1. LEUKEMIA Dr. Omar Alshaer

2. Acute Leukemia

23.  1/ A 40-year-old woman complains of fatigue and nausea of 3 months in duration. Physical examination reveals numerous pustules on the face, as well as splenomegaly and hepatomegaly. Laboratory studies show hemoglobin of 6.3 g/dL and platelets of 50,000/mL. A peripheral smear shows malignant cells with Auer rods. The patient develops diffuse purpura, bleeding from the gums, and laboratory features of disseminated intravascular coagulation (DIC). Which of the following is the appropriate diagnosis?  (A) Acute lymphoblastic leukemia  (B) Acute megakaryocytic leukemia  (C) Acute promyelocytic leukemia  (D) Chronic myelogenous leukemia

24. Acute Leukemia  1/ A 40-year-old woman complains of fatigue and nausea of 3 months in duration. Physical examination reveals numerous pustules on the face, as well as splenomegaly and hepatomegaly. Laboratory studies show hemoglobin of 6.3 g/dL and platelets of 50,000/mL. A peripheral smear shows malignant cells with Auer rods. The patient develops diffuse purpura, bleeding from the gums, and laboratory features of disseminated intravascular coagulation (DIC). Which of the following is the appropriate diagnosis?  (A) Acute lymphoblastic leukemia  (B) Acute megakaryocytic leukemia  (C) Acute promyelocytic leukemia  (D) Chronic myelogenous leukemia

25. Acute Leukemia  2/ Cytogenetic studies in malignant cells from the patient described in Question 1 demonstrate a chromosomal translocation. Which of the following is the mutation?  (A) t (9:11)  (B) t (15:17)  (C) t (8:24)  (D) t (9:22)

26. Acute Leukemia  2/ Cytogenetic studies in malignant cells from the patient described in Question 1 demonstrate a chromosomal translocation. Which of the following is the mutation?  (A) t (9:11)  (B) t (15:17)  (C) t (8:24)  (D) t (9:22)

27. Acute Leukemia  3/ A 6-year-old boy presents with fatigue, fever, and night sweats. Physical examination reveals marked pallor. Palpation of his sternum demonstrates diffuse tenderness. Laboratory studies disclose anemia, thrombocytopenia, and leukocytosis. The WBC differential count shows that 90% lymphoid blasts. Which of the following is the appropriate diagnosis?  (A) Acute lymphoblastic leukemia  (B) Acute myelogenous leukemia  (C) Acute promyelocytic leukemia  (D) Chronic lymphocytic leukemia

28. Acute Leukemia  3/ A 6-year-old boy presents with fatigue, fever, and night sweats. Physical examination reveals marked pallor. Palpation of his sternum demonstrates diffuse tenderness. Laboratory studies disclose anemia, thrombocytopenia, and leukocytosis. The WBC differential count shows that 90% lymphoid blasts. Which of the following is the appropriate diagnosis?  (A) Acute lymphoblastic leukemia  (B) Acute myelogenous leukemia  (C) Acute promyelocytic leukemia  (D) Chronic lymphocytic leukemia

29. Chronic Leukemia

44.  1/ what chronic leukemia is most common in older people, ages >60?  A- CLL  B- CML  C- CMML  2/ what genetic change defines chronic myelogenous leukemia?  A- PH, t(9;22) BCR ‐ ABL  B- t(8; 14)  C- t(14; 18) BCL ‐ 2

45. Chronic Leukemia  1/ what chronic leukemia is most common in older people, ages >60?  A- CLL  B- CML  C- CMML  2/ what genetic change defines chronic myelogenous leukemia?  A- PH, t(9;22) BCR ‐ ABL  B- t(8; 14)  C- t(14; 18) BCL ‐ 2

46. Chronic Leukemia  3/ main chromosomal abnormalities in MDS?  A- ‐ 6, ‐ 5  B- ‐ 5, ‐ 7  C- ‐ 6, ‐ 7  4/ chronic leukemia occur mainly in?  A- Infants  B- Children  C- Adults

47. Chronic Leukemia  3/ main chromosomal abnormalities in MDS?  A- ‐ 6, ‐ 5  B- ‐ 5, ‐ 7  C- ‐ 6, ‐ 7  4/ chronic leukemia occur mainly in?  A- Infants  B- Children  C- Adults

48. Chronic Leukemia  A- Acute 5/ A 60-year-old man complains of night sweats, weight loss, easy fatigability, and discomfort in the left upper abdominal quadrant. Physical examination reveals splenomegaly. Laboratory studies show leukocytosis (40,000/mL). A peripheral blood smear demonstrates mature and maturing granulocytes, myelocytes, basophils, and occasional myeloblasts. The bone marrow is hypercellular and dominated by WBC precursors. Megakaryocytes are numerous, and RBC precursors are less prominent. Cytogenetic studies disclose a monoclonal population of abnormal cells with a t(9;22) chromosomal translocation. What is the appropriate diagnosis?  lymphoblastic leukemia  B- Acute myeloid leukemia  C- Chronic lymphocytic leukemia  D- Chronic myeloid leukemia

49. Chronic Leukemia  A- Acute 5/ A 60-year-old man complains of night sweats, weight loss, easy fatigability, and discomfort in the left upper abdominal quadrant. Physical examination reveals splenomegaly. Laboratory studies show leukocytosis (40,000/mL). A peripheral blood smear demonstrates mature and maturing granulocytes, myelocytes, basophils, and occasional myeloblasts. The bone marrow is hypercellular and dominated by WBC precursors. Megakaryocytes are numerous, and RBC precursors are less prominent. Cytogenetic studies disclose a monoclonal population of abnormal cells with a t(9;22) chromosomal translocation. What is the appropriate diagnosis?  lymphoblastic leukemia  B- Acute myeloid leukemia  C- Chronic lymphocytic leukemia  D- Chronic myeloid leukemia