Question 1

When rouleaux is present, the erythrocyte sedimentation rate (ESR)  will be ____________.

Accepted Answer

A)   Increased
B)   Normal
C)   Decreased
D)   Variable
E)   None of the above

Question 2

The presence of __________ circulating in the blood is a late finding seen in advanced multiple myeloma.

Accepted Answer

A)   Megakaryocytes
B)   Plasma cells
C)   Neutrophils
D)   Eosinophils
E)   None of the above

Question 3

The clone of cells produced in Waldenström's macroglobulinemia is an intermediate stage of development between the mature lymphocytes and the early plasma cells. These cells are commonly referred to as:

Accepted Answer

A)   Plasmacytoid lymphocytes
B)   Prolymphocytes
C)   Reed-Sternberg cells
D)   A and B
E)   A and C

Question 4

__________ light chains are most commonly found in patients with myeloma-related amyloidosis.

Accepted Answer

A)   Epsilon
B)   Delta
C)   Lambda
D)   Mu
E)   None of the above

Question 5

Which of the following is characterized by the excessive production of the heavy chain portion of the antibody subunit?

Accepted Answer

A)   Waldenström's macroglobulinemia
B)   Heavy chain disease
C)   Monoclonal gammopathy of undetermined significance (MGUS) 
D)   Solitary plasmacytoma
E)   Multiple myeloma

Question 6

A patient suspected of multiple myeloma presents with the following results: Hb 12 g/dL; corrected serum calcium, 11 mg/dL; one lytic bone lesion; and small M-spike by SPEP, with IgG <5 g/dL; urine light chains 2 g/24 hr. Which stage in multiple myeloma is consistent with the given results?

Accepted Answer

A)   Low myeloma mass
B)   Intermediate myeloma mass
C)   High myeloma mass
D)   All of the above
E)   None of the above

Question 7

What is a plasmacytoma?

Accepted Answer

A)   A disease affecting the blood clotting process
B)   A fully differentiated T lymphocyte
C)   A fully differentiated B lymphocyte
D)   Tumors composed of plasma cells
E)   None of the above

Question 8

Multiple myeloma can be differentiated from primary plasma cell leukemia by which of the following?

Accepted Answer

A)   Hyperviscosity
B)   Platelet dysfunction
C)   Presence of plasma cells in circulation
D)   Splenomegaly
E)   Hypercalcemia

Question 9

Macroglobulinemia refers to the overproduction of monoclonal __________.

Accepted Answer

A)   IgG
B)   IgM
C)   IgE
D)   IgD
E)   IgA

Question 10

β2-Microglobulin used in conjunction with serum __________ may be the best system for staging myeloma based on prognosis.

Accepted Answer

A)   α2 macroglobulin
B)   Albumin
C)   Calcium
D)   Creatine
E)   None of the above

Question 11

Which monoclonal gammopathy occurs in the sixth to eighth decade of life and is characterized by the presence of an M-spike with IgG < 3.5 g/dL, IgA < 20 g/dL, urinary light chains < 1.0 g/24 hr, and < 10% plasma cells in the bone marrow?

Accepted Answer

A)   Multiple myeloma
B)   Waldenström's macroglobulinemia
C)   Solitary plasmacytoma
D)   Monoclonal gammopathy of undetermined significance
E)   None of the above

Question 12

An evaluation of multiple myeloma includes:

Accepted Answer

A)   Bone marrow biopsy
B)   SPEP
C)   Immunoelectrophoresis and immunofixation
D)   Serum free light chain (FL
C)   assays
E)   All of the above

Question 13

A patient suspected of multiple myeloma presents with the following results: Hb 8.0 g/dL; corrected serum calcium, 11 mg/dL; two lytic bone lesions, and a large M-spike by SPEP, with IgG 8 g/dL. Which stage in multiple myeloma is consistent with the given results?

Accepted Answer

A)   Low myeloma mass
B)   Intermediate myeloma mass
C)   High myeloma mass
D)   All of the above
E)   None of the above

Question 14

Which hemostasis parameter is usually normal in patients with Waldenström's macroglobulinemia?

Accepted Answer

A)   Bleeding time
B)   Platelet count
C)   Prothrombin time (PT) 
D)   Activated partial thromboplastin time (APTT) 
E)   None of the above

Question 15

Which variant of multiple myeloma produces a malignant clone of plasma cells that are too immature to secrete immunoglobulins and does not produce an M-spike by electrophoretic studies?

Accepted Answer

A)   Smoldering myeloma
B)   Classic multiple myeloma
C)   Advanced myeloma
D)   Nonsecretory myeloma
E)   None of the above

Question 16

What is the etiology of macroglobulinemia?

