WHO Hematology 2017 Review -3 - thehematologist.org

This Part has 55 MCQs from chapter 8 (Upto Page 145) of WHO Hematology 2017 in form of MCQs and True/False

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Question 1 of 35

1. All of the following are considered to be acute myeloid leukaemias without regard to blast cell count EXCEPT ?

A. t(8;21)(q22;q22.1 )

B. inv(16)(p13.1q22)

C. t(16;16)(p13.1;q22)

D. t(9;11)(p21.3;q23.3)

Question 1 of 35

Question 2 of 35

2. True for Acute myeloid leukaemia with t(8;21) are all except ?

A. RUNX1-RUNX1T1

B. Favourable long-term outcome

C. 20% of cases of AML

D. Blasts show perinuclear clearing (hofs).

Question 2 of 35

Question 3 of 35

3. True for AML with t(8;21) blasts immunophenotype are ?

A. High-intensity expression of CD34

B. Weak expression of CD33

C. Coexpressing CD34 and CD15

D. All of these

Question 3 of 35

Question 4 of 35

4. All are true for Acute myeloid leukaemia with t(8;21)(q22;q22.1) except ?

A. RUNX1 codes the alpha subunit of CBF

B. KIT mutations occur in < 10 % of cases

C. High rate of complete remission

D. Presence of KIT mutation has adverse impact

Question 4 of 35

Question 5 of 35

5. AML that usually shows monocytic and granulocytic differentiation and characteristically an abnormal eosinophil component in the bone marrow.

A. RUNX1-RUNX1T1

B. CBFB-MYH11

C. PML-RARA

D. All of these

Question 5 of 35

Question 6 of 35

6. Incidence of Acute myeloid leukaemia with inv(16) or t(16;16) is ?

A. 5%

B. 10%

C. 15%

D. 20%

Question 6 of 35

Question 7 of 35

7. True for Acute myeloid leukaemia with CBFB-MYH11 are all except ?

A. Marrow shows a variable number of eosinophils

B. Myelomonocytic leukaemia

C. Monoblasts show non-specific esterase reactivity

D. Mutations of KIT are uncommon in this subtype

Question 7 of 35

Question 8 of 35

8. Mutations of KIT occur in 30- 40% of cases of core binding factor (CBF) Acute myeloid leukemia.

A. True

B. False

Question 8 of 35

Question 9 of 35

9. AML with inv(16) or t(16;16) is associated with a high rate of complete remission and favourable overall survival when treated with intensive consolidation therapy.

A. True

B. False

Question 9 of 35

Question 10 of 35

10. Most common mutation in Acute myeloidleukaemia with inv(16) or t(16;16) is ?

A. KIT

B. NRAS

C. KRAS

D. ASXL2

Question 10 of 35

Question 11 of 35

11. AML with basophilia is seen in association? [NEET SS 2018]

A. With t(8;21)

B. With t(6:9)

C. With t(9;11)

D. With t(3;3)

Question 11 of 35

Question 12 of 35

12. AML with elevated PLT count is associated with ?

A. inv(16)(p13.1q22)

B. t(6;9)(p23;q34.1)

C. inv(3)(q21.3q26.2)

D. t(9;11)(p21.3;q23.3)

Question 12 of 35

Question 13 of 35

13. NOT in favourable risk category of AML as per 2017 ELN risk stratification?

A. t(8;21)

B. Mutated NPM1 without FLT3-ITD

C. Biallelic mutated CEBPA

D. Wild-type NPM1 without FLT3-ITD

Question 13 of 35

Question 14 of 35

14. Poor cytogentic risk factor in AML includes all except ?

A. −5 or del(5q)

B. t(9;22)(q34.1;q11.2)

C. inv(3)(q21.3q26.2)

D. t(16;16)(p13.1;q22)

Question 14 of 35

Question 15 of 35

15. Which of the following is true for relapse rate in favorable risk AML with chemotherapy without allogeneic HSCT ?

A. 20%

B. 40%

C. 60%

D. 80%

Question 15 of 35

Question 16 of 35

16. A newly diagnosed case of acute myeloid leukemia demonstrates positivity of blasts by ﬂow cytometry for CD19 in addition to CD34, MPO, CD13 and HLA- DR. The most likely cytogenetic abnormality associated with this immunophenotype is:-

A. t(9;22)

B. t(8;21)

C. t(16;16)

D. t(15;17)

Question 16 of 35

Question 17 of 35

17. True regarding acute promyelocytic leukemia:-

A. There are two distinct subtypes, classical and microgranular. The treatment of these two subtypes is distinctly diﬀerent.

B. The total WBC count in the microgranular variant is typically very high

C. The leukemic cells typically lack CD117

D. Prognosis for APL is poor due to high incidence of disseminated intravascular coagulation (DIC)

Question 17 of 35

Question 18 of 35

18. Acute myeloid leukemia with t(1;22) (p13.3;q13.1); RBM15- MKL1 is most likely to present in which of the following patients?

