[MCQs] Plasma Cell Disorders- Part 3

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Plasma Cell Disorders- Part 3

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Question 1

The classic triad of myeloma consists of all except ?

A	Marrow plasmacytosis (>10%)
B	Bence Jones proteins in urine
C	Lytic bone lesions
D	Serum and/or urine M component

Question 1 Explanation:

The classic triad of myeloma is marrow plasmacytosis (>10%), lytic bone lesions, and a serum and/or urine M component.

Question 2

Bone marrow plasma cells are ?

A	CD130+
B	CD134+
C	CD138+
D	CD142+

Question 2 Explanation:

Bone marrow plasma cells are CD138+ and monoclonal. Diagnosis of IgM myeloma is reserved for patients with lytic bone lesions & predominant infiltration with CD138+ plasma cells in bone marrow.

Question 3

What percentage of patients with MGUS go on to develop myeloma ?

A	~ 1 % per year
B	~ 2 % per year
C	~ 3 % per year
D	~ 4 % per year

Question 3 Explanation:

With long-term follow-up, ~1% per year of patients with MGUS go on to develop myeloma.

Question 4

Which of the following statements about myeloma is false ?

A	All myeloma is preceded by MGUS
B	Serum alkaline phosphatase is normal
C	Dipsticks for detecting proteinuria not reliable for light chains
D	None of the above

Question 4 Explanation:

Serum alkaline phosphatase is usually normal even with extensive bone involvement because of the absence of osteoblastic activity

Question 5

Which of the following factor is associated with higher incidence of progression of MGUS to myeloma ?

A	Non-IgG subtype
B	Abnormal kappa/lambda free light chain ratio
C	Serum M protein > 1.5 g/dL
D	All of the above

Question 5 Explanation:

Non-IgG subtype, abnormal kappa/lambda free light chain ratio, and serum M protein > 15 g/L (1.5 g/dL) are associated with higher incidence of progression of MGUS to myeloma.

Question 6

Extramedullary plasmacytoma usually involves ?

A	Lung-associated lymphatic tissue
B	Gut-associated lymphatic tissue
C	Submucosal lymphoid tissue of nasopharynx or sinuses
D	Any of the above

Question 6 Explanation:

Extramedullary plasmacytomas usually involve the submucosal lymphoid tissue of the nasopharynx or paranasal sinuses without marrow plasmacytosi

Question 7

Which of the following is a Myeloma staging system ?

A	Ann Arbor staging system
B	Binet staging system
C	RAI staging system
D	Durie-Salmon staging system

Question 7 Explanation:

Durie-Salmon staging system is based on Hb, calcium, M component & degree of skeletal involvement.

Question 8

All of the following is true for monoclonal gammopathies of uncertain significance (MGUS) except ?

A	< 10% bone marrow plasma cells
B	< 3 g/dL of M components
C	Urinary Bence Jones protein
D	No bone lesions

Question 8 Explanation:

Diagnostic Criteria for MGUS are M protein in serum < 3 g/dL, bone marrow clonal plasma cells < 10%, no evidence of other B cell proliferative disorders, no myeloma-related organ or tissue impairment (no bone lesions)

Question 9

In MGUS, which is the most common immunoglobulin affected ?

A	IgG
B	IgM
C	IgA
D	Biclonal gammopathies

Question 9 Explanation:

Serum M component is IgG in 53% of patients, IgA in 25%, and IgD in 1%. 20% of patients have only light chains in serum and urine

Question 10

The normal free light-chain (/) ratio is ?

A	0.06 to 0.65
B	0.12 to 0.95
C	0.26 to 1.65
D	1.86 to 2.35

Question 11

For diagnosis of myeloma, marrow plasmacytosis must be ?

A	> 5 %
B	> 10 %
C	> 15 %
D	> 20 %

Question 12

For diagnosis of myeloma, which of the following are included ?

A	Hemoglobin
B	Serum calcium & degree of skeletal involvement
C	M component
D	All of the above

Question 13

Which of the following is associated with poor prognosis in a patient of myeloma ?

A	Elevated levels of IL-6
B	High labeling index
C	High levels of lactate dehydrogenase
D	All of the above

Question 13 Explanation:

All of the above

Question 14

In myeloma, which of the following is the single most powerful predictor of survival and can substitute for staging ?

A	Serum Beta 2-microglobulin
B	Lactate dehydrogenase
C	Thymidine kinase
D	% plasma cells in marrow

Question 15

In myeloma, which of the following is the single most powerful predictor of survival and can substitute for staging ?

A	Serum Beta 2-microglobulin
B	Serum levels of IL-6 & Soluble IL-6 receptors
C	C-reactive protein
D	Hepatocyte growth factor

Question 16

In myeloma, which of the following is the single most powerful predictor of survival and can substitute for staging ?

A	Serum Beta 2-microglobulin
B	C-terminal cross-linked telopeptide of collagen I
C	TGF-beta
D	Syndecan-1

Question 16 Explanation:

Serum 2-microglobulin is the single most powerful predictor of survival and can substitute for staging. Beta-2 microglobulin is a surrogate marker for the overall body tumor burden.

