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Questions and Answers
What is the cutoff point for diagnosing acute leukemia based on blast cells in bone marrow?
What is the cutoff point for diagnosing acute leukemia based on blast cells in bone marrow?
Why is a bone marrow aspirate (BMA) necessary in cases of suspected acute leukemia?
Why is a bone marrow aspirate (BMA) necessary in cases of suspected acute leukemia?
Which of the following plays a crucial role in the classification of acute leukemia?
Which of the following plays a crucial role in the classification of acute leukemia?
What does a confirmed diagnosis of acute leukemia typically require in terms of blast cell percentage?
What does a confirmed diagnosis of acute leukemia typically require in terms of blast cell percentage?
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Which of the following statements is true regarding the examination of bone marrow in acute leukemia?
Which of the following statements is true regarding the examination of bone marrow in acute leukemia?
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Which feature indicates the presence of myeloblasts?
Which feature indicates the presence of myeloblasts?
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What condition is associated with normochromic normocytic anemia?
What condition is associated with normochromic normocytic anemia?
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What might blood film analysis show in a patient with acute leukemia?
What might blood film analysis show in a patient with acute leukemia?
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What percentage of leukemic blasts is usually seen in the bone marrow for a patient diagnosed with acute leukemia?
What percentage of leukemic blasts is usually seen in the bone marrow for a patient diagnosed with acute leukemia?
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Which of the following is not a typical feature of myeloblasts?
Which of the following is not a typical feature of myeloblasts?
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What are the two major types of acute leukemia?
What are the two major types of acute leukemia?
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At what age group can acute leukemia occur?
At what age group can acute leukemia occur?
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Which statement is true about the classification of acute leukemia?
Which statement is true about the classification of acute leukemia?
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What do ALL and AML stand for in the context of acute leukemia?
What do ALL and AML stand for in the context of acute leukemia?
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Which clinical feature distinguishes acute leukemia from chronic leukemia?
Which clinical feature distinguishes acute leukemia from chronic leukemia?
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What is characterized by an increase in the total white blood cell (WBC) count above the upper limit of normal?
What is characterized by an increase in the total white blood cell (WBC) count above the upper limit of normal?
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Which condition is indicated by a neutrophil count greater than 7.0 × 10^9/L?
Which condition is indicated by a neutrophil count greater than 7.0 × 10^9/L?
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Which of the following is defined as a decrease in the total white blood cell count below 4.0 × 10^9/L?
Which of the following is defined as a decrease in the total white blood cell count below 4.0 × 10^9/L?
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What is the term used for an increase in neutrophil count specifically?
What is the term used for an increase in neutrophil count specifically?
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What is the primary purpose of immunophenotyping in the diagnosis of leukemia?
What is the primary purpose of immunophenotyping in the diagnosis of leukemia?
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What does lymphocytosis indicate in a blood analysis?
What does lymphocytosis indicate in a blood analysis?
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Which of the following tests is least useful for differentiating between acute lymphoblastic leukemia and acute myeloid leukemia?
Which of the following tests is least useful for differentiating between acute lymphoblastic leukemia and acute myeloid leukemia?
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What finding in a physical examination is most indicative of a hematological condition related to leukemia?
What finding in a physical examination is most indicative of a hematological condition related to leukemia?
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Which factor is critical for the definitive differentiation between acute lymphoblastic leukemia and acute myeloid leukemia?
Which factor is critical for the definitive differentiation between acute lymphoblastic leukemia and acute myeloid leukemia?
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Which of the following statements is true regarding acute leukemias?
Which of the following statements is true regarding acute leukemias?
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Study Notes
Bone Marrow Aspirate
- A bone marrow aspirate is required to confirm acute leukemia diagnosis, especially when blood counts are low.
- A cutoff point of 20% blast cells in bone marrow indicates acute leukemia.
- A bone marrow aspirate usually shows infiltration with 10% leukemic blasts.
Myeloblast Morphology
- Myeloblasts have a rather high nucleocytoplasmic ratio.
- The nuclei of myeloblasts have somewhat coarse and clumped chromatin.
- Myeloblasts have two or more nucleoli.
- Myeloblasts have agranular cytoplasm.
- Myeloblasts tend to be small in size.
Differentiating Acute Leukemias
- Immunophenotyping of blast cells is the best test to differentiate between acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML).
Acute Leukemia
- Acute leukemia can occur at any age.
- Acute leukemia is a type of neoplastic white blood cell disorder.
- Acute leukemia (AL) is categorized into two major types:
- Acute lymphoblastic leukemia (ALL)
- Acute myeloblastic leukemia (AML)
Non-Neoplastic White Blood Cell (WBC) Disorders
- Leukocytosis is an increase in the total white blood cell count above the upper limit of normal (> 11 × 109/L).
- Leukopenia is a decrease in the total white blood cell count below the lower limit of normal.
- Neutrophilia is a type of leukocytosis with a neutrophil count > 7.0 × 109/L.
- Eosinophilia is a type of leukocytosis with an eosinophil count > 0.5 × 109/L.
- Basophilia is a type of leukocytosis with a basophil count > 0.1 × 109/L.
- Lymphocytosis is a type of leukocytosis with a lymphocyte count > 3.5 × 109/L.
- Lymphopenia is a type of leukopenia with a lymphocyte count < 1.5 × 109/L.
- Monocytosis is a type of leukocytosis with a monocyte count > 1.0 × 109/L.
- Neutropenia is a type of leukopenia with a neutrophil count < 2 × 109/L.
- Reactive leukocytosis is more commonly encountered in routine work than neoplastic states.
Peripheral Blood Smear
- A peripheral blood smear showing normal blood leukocyte morphology.
Bone Marrow Aspirate (Normal)
- Bone marrow aspirate showing a normal maturation sequence of granulocytic cells, with the nucleus becoming smaller.
Case Scenario Discussion
- A 22-year-old female with fever, bone pain, cervical lymphadenopathy, multiple bleeding spots, and many blasts in the peripheral blood likely has acute leukemia.
- The Philadelphia chromosome is associated with chronic myeloid leukemia, not acute leukemia.
- Splenomegaly is not specific to a particular type of leukemia and is not helpful in differentiating between ALL and AML.
- The white blood cell count in the peripheral blood is not reliable in differentiating ALL and AML.
- The number of blasts in the bone marrow aspirate is used to diagnose acute leukemia, but not to differentiate between specific types of leukemia.
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Description
This quiz covers the essentials of acute leukemia, focusing on the significance of bone marrow aspirate for diagnosis. It includes details on myeloblast morphology and the differentiation between acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Test your knowledge on these critical topics in hematology.