A. A 5- year- old girl with Down’s syndrome

B. A 5- month- old girl without Down’s syndrome

C. A 5- month- old boy with Down’s syndrome

D. A 15- year- old girl with Down’s syndrome

Question 18 of 35

Question 19 of 35

19. Which of the following findings is not expected in acute myeloid leukemia with inv(3)(q21q26.2) or t(3;3)(q21;q26.2); GATA2, MECOM?

A. Thrombocytosis

B. Basophilia

C. Multilineage dysplasia

D. Increased megakaryocytes

Question 19 of 35

Question 20 of 35

20. Which of the following findings is not expected in acute myeloid leukemia with t(6;9)(p23;q34); DEK- NUP214?

A. Thrombocytosis

B. Basophilia

C. Multilineage dysplasia

D. Pancytopenia

Question 20 of 35

Question 21 of 35

21. Which of the following is not associated with monocytic diﬀerentiation in acute myeloid leukemia?

A. Disseminated intravascular coagulation

B. Gingival involvement

C. Central nervous system involvement

D. Bone marrow fibrosis

Question 21 of 35

Question 22 of 35

22. True for Acute promyelocytic leukaemia with PML-RARA are all except ?

A. APL accounts for 5-8% of AML cases

B. Associated with DIC and increased fibrinolysis

C. Leukocyte count is very high in hypergranular variant

D. French-American-British (FAB) classification M 3

Question 22 of 35

Question 23 of 35

23. Distinct morphological features of microgranular (hypogranular) APL are ?

A. Predominantly bilobed nuclei

B. Submicroscopic size of the azurophilic granules

C. Markedly elevated TLC

D. All of these

Question 23 of 35

Question 24 of 35

24. APL with PML-RARA (hypergranular variant) is characterized by low or absent expression of all except ?

A. HLA-DR

B. CD34

C. CD11a

D. CD33

Question 24 of 35

Question 25 of 35

25. In cases with microgranular morphology or the bcr3 transcript of the PML-RARA fusion gene, there is frequently expression of CD34 in contrast to weak or absent expression of CD34 in hypergranular variant.

A. True

B. False

Question 25 of 35

Question 26 of 35

26. FLT3-ITD and FLT3 tyrosine kinase domain (FLT3-TKD) mutation, occur in >50% of APL.

A. True

B. False

Question 26 of 35

Question 27 of 35

27. APML with PML-RARA (hypergranular variant) is characterized by:-

A. Low or absent expression of HLA-DR

B. Low or absent expression of CD34

C. Homogeneous bright expression of CD33

D. All of these

Question 27 of 35

Question 28 of 35

28. Risk stratification score used in APML ie Sanz Score is based upon?

A. Age and TLC

B. Age, Platelet count and TLC

C. Platelet count and TLC

D. TLC only

Question 28 of 35

Question 29 of 35

29. True regarding acute promyelocytic leukemia:-

A. There are two distinct subtypes, classical and microgranular. The treatment of these two subtypes is distinctly diﬀerent.

B. The total WBC count in the microgranular variant is typically very high

C. The leukemic cells typically lack CD117

D. Prognosis for APL is poor due to high incidence of disseminated intravascular coagulation (DIC)

Question 29 of 35

Question 30 of 35

30. The presence of a FLT3- ITD mutation in acute promyelocytic leukemia with PML- RARA is associated with which of the following?

A. Microgranular variant of disease

B. Lower WBC count at presentation

C. Resistance to all-trans-retinoic acid (ATRA)

D. Increased sensitivity to all-trans-retinoic acid (ATRA)

Question 30 of 35

Question 31 of 35

31. All are true for Acute myeloid leukaemia with mutated NPM1 except ?

A. Involve exon 12 of NPM1

B. Aberrant cytoplasmic expression of NPM1

C. Myelomonocytic or monocytic features

D. Mostly presents in pediatric cases

Question 31 of 35

Question 32 of 35

32. All are true for Acute myeloid leukaemia with mutated NPM1 except ?

A. Strong association with Acute monocytic leukemia

B. Multilineage dysplasia can be seen in 25% of cases

C. NPM1 immunohistochemistry can be done on marrow biopsy

D. Usually associated with a Complex karyotype

Question 32 of 35

Question 33 of 35

33. AML with mutated NPM1 typically shows a good response to induction therapy and cases with a normal karyotype, in the absence of FLT3-ITD mutation, have a characteristically favourable prognosis.

A. True

B. False

Question 33 of 35

Question 34 of 35

34. True for Acute myeloid leukaemia with biallelic mutation of CEBPA is/are ?

A. More than 70% of cases have a normal karyotype.

B. Favourable prognosis

C. Patients with biallelic CEBPA mutations should be evaluated for a familial syndrome

D. All of these

Question 34 of 35

Question 35 of 35

35. Which of the following is true for Acute myeloid leukaemia with mutated RUNX1 except?

A. Higher frequency in older adults

B. Associated with radiation exposure

C. Associated with better overall survival

D. Germline studies should be performed

Question 35 of 35

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