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Exam 25: Myelodysplastic Syndromes

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Question 1

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An unknown cell possesses the following characteristics: blastlike with open chromatin pattern,prominent nucleoli,absence of granules,and a high N:C ratio.Based on this information,what is the cell's most probable identity?

A) Agranular blast
B) Granular blast
C) Dysplastic promyelocyte
D) Promyelocyte

E) B) and C)
F) A) and C)

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Question 2

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Explain the pathophysiology of MDS.

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MDS results from persistent gr...

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Question 3

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A technologist is reviewing a blood smear and finds a rare blast.Bone marrow analysis shows dysplasia in 30% of the erythroblasts and the myeloid precursors and 4% blasts.What is a possible diagnosis based on these findings?

Which of the following does the World Health Organization's classification consider an MDS/MPN variant?

A bone marrow specimen is received in the cytogenetics lab.FISH analysis has been ordered.The laboratician performs the assay and notices that 96% of the patient's cells contain both 5q- and 12q- deletions.These cytogenetic findings are characteristic of:

According to the WHO classification,what percent of blasts must be present in the bone marrow to classify a patient with acute leukemia?

Myelodysplastic syndromes are sometimes called preleukemias because:

Which of the following is a defining characteristic of myelodysplastic syndromes (MDS) ?

The chromosomal abnormalities present in most cases of MDS are located on which of the following chromosomes?

Which of the following characteristics are associated with a poor prognosis for MDS?

Which World Health Organization (WHO) classification for MDS is best supported when the peripheral blood shows a general cytopenia,5-19% blasts with Auer rods,and <1 × 10⁹ /L monocytes?

All of the following are included in the MDS/MPN family except:

A 61-year-old woman saw her primary care physician because of fatigue and dyspnea on exertion for the past 3 months.Past medical history noted that the patient had been treated 5 years earlier with the DNA alkylating agent cyclophosphamide,non-Hodgkin lymphoma.A CBC revealed the following: WBC: 3.6* 10⁹/L RBC: 2.8 * 10₁₂ /L Hb: 9.1 g/dL MCV: 104 fL Reticulocyte count: 2.0% Normal vitamin B₁₂ and folic acid levels PLT: 120 * 10⁹/L Differential: 6% blasts A bone marrow biopsy revealed hypercellularity,and dyshematopoiesis of all three myeloid lineages. Suggest an appropriate follow-up test and a likely diagnosis for this patient.

Explain the relationship between myelodysplastic syndromes and acute leukemia.

Which of the World Health Organization's MDS subgroups contains two or more cytopenias,rare or no blasts,<1 × 10⁹/L monocytes in the peripheral blood,<5% blasts,and <15% ringed sideroblasts in the bone marrow?

Which of the following represents the granule pattern of a dysplastic cell in MDS?

A 60-year-old patient visited his general practitioner because of fatigue and unexplained bruising.Physical examination revealed a frail,thin,pale man with widespread bruising.A CBC was ordered and revealed abnormal granularity of platelets and leukocytes.Red cells appeared dimorphic.Bone marrow analysis showed 20% ringed sideroblasts with dysplastic changes in RBC and WBC precursors.No cytogenetic abnormalities were detected.Based on this information,what is a probable diagnosis?

Which test or tests support the theory that the abnormal cells in MDS are clones derived from an abnormal pluripotent stem cell?

All of the following are considered morphologic evidence of dyserythropoiesis except:

What is the major criterion for the diagnosis of acute leukemia?