Granulopoietic Alterations: Quantitative

Granulopoietic Alterations: Quantitative

1. Causes of Leukocytosis

• Leukocytosis can be caused by:
    - A. Increased movement of immature cells out of the bone marrow's proliferative compartment.
    - B. Increased mobilization of granulocytes from the maturation-storage compartment.
    - C. Increased movement of granulocytes from the marginating pool to the circulating pool.
    - D. All of the above.

• Answer: D. All of the above.

2. Conditions Related to Neutrophilia

• Neutrophilia can be related to a variety of conditions or disorders, including:
    - A. Surgery.
    - B. Burns.
    - C. Stress.
    - D. All of the above.

• Answer: D. All of the above.

3. Differentiating Leukemoid Reaction from Chronic Myelogenous Leukemia

• A laboratory assay that can be used to differentiate a leukemoid reaction from chronic myelogenous leukemia:
    - A. Leukocyte alkaline phosphatase (LAP) stain.
    - B. Erythrocyte sedimentation rate (ESR).
    - C. Assessment of the shift to the left.
    - D. An absolute neutrophil count.

• Answer: A. Leukocyte alkaline phosphatase (LAP) stain.

4. Charcot-Leyden Crystals

• Charcot-Leyden crystals can be found in patients with active eosinophilic inflammation in:
    - A. Sputum.
    - B. Tissues.
    - C. Stool.
    - D. All of the above.

• Answer: D. All of the above.

5. Conditions Observed in Monocytosis

• Monocytosis can be observed in:
    - A. Tuberculosis.
    - B. Fever of unknown origin.
    - C. Rheumatoid arthritis.
    - D. All of the above.

• Answer: D. All of the above.

6. Neutropenia

• Neutropenia can be observed in:
    - A. Bone marrow injury.
    - B. Nutritional deficiency.
    - C. Increased destruction and utilization.
    - D. All of the above.

• Answer: D. All of the above.

7. Cyclic Neutropenia

• Cyclic neutropenia is characterized by:
    - A. Early manifestation in infants.
    - B. No risk of infection at any phase.
    - C. An abundance of basophils.
    - D. Contributing to antibody production.

• Answer: A. Early manifestation in infants.

Morphological Abnormalities of Mature Granulocytes

8. Pseudo-Pelger-Huët Anomaly

• Pseudo-Pelger-Huët anomaly may be associated with the clinical condition of:
    - A. Acute infection.
    - B. Chronic leukemia.
    - C. Iron deficiency anemia.
    - D. Aplastic anemia.

• Answer: A. Acute infection.

9. Characteristic of Pelger-Huët Anomaly

• Which of the following is characteristic of Pelger-Huët anomaly?
    - A. Dark blue-black precipitates of RNA.
    - B. Five or more nuclear segments.
    - C. Failure of the nucleus to segment.
    - D. Precipitated mucopolysaccharides.

• Answer: C. Failure of the nucleus to segment.

10. Associations of Pelger-Huët Anomaly

• Pelger-Huët anomaly may be:
    - A. Associated with a deficiency of vitamin B12 or folic acid.
    - B. Associated with frequent infections in children or young adults.
    - C. Related to a maturational arrest in some acute infections.
    - D. Associated with viral infections and burns.

• Answer: C. Related to a maturational arrest in some acute infections.

11. Differentiating Conditions with Increased Neutrophilic Bands

• Pelger-Huët anomaly can be differentiated from conditions with an increased percentage of neutrophilic bands by the presence of:
    - A. Flow cytometry for CD11b.
    - B. Hyposegmentation of neutrophils.
    - C. All bilobed segmented neutrophils.
    - D. Both B and C.

• Answer: B. Hyposegmentation of neutrophils.

12. Characteristics of Hypersegmentation

• Which of the following is characteristic of hypersegmentation?
    - A. Dark blue-black precipitates of RNA.
    - B. Five or more nuclear segments.
    - C. Failure of the nucleus to segment.
    - D. Precipitated mucopolysaccharides.

• Answer: B. Five or more nuclear segments.

13. Associations of Hypersegmentation

• Hypersegmentation may be:
    - A. Associated with a deficiency of vitamin B12 or folic acid.
    - B. Associated with frequent infections in children or young adults.
    - C. Related to a maturational arrest in some acute infections.
    - D. Associated with viral infections and burns.

• Answer: A. Associated with a deficiency of vitamin B12 or folic acid.

14. Characteristics of Döhle Body Inclusions

• Which of the following is characteristic of Döhle body inclusions?
    - A. Gigantic peroxidase-positive deposits.
    - B. Precipitated mucopolysaccharides.
    - C. Dark-blue cytoplasmic inclusions.
    - D. Single or multiple pale-blue staining inclusions.

• Answer: D. Single or multiple pale-blue staining inclusions.

15. Associations of Döhle Bodies

• Döhle bodies may be:
    - A. Associated with a deficiency of vitamin B12 or folic acid.
    - B. Associated with frequent infections in children or young adults.
    - C. Related to a maturational arrest in some acute infections.
    - D. Associated with viral infections and burns.

