitation of FISH is that only __ abnormalities can be investigated. It is not a universal screen. | specific
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| Dividing cells is not required when using __. | FISH (flourescent in situ hybridization)
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| FISH can be performed on __ material and on various __ material. | archived material, various histologic material
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| An instrument in which cells suspended in fluid flow one at a time through a focus of exciting light, which is scattered in patterns characteristic to the cells and their components, is called a __ __. | flow cytometer
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| A flow cytometer is capable of __, has the ability to __ and __ cells in heterogenous cell populations. | immunophenotyping, identify and quantify
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| Flow cytometry allows us to analyze the cell lineage in __ leukemias, __ populations, chronic __ disorders, and monitor __ states. | acute leukemias, lymphoid populations, chronic myeloid disorders, and monitor immunodeficiency states
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| Flow cytometry allows for specimen processing of __ __, __ __, and __ tissue. | peripheral blood, bone marrow, and lymphoid tissue
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| Flow cytometry allows for processing of body __ fluids, and solid __. | cavity fluids, solid tissues
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| Cytometer specimens should be collected with vaccutainers with __ or __, then taken to a lab at room temperature. | EDTA or heparin
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| Cytometer tissue samples are submitted in __ __. | culture media
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| Purify cytometer specimens by __ RBCS. | lysing
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| The viability of cytometer cells is determined by __ __ or __. | cell counters or staining
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| Cytometry specimens are run through a __. | cytocentrifuge
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| Cytometry samples are stained with __-__ __ antibodies. | flourochrome-conjugated monoclonal antibodies
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| A cytometer can detect __ antigens simultaneously on an individual cell. | 17
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| When particles are illuminated in a flow cytometer, they emit __ __ registered by detectors. | flourescent signals
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| Results from a flow cytometer are converted to __ __ and analyzed using software. | digital output
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| A flow cytometer consists of what 4 parts? | 1) fluids 2) laser (light source) 3) detection system 4) computer
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| Injecting the cell suspension in a flow cytometer into a stream of sheath fluid is called __ __. | hydrodynamic focusing
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| The laser in a flow cytometer is __ or __-__. | argon or helium-neon
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| When current is applied to the gas in a flow cytometer, it raises the gas to an __ state. | excited
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| When electrons in a flow cytometer return to a __ __ after reaching an excited state, they emit photons of light. | ground state
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| A narrow beam of light is produced within a flow cytometer that is then used to illuminate individual cells. Each cell is stained with __ conjugated to specific __. | antibodies conjugated to specific fluorochromes
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| Photodetectors inside a flow cytometer will detect different __ emitted from the cells. | fluorochromes
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| __ angle light scatter measures cell size inside of a flow cytometer. | Forward
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| __ angel side scatter at 90 degrees measures internal complexity and granulation of cells. | Right
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| __ is used in the diagnosis, classification, and monitoring of leukemias and lymphomas. | Immunophenotyping
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| Immunophenotyping creates __ __ __ (MRD) post treatment. | minimal residual disease - residual disease refers to malignant cells that remind in the patient after treatment
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| About staining and detection: What does LAP stand for? | Leukocyte alkaline phosphate.
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| What is the LAP enzyme activity useful for with regard to detecting cancer? | Differentiating CML from a leukemoid reaction that may be seen in severe infections.
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| What does CML stand for? | Chronic myelogenous leukemia
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| Where do LAP enzymes appear? | Secondary granules of neutrophils
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| What is present in the primary granules of neutrophils with the letters NADC? | Naphthol AS-D Chloroacetate
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| Naphthol AS-D Chloroacetate shows positive in what kind of cells? | myeloid
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| Naphthol AS-D Chloroacetate shows negative or weakly in what kind of cells? | monocytes
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| Naphthol AS-D Chloroacetate also shows positive in __ __. | leukemic myeloblasts
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| Granules of Naphthol AS-D Chloroacetate stain __ __. | blue black
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| Auer rods with Naphthol AS-D Chloroacetate test __ (negative or positive?). | positively
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| a-Naphthyl butyrate esterase show __ in cells of monocytic origin if monocytic leukemia is present. | positive
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| Factor VIII is an essential __ __ __ in humans. | blood clotting protein
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| It is likely that there is a causal association between some __ __ and factor VIII antibodies, but it is an extremely rare complication of cancer. | solid tumors
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| Monoclonal or polyclonal antibodies against factor VIII-related antigen or platelet glycoprotein have given positive results in __ leukemia. | megakaryoblastic
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