Question 17

Which of the following drugs is useful in treatment of myeloma ?

A	Vincristine
B	Doxorubicin
C	Melphalan
D	All of the above

Question 18

Which of the following drug must not be used in myeloma patients who are transplant candidates ?

A	Melphalan
B	Thalidomide
C	High-dose pulsed glucocorticoids
D	High-dose pulsed glucocorticoids

Question 18 Explanation:

In myeloma patients who are transplant candidates, alkylating agents like melphalan should be avoided as they damage stem cells, leading to decreased ability to collect stem cells for autologous transplant

Question 19

Dexamethasone is recommended with which of the following drugs for treatment of myeloma ?

A	Vincristine doxorubicin
B	Lenalidomide
C	Bortezomib
D	All of the above

Question 19 Explanation:

In myeloma treatment, dexamethasone with bortezomib, lenalidomide or thalidomide leads to high response rates without compromising collection of stem cells for transplantation.

Question 20

Lenalidomide and/or bortezomib target which of the following ?

A	Tumor cell
B	Tumor cell - bone marrow interaction
C	Bone marrow milieu
D	All of the above

Question 20 Explanation:

Lenalidomide & bortezomib target tumor cell, tumor cell - bone marrow interaction & bone marrow milieu

Question 21

Hematologic diseases causing massive splenomegaly and anemia with absent hyperviscosity include ?

A	Chronic myeloid leukemia
B	Agnogenic myeloid metaplasia (with myelofibrosis
C	Chronic lymphocytic leukemia or its prolymphocytic variant
D	All of the above

Question 22

Hematologic diseases causing massive splenomegaly and anemia with absent hyperviscosity include ?

A	Hodgkin's disease
B	Heavy-chain diseases
C	Amyloidosis (associated with plasma-cell dyscrasias)
D	All of the above

Question 23

Hematologic diseases causing massive splenomegaly and anemia with hyperviscosity include all except ?

A	Polycythemia vera
B	Multiple myeloma
C	Heavy-chain diseases
D	POEMS syndrome 787 Hematologic diseases causing massive splenomegaly and anemia with hyperviscosity include all except ? N Engl J Med 2001;345:682 A. Waldenström’s macroglobulinemia B. Chronic myeloid leukemia C. Polycythemia vera D. Multiple myeloma 788 Hematologic diseases causeing massive splenomegaly, anemia and hyperviscosity include all except ? N Engl J Med 2001;345:682 A. Polycythemia vera B. Heavy-chain diseases C. POEMS syndrome D. Waldenström’s macroglobulinemia 789 Hematologic diseases causeing massive splenomegaly, anemia and hyperviscosity include all except ? N Engl J Med 2001;345:682 A. Polycythemia vera B. Multiple myeloma C. POEMS syndrome D. Hodgkin’s disease 790 Hematologic diseases causeing massive splenomegaly, anemia and without hyperviscosity include all except ? N Engl J Med 2001;345:682 A. Chronic myeloid leukemia B. Agnogenic myeloid metaplasia (with myelofibrosis) C. POEMS syndrome D. Chronic lymphocytic leukemia 791 Hematologic diseases causeing massiv

Question 24

Hematologic diseases causing massive splenomegaly and anemia with hyperviscosity include all except ?

A	Waldenström’s macroglobulinemia
B	Chronic myeloid leukemia
C	Polycythemia vera
D	Multiple myeloma

Question 25

Hematologic diseases causeing massive splenomegaly, anemia and hyperviscosity include all except ?

A	Polycythemia vera
B	Heavy-chain diseases
C	POEMS syndrome
D	Waldenström’s macroglobulinemia

Question 26

Hematologic diseases causeing massive splenomegaly, anemia and hyperviscosity include all except ?

A	Polycythemia vera
B	Multiple myeloma
C	POEMS syndrome
D	Hodgkin's disease

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See all quizzes of the Plasma Cell Disorders at here:

Plasma Cell Disorders Part 1 | Plasma Cell Disorders Part 2 | Plasma Cell Disorders Part 3 | Plasma Cell Disorders Part 4

II. Preview all questions below

1.The classic triad of myeloma consists of all except ?
A. Marrow plasmacytosis (>10%)
B. Bence Jones proteins in urine
C. Lytic bone lesions
D. Serum and/or urine M component

2. Bone marrow plasma cells are ?
A. CD130+
B. CD134+
C. CD138+
D. CD142+

3. What percentage of patients with MGUS go on to develop myeloma ?
A. ~ 1 % per year
B. ~ 2 % per year
C. ~ 3 % per year
D. ~ 4 % per year

4. Which of the following statements about myeloma is false ?
A. All myeloma is preceded by MGUS
B. Serum alkaline phosphatase is normal
C. Dipsticks for detecting proteinuria not reliable for light
chains
D. None of the above