• Answer: D. Associated with viral infections and burns.

16. Toxic Granulation Characteristics

• Which of the following is characteristic of toxic granulation?
    - A. Dark blue-black precipitates of RNA.
    - B. Five or more nuclear segments.
    - C. Failure of the nucleus to segment.
    - D. Precipitated mucopolysaccharides.

• Answer: A. Dark blue-black precipitates of RNA.

17. Human Diseases Caused by Ehrlichia Species

• In the United States, human diseases caused by Ehrlichia species can be caused by:
    - A. E. chaffeensis.
    - B. E. ewingii.
    - C. E. phagocytophila (similar or identical to).
    - D. All of the above.

• Answer: D. All of the above.

18. Transmission of Ehrlichiosis

• Ehrlichiosis is transmitted by:
    - A. Mosquitoes.
    - B. Ticks.
    - C. Rats.
    - D. Cats.

• Answer: B. Ticks.

19. May-Hegglin Anomaly Characteristics

• Which of the following is characteristic of May-Hegglin anomaly?
    - A. Gigantic peroxidase-positive deposits.
    - B. Precipitated mucopolysaccharides.
    - C. Döhle body-like inclusions and giant platelets.
    - D. Single or multiple pale-blue-staining inclusions.

• Answer: C. Döhle body-like inclusions and giant platelets.

20. Differentiation of May-Hegglin from Similar Conditions

• May-Hegglin can be differentiated from similar conditions by:
    - A. Presence of thrombocytosis.
    - B. Presence of abnormally large platelets.
    - C. Excessively granulated platelets.
    - D. An increase of lymphocytes.

• Answer: B. Presence of abnormally large platelets.

21. Characteristics of Chédiak-Higashi Syndrome

• Which of the following is characteristic of Chédiak-Higashi syndrome?
    - A. Gigantic peroxidase-positive deposits.
    - B. Precipitated mucopolysaccharides.
    - C. Döhle body-like inclusions.
    - D. Single or multiple pale-blue staining inclusions.

• Answer: A. Gigantic peroxidase-positive deposits.

22. Associations of Chédiak-Higashi Syndrome

• Chédiak-Higashi syndrome may be:
    - A. Associated with a deficiency of vitamin B12 or folic acid.
    - B. Associated with frequent infections in children or young adults.
    - C. Related to a maturational arrest in some acute infections.
    - D. Associated with viral infections and burns.

• Answer: B. Associated with frequent infections in children or young adults.

23. Neutrophilic Series in Chédiak-Higashi Syndrome

• Chédiak-Higashi syndrome is associated with the:
    - A. Neutrophilic series.
    - B. Monocytic-macrophage series.
    - C. Lymphocytic series.
    - D. Erythrocytic series.

• Answer: A. Neutrophilic series.

24. Differentiation of Chédiak-Higashi Syndrome

• Chédiak-Higashi syndrome can be differentiated from other intracellular inclusions by:
    - A. Presence of platelets.
    - B. Abnormal inclusions in neutrophils and lymphocytes.
    - C. Foamy cytoplasm.
    - D. Pyknotic nucleus.

• Answer: B. Abnormal inclusions in neutrophils and lymphocytes.

25. Alder-Reilly Inclusions Characteristic

• Which of the following is characteristic of Alder-Reilly inclusions?
    - A. Gigantic peroxidase-positive deposits.
    - B. Precipitated mucopolysaccharides (mucopolysaccharidosis).
    - C. Döhle body-like inclusions.
    - D. Single or multiple pale-blue-staining inclusions.

• Answer: B. Precipitated mucopolysaccharides.

Case Study Observations and Diagnoses

Case 18.2

• Based on the history and laboratory data presented, a likely diagnosis is:
    - A. Iron deficiency anemia.
    - B. Acute inflammation.
    - C. Chronic fungal infection.
    - D. A viral infection.

• Answer: B. Acute inflammation.

Case 18.3

• A significant laboratory observation in this case is:
    - A. Toxic granulation.
    - B. Ehrlichia morulae.
    - C. Increased number of vacuoles.
    - D. Hyposegmentation of neutrophils.

• Answer: A. Toxic granulation.

Case 18.4

• The most significant laboratory observation in this case is:
    - A. Severe allergic reaction.
    - B. Increase in lymphocytes.
    - C. Increase in band neutrophils.
    - D. Increase in platelets.

• Answer: C. Increase in band neutrophils.

Case 18.5

• A significant laboratory observation in this case is:
    - A. Toxic granulation.
    - B. Döhle bodies.
    - C. Malaria.
    - D. Lymphocytopenia.

• Answer: B. Döhle bodies.

Case 18.6

• A likely diagnosis in this case is:
    - A. Chédiak-Higashi syndrome.
    - B. Gaucher's disease.
    - C. Lymphocytic leukemia.
    - D. Iron deficiency anemia.

• Answer: B. Gaucher's disease.

Case 18.7

• The most significant routine laboratory finding in this case is:
    - A. Neutrophilia.
    - B. Lymphocytosis.
    - C. Anemia.
    - D. Thrombocytosis.

• Answer: A. Neutrophilia.