Question 1

Myeloma patients treated with alkylating agents have a significant risk of developing treatment-related __________.

Accepted Answer

A)   Acute myelogenous leukemia
B)   Chronic myelogenous leukemia
C)   Chronic lymphocytic leukemia
D)   Acute lymphoblastic leukemia
E)   None of the aboveF) A) and E)
G) A) and B) A

Question 2

Neurologic manifestations such as blurred vision, headaches, and episodes of consfusion occur in patients with Waldenström's macroglobulinemia due to __________.

Accepted Answer

A)   Hyperviscosity syndrome
B)   Splenomegaly
C)   Bone lesions
D)   Renal failure
E)   None of the aboveF) A) and D)
G) D) and E)

Question 3

What is the benefit of plasmapheresis used for treating patients with Waldenström's macroglobulinemia?

Accepted Answer

A)   Removes IgM from circulation
B)   Removes IgG from circulation
C)   Removes IgA from circulation
D)   Removes IgD from circulation
E)   Removes IgE from circulationF) A) and D)
G) A) and E) A

Question 4

What is the cause of decreased production of formed elements in the marrow (red cells, white cells, platelets)  seen in patients with multiple myeloma?

Accepted Answer

A)   Stem cell defect
B)   Malignant plasma cell mass replaces normal marrow
C)   Growth factor deficiency
D)   All of the above
E)   None of the aboveF) C) and D)
G) A) and B)

Question 5

Immune globulins (antibodies)  are proteins produced by __________.

Accepted Answer

A)   B lymphocytes
B)   T lymphocytes
C)   NK cells
D)   Granulocytes
E)   None of the aboveF) B) and C)
G) A) and B)

Question 6

Which class of immunoglobulin has the largest molecular weight?

Accepted Answer

A)   IgG
B)   IgA
C)   IgM
D)   IgD
E)   IgEF) None of the above
G) C) and D)

Question 7

The plasma cell disorders are characterized by:

Accepted Answer

A)   Excess production of immune globulins
B)   Decrease production of immune globulins
C)   Normal production of immune globulins
D)   Decreased erythrocyte sedimentation ratio
E)   None of the aboveF) C) and D)
G) B) and D)

Question 8

A __________ is a protein that precipitates on exposure to cold, causing such symptoms as Raynaud's phenomenon and thrombosis of small arteries in Waldenström's macroglobulinemia.

Accepted Answer

A)   Microglobulin
B)   Macroglobulin
C)   Cryoglobulin
D)   Gammaglobulin
E)   None of the aboveF) B) and E)
G) A) and B)

Question 9

Urine immunoelectrophoresis is used to distinguish between __________ and __________ light chains in urine.

Accepted Answer

A)   Kappa/epsilon
B)   Kappa/lambda
C)   Kappa/mu
D)   Gamma/lambda
E)   None of the aboveF) A) and C)
G) A) and B)

Question 10

When evaluating a plasma cell disorder, which immunologic technique is capable of quantitating a monoclonal immunoglobulin?

Accepted Answer

A)   Radial immunodiffusion
B)   Immunoelectrophoresis
C)   Immunofixation
D)   SPEP
E)   All of the aboveF) B) and E)
G) A) and B)

Question 11

In multiple myeloma, a plasma cell will sometimes contain clumps of aggregated immunoglobulin that stain red with Wright-Giemsa stain. These aggregates are referred to as:

Accepted Answer

A)   Russell bodies
B)   Howell-Jolly bodies
C)   Flame cells
D)   Basophilic stippling
E)   Döhle bodiesF) C) and D)
G) A) and D)

Question 12

Which multiple myeloma manifestation describes the formation of abnormal proteins in organ systems due to deposition of immunoglobulin light chains leading to kidney and renal dysfunction?

Accepted Answer

A)   Spherocytosis
B)   Amyloidosis
C)   Osteocytosis
D)   Thrombocytosis
E)   None of the aboveF) A) and B)
G) A) and C)

Question 13

Which of the following immunoglobulins are associated with heavy chain disease?

Accepted Answer

A)   IgG, IgD, IgE
B)   IgG, IgM, IgE
C)   IgG, IgM, IgA
D)   IgA, IgD, IgE
E)   None of the aboveF) None of the above
G) C) and E)

Question 14

Bacterial infection is the most common cause of death in multiple myeloma patients due to __________.

Accepted Answer

A)   Decreased production of normal immunoglobulin
B)   Increased production of normal immunoglobulin
C)   Anemia
D)   All of the above
E)   None of the aboveF) A) and B)
G) B) and D)

Question 15

Which light chain protein is characteristically present in multiple myeloma?

