Pathology Notes

Practice questions answers Myeloid neoplasms II © Jun Wang, MD, PhD 1. C. The presence of immature white cells in a background of sudden onset of anemia and bleeding is suspicious for acute leukemia, either myeloid or lymphocytic . Since the diagnosis of acute leukemia is based on the quantity of blast in either peripheral blood or bone marrow, flow cytometry studies would be the most important test to confirm the diagnosis. Biopsy of the gum ulcer would not yield any useful information since the disorder is hematopoietic. Blood culture is for infections. Immunofixation is used to detect monoclonal immunoglobulin, as seen in plasma cell disorders, or tumors with plasma cell differentiation, such as multiple myeloma , plasmacytoma , monoclonal gammopathy of undetermined significance (MGUS) , and lymphoplasmacytic lymphoma . Monospot is used to detect heterophile antibodies, as seen in infectious mononucleosis . 2. D. This patient presents with pancytopenia and blasts are

Practice questions Myeloid neoplasms II © Jun Wang, MD, PhD 1. Use this case and image for the next five questions. A 22-year-old woman presents with large bruises on her skin and gum bleeding for 5 days. Her past medical history is unremarkable. She does not smoke nor drink alcohol. Physical examination reveal purpuric spots at her upper chest and arms. A few small ulcers are seen in her gum. No lymphadenopathy is seen. Laboratory tests reveal a hemoglobin of 8.5 g/dl (normal 12-16 g/dl), white cell count of 3.5 x 10 9 /L (normal 5-11 x 10 9 /L), platelet count 75 x 10 9 /L (normal 150-450 x 10 9 /L). PT and aPTT are within normal range. An image of the peripheral blood smear is shown. What test would confirm the diagnosis?   (Image credit: The Armed Forces Institute of Pathology (AFIP) [Public domain]) A. Biopsy of the gum ulcer B. Blood culture C. Flow cytometry D. Immunofixation E. Monospot 2.