Accepted Answer

A)   Loss of regulation of a clone of immature lymphocytes
B)   Loss of regulation of a clone of cells that are staged between the mature lymphocytes and early plasma cells
C)   Loss of regulation of granulocytic cells
D)   All of the above
E)   None of the above

Question 17

The plasma cell is the fully differentiated __________.

Accepted Answer

A)   T lymphocyte
B)   B lymphocyte
C)   Null killer (NK)  cell
D)   Granulocyte
E)   None of the above

Question 18

What does immunoelectrophoresis determine?

Accepted Answer

A)   The specific antibody class present in the serum
B)   The presence or absence of a lipoprotein
C)   Osteoblast activating factor
D)   24-hour urine protein
E)   None of the above

Question 19

Another name used in describing the plasma cell disorders is __________.

Accepted Answer

A)   Lymphoma
B)   Myeloproliferative disease
C)   Monoclonal gammopathies
D)   All of the above
E)   None of the above

Question 20

A 63-year-old black man presents with an elevated ESR, 10-30% plasma cells in the bone marrow, M-spike by SPEP, and 4.0 g/dL of serum IgG by radial diffusion. Which plasma cell disorder is implicated?

Accepted Answer

A)   Solitary plasmacytoma
B)   Multiple myeloma
C)   Waldenström's macroglobulinemia
D)   Alpha heavy chain disease
E)   Gamma heavy chain disease

Exam 22: Multiple Myeloma and Related Plasma Cell Disorders

The clone of cells produced in Waldenström's macroglobulinemia is an intermediate stage of development between the mature lymphocytes and the early plasma cells. These cells are commonly referred to as:

Correct AnswerverifiedShow Answer

__________ light chains are most commonly found in patients with myeloma-related amyloidosis.

Correct AnswerverifiedShow Answer

A patient suspected of multiple myeloma presents with the following results: Hb 8.0 g/dL; corrected serum calcium, 11 mg/dL; two lytic bone lesions, and a large M-spike by SPEP, with IgG 8 g/dL. Which stage in multiple myeloma is consistent with the given results?

Correct AnswerverifiedShow Answer

What is the etiology of macroglobulinemia?

Correct AnswerverifiedShow Answer

The presence of __________ circulating in the blood is a late finding seen in advanced multiple myeloma.

Correct AnswerverifiedShow Answer

Multiple myeloma can be differentiated from primary plasma cell leukemia by which of the following?

Correct AnswerverifiedShow Answer

What does immunoelectrophoresis determine?

Correct AnswerverifiedShow Answer

Which of the following is characterized by the excessive production of the heavy chain portion of the antibody subunit?

Correct AnswerverifiedShow Answer

Which hemostasis parameter is usually normal in patients with Waldenström's macroglobulinemia?

Correct AnswerverifiedShow Answer

A patient suspected of multiple myeloma presents with the following results: Hb 12 g/dL; corrected serum calcium, 11 mg/dL; one lytic bone lesion; and small M-spike by SPEP, with IgG <5 g/dL; urine light chains 2 g/24 hr. Which stage in multiple myeloma is consistent with the given results?

Correct AnswerverifiedShow Answer

The plasma cell is the fully differentiated __________.

Correct AnswerverifiedShow Answer

Which variant of multiple myeloma produces a malignant clone of plasma cells that are too immature to secrete immunoglobulins and does not produce an M-spike by electrophoretic studies?

Correct AnswerverifiedShow Answer

Macroglobulinemia refers to the overproduction of monoclonal __________.

Correct AnswerverifiedShow Answer

β2-Microglobulin used in conjunction with serum __________ may be the best system for staging myeloma based on prognosis.

Correct AnswerverifiedShow Answer

Which monoclonal gammopathy occurs in the sixth to eighth decade of life and is characterized by the presence of an M-spike with IgG < 3.5 g/dL, IgA < 20 g/dL, urinary light chains < 1.0 g/24 hr, and < 10% plasma cells in the bone marrow?

Correct AnswerverifiedShow Answer

An evaluation of multiple myeloma includes:

Correct AnswerverifiedShow Answer

When rouleaux is present, the erythrocyte sedimentation rate (ESR) will be ____________.

Correct AnswerverifiedShow Answer

A 63-year-old black man presents with an elevated ESR, 10-30% plasma cells in the bone marrow, M-spike by SPEP, and 4.0 g/dL of serum IgG by radial diffusion. Which plasma cell disorder is implicated?

Correct AnswerverifiedShow Answer

What is a plasmacytoma?

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Another name used in describing the plasma cell disorders is __________.

Correct AnswerverifiedShow Answer

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β₂-Microglobulin used in conjunction with serum __________ may be the best system for staging myeloma based on prognosis.

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