Accepted Answer

A)   Protein C
B)   Protein 4.1
C)   Tamm-Horsfall
D)   Bence-Jones
E)   None of the aboveF) A) and E)
G) A) and D)

Question 16

Multiple myeloma affects which age group?

Accepted Answer

A)   Children
B)   Elderly
C)   Newborns
D)   Adolescents
E)   None of the aboveF) D) and E)
G) C) and E)

Question 17

Myeloma cells may diffusely infiltrate organs such as the __________ resulting in enlargement and dysfunction.

Accepted Answer

A)   Liver
B)   Spleen
C)   Kidney
D)   All of the above
E)   None of the aboveF) None of the above
G) All of the above D

Question 18

Serum protein electrophoresis (SPEP)  demonstrates the absence of a gamma peak. This finding is consistent with which plasma cell disorder?

Accepted Answer

A)   IgG myeloma with M-spike
B)   Hypergammaglobulinemia
C)   Hypogammaglobulinemia
D)   Waldenström's macroglobulinemia
E)   None of the aboveF) None of the above
G) C) and D)

Question 19

Extramedullary infiltration of plasmacytoid lymphs in Waldenström's macroglobulinemia occurs in the __________.

Accepted Answer

A)   Liver
B)   Spleen
C)   Lymph nodes
D)   All of the above
E)   None of the aboveF) B) and C)
G) A) and C)

Question 20

What is the definition of a solitary plasmacytoma?

Accepted Answer

A)   A benign clone of cells localized to one area
B)   A malignancy composed of a clone of cells that is systemically exacerbated
C)   A malignancy composed of a clone of cells localized to one area
D)   A benign clone of cells systemically exacerbated
E)   None of the aboveF) A) and B)
G) B) and D)

Exam 22: Multiple Myeloma and Related Plasma Cell Disorders

Myeloma patients treated with alkylating agents have a significant risk of developing treatment-related __________.

Correct AnswerverifiedA

Neurologic manifestations such as blurred vision, headaches, and episodes of consfusion occur in patients with Waldenström's macroglobulinemia due to __________.

Correct AnswerverifiedShow Answer

What is the benefit of plasmapheresis used for treating patients with Waldenström's macroglobulinemia?

Correct AnswerverifiedA

What is the cause of decreased production of formed elements in the marrow (red cells, white cells, platelets) seen in patients with multiple myeloma?

Correct AnswerverifiedShow Answer

Immune globulins (antibodies) are proteins produced by __________.

Correct AnswerverifiedShow Answer

Which class of immunoglobulin has the largest molecular weight?

Correct AnswerverifiedShow Answer

The plasma cell disorders are characterized by:

Correct AnswerverifiedShow Answer

A __________ is a protein that precipitates on exposure to cold, causing such symptoms as Raynaud's phenomenon and thrombosis of small arteries in Waldenström's macroglobulinemia.

Correct AnswerverifiedShow Answer

Urine immunoelectrophoresis is used to distinguish between __________ and __________ light chains in urine.

Correct AnswerverifiedShow Answer

When evaluating a plasma cell disorder, which immunologic technique is capable of quantitating a monoclonal immunoglobulin?

Correct AnswerverifiedShow Answer

In multiple myeloma, a plasma cell will sometimes contain clumps of aggregated immunoglobulin that stain red with Wright-Giemsa stain. These aggregates are referred to as:

Correct AnswerverifiedShow Answer

Which multiple myeloma manifestation describes the formation of abnormal proteins in organ systems due to deposition of immunoglobulin light chains leading to kidney and renal dysfunction?

Correct AnswerverifiedShow Answer

Which of the following immunoglobulins are associated with heavy chain disease?

Correct AnswerverifiedShow Answer

Bacterial infection is the most common cause of death in multiple myeloma patients due to __________.

Correct AnswerverifiedShow Answer

Which light chain protein is characteristically present in multiple myeloma?

Correct AnswerverifiedShow Answer

Multiple myeloma affects which age group?

Correct AnswerverifiedShow Answer

Myeloma cells may diffusely infiltrate organs such as the __________ resulting in enlargement and dysfunction.

Correct AnswerverifiedD

Serum protein electrophoresis (SPEP) demonstrates the absence of a gamma peak. This finding is consistent with which plasma cell disorder?

Correct AnswerverifiedShow Answer

Extramedullary infiltration of plasmacytoid lymphs in Waldenström's macroglobulinemia occurs in the __________.

Correct AnswerverifiedShow Answer

What is the definition of a solitary plasmacytoma?

Correct AnswerverifiedShow Answer

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Urine immunoelectrophoresis is used to distinguish between and light chains in urine.

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