5. Which of the following factor is associated with higher incidence of progression of MGUS to myeloma ?
A. Non-IgG subtype
B. Abnormal kappa/lambda free light chain ratio
C. Serum M protein > 1.5 g/dL
D. All of the above

6. Extramedullary plasmacytoma usually involves ?

A. Lung-associated lymphatic tissue
B. Gut-associated lymphatic tissue
C. Submucosal lymphoid tissue of nasopharynx or sinuses
D. Any of the above

7. Which of the following is a Myeloma staging system ?
A. Ann Arbor staging system
B. Binet staging system
C. RAI staging system
D. Durie-Salmon staging system

8. What other parameter besides serum 2-microglobulin is used in International Staging System (ISS) for myeloma ?
A. Serum albumin
B. Hemoglobin
C. Serum calcium
D. Serum creatinine

9. All of the following is true for monoclonal gammopathies of uncertain significance (MGUS) except ?
A. < 10% bone marrow plasma cells
B. < 3 g/dL of M components
C. Urinary Bence Jones protein
D. No bone lesions

10. In MGUS, which is the most common immunoglobulin affected ?
A. IgG
B. IgM
C. IgA
D. Biclonal gammopathies

11. The normal free light-chain (/) ratio is ?
A. 0.06 to 0.65
B. 0.12 to 0.95
C. 0.26 to 1.65
D. 1.86 to 2.35
12. For diagnosis of myeloma, marrow plasmacytosis must be ?
A. > 5 %

B. > 10 %
C. > 15 %
D. > 20 %
13. For diagnosis of myeloma, which of the following are included ?
A. Hemoglobin
B. Serum calcium & degree of skeletal involvement
C. M component
D. All of the above

14. Which of the following is associated with poor prognosis in a patient of myeloma ?
A. Elevated levels of IL-6
B. High labeling index
C. High levels of lactate dehydrogenase
D. All of the above

15. In myeloma, which of the following is the single most powerful predictor of survival and can substitute for staging ?
A. Serum Beta
2-microglobulin
B. Lactate dehydrogenase
C. Thymidine kinase
D. % plasma cells in marrow
16. In myeloma, which of the following is the single most powerful predictor of survival and can substitute for staging ?
A. Serum Beta
2-microglobulin
B. Serum levels of IL-6 & Soluble IL-6 receptors
C. C-reactive protein
D. Hepatocyte growth factor
17. In myeloma, which of the following is the single most powerful predictor of survival and can substitute for staging ?
A. Serum Beta
2-microglobulin
B. C-terminal cross-linked telopeptide of collagen I
C. TGF-beta
D. Syndecan-1

18. Which of the following drugs is useful in treatment of myeloma ?
A. Vincristine
B. Doxorubicin
C. Melphalan
D. All of the above

19. Which of the following drug must not be used in myeloma patients who are transplant candidates ?
A. Melphalan
B. Thalidomide
C. High-dose pulsed glucocorticoids
D. Bortezomib

20. Dexamethasone is recommended with which of the following drugs for treatment of myeloma ?
A. Vincristine, doxorubicin
B. Lenalidomide
C. Bortezomib
D. All of the above

21. Lenalidomide and/or bortezomib target which of the following ?
A. Tumor cell
B. Tumor cell – bone marrow interaction
C. Bone marrow milieu
D. All of the above

22. Hematologic diseases causing massive splenomegaly and anemia with absent hyperviscosity include ?
A. Chronic myeloid leukemia
B. Agnogenic myeloid metaplasia (with myelofibrosis)
C. Chronic lymphocytic leukemia or its prolymphocytic variant
D. All of the above

23. Hematologic diseases causing massive splenomegaly and anemia with absent hyperviscosity include ?
A. Hodgkin’s disease
B. Heavy-chain diseases
C. Amyloidosis (associated with plasma-cell dyscrasias)
D. All of the above

24. Hematologic diseases causing massive splenomegaly and anemia with hyperviscosity include all except ?
A. Polycythemia vera
B. Multiple myeloma
C. Heavy-chain diseases
D. POEMS syndrome
25. Hematologic diseases causing massive splenomegaly and anemia with hyperviscosity include all except ?
A. Waldenström’s macroglobulinemia

B. Chronic myeloid leukemia
C. Polycythemia vera
D. Multiple myeloma
26. Hematologic diseases causeing massive splenomegaly, anemia and hyperviscosity include all except ?
N Engl J Med 2001;345:682
A. Polycythemia vera
B. Heavy-chain diseases
C. POEMS syndrome
D. Waldenström’s macroglobulinemia

27. Hematologic diseases causeing massive splenomegaly, anemia and hyperviscosity include all except ?
A. Polycythemia vera
B. Multiple myeloma
C. POEMS syndrome
D.Hodgkin’s disease

Plasma Cell Disorders

[MCQs] Plasma Cell Disorders- Part 3

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Plasma Cell Disorders- Part 3

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[MCQs] Plasma Cell Disorders- Part 4

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