Test Bank For Diagnostic Pathology: Blood and Bone Marrow, 3rd Edition
Author: Kathryn Foucar
, Diagnostic Pathology: Blood and Bone Marrow, 3rd Edition (Foucar et al.)
SECTION 1: INTRODUCTION
MCQs (1–40)
Morphology-Based (1–15)
Q1
Peripheral smear shows blasts with Auer rods and abundant azurophilic granules.
Bone marrow is hypercellular with >20% blasts.
A. AML with t(8;21)
B. Acute promyelocytic leukemia
C. ALL
D. MDS with excess blasts
Answer: B
Explanation:
• Morphology: Auer rods + hypergranular promyelocytes → classic for APL
• Immunophenotype: CD33+, CD13+, MPO+, HLA-DR−
• Genetics: t(15;17), PML-RARA
• Why others wrong:
o A: t(8;21) AML shows blasts but not heavy granulation
o C: ALL lacks Auer rods
o D: MDS blasts <20%
Q2
Bone marrow biopsy shows hypercellularity with trilineage dysplasia, including
hypolobated megakaryocytes.
A. AML
B. MDS
, C. CML
D. Aplastic anemia
Answer: B
Explanation:
• Morphology: Dysplasia across lineages = MDS hallmark
• Immunophenotype: Variable; often abnormal myeloid markers
• Genetics: del(5q), monosomy 7, SF3B1
• Why others wrong:
o A: ≥20% blasts required
o C: granulocytic proliferation without dysplasia
o D: hypocellular marrow
Q3
Peripheral smear shows teardrop cells and leukoerythroblastosis.
A. Essential thrombocythemia
B. Primary myelofibrosis
C. CLL
D. Iron deficiency anemia
Answer: B
Explanation:
• Morphology: Teardrop RBCs + nucleated RBCs → marrow fibrosis
• Immunophenotype: Not primary diagnostic
• Genetics: JAK2, CALR, MPL
• Why wrong:
o A: thrombocytosis without fibrosis
o C: lymphocytosis + smudge cells
o D: microcytosis
, Q4
Smear shows smudge cells and small mature lymphocytes.
A. CLL
B. ALL
C. Hairy cell leukemia
D. MDS
Answer: A
Explanation:
• Morphology: Smudge cells → fragile lymphocytes
• Immunophenotype: CD5+, CD23+
• Genetics: del(13q), trisomy 12
• Why wrong:
o B: blasts, not mature lymphocytes
o C: hairy projections
o D: dysplasia
Q5
Bone marrow shows dry tap, biopsy reveals fibrosis and atypical megakaryocytes.
A. AML
B. Primary myelofibrosis
C. CML
D. MDS
Answer: B
Explanation:
• Morphology: Fibrosis → dry tap
• Genetics: JAK2/CALR/MPL
Author: Kathryn Foucar
, Diagnostic Pathology: Blood and Bone Marrow, 3rd Edition (Foucar et al.)
SECTION 1: INTRODUCTION
MCQs (1–40)
Morphology-Based (1–15)
Q1
Peripheral smear shows blasts with Auer rods and abundant azurophilic granules.
Bone marrow is hypercellular with >20% blasts.
A. AML with t(8;21)
B. Acute promyelocytic leukemia
C. ALL
D. MDS with excess blasts
Answer: B
Explanation:
• Morphology: Auer rods + hypergranular promyelocytes → classic for APL
• Immunophenotype: CD33+, CD13+, MPO+, HLA-DR−
• Genetics: t(15;17), PML-RARA
• Why others wrong:
o A: t(8;21) AML shows blasts but not heavy granulation
o C: ALL lacks Auer rods
o D: MDS blasts <20%
Q2
Bone marrow biopsy shows hypercellularity with trilineage dysplasia, including
hypolobated megakaryocytes.
A. AML
B. MDS
, C. CML
D. Aplastic anemia
Answer: B
Explanation:
• Morphology: Dysplasia across lineages = MDS hallmark
• Immunophenotype: Variable; often abnormal myeloid markers
• Genetics: del(5q), monosomy 7, SF3B1
• Why others wrong:
o A: ≥20% blasts required
o C: granulocytic proliferation without dysplasia
o D: hypocellular marrow
Q3
Peripheral smear shows teardrop cells and leukoerythroblastosis.
A. Essential thrombocythemia
B. Primary myelofibrosis
C. CLL
D. Iron deficiency anemia
Answer: B
Explanation:
• Morphology: Teardrop RBCs + nucleated RBCs → marrow fibrosis
• Immunophenotype: Not primary diagnostic
• Genetics: JAK2, CALR, MPL
• Why wrong:
o A: thrombocytosis without fibrosis
o C: lymphocytosis + smudge cells
o D: microcytosis
, Q4
Smear shows smudge cells and small mature lymphocytes.
A. CLL
B. ALL
C. Hairy cell leukemia
D. MDS
Answer: A
Explanation:
• Morphology: Smudge cells → fragile lymphocytes
• Immunophenotype: CD5+, CD23+
• Genetics: del(13q), trisomy 12
• Why wrong:
o B: blasts, not mature lymphocytes
o C: hairy projections
o D: dysplasia
Q5
Bone marrow shows dry tap, biopsy reveals fibrosis and atypical megakaryocytes.
A. AML
B. Primary myelofibrosis
C. CML
D. MDS
Answer: B
Explanation:
• Morphology: Fibrosis → dry tap
• Genetics: JAK2/CALR/MPL
