AOCNP Hematologic Malignancies 1

Question 1

Which type of leukemia is the most common leukemia in adults in the United States?

Accepted Answer

Chronic lymphocytic leukemia (CLL)

Answer

Chronic lymphocytic leukemia (CLL) is the most common adult leukemia in Western countries, accounting for approximately 25–30% of all leukemias.

Question 2

The Philadelphia chromosome, resulting from a t(9;22) translocation that produces the BCR-ABL fusion gene, is the hallmark of which leukemia?

Accepted Answer

Chronic myeloid leukemia (CML)

Answer

The Philadelphia chromosome [t(9;22)] producing BCR-ABL is the defining molecular abnormality of CML and the target of tyrosine kinase inhibitors like imatinib.

Question 3

A patient is diagnosed with acute promyelocytic leukemia (APL, AML-M3). Which agent is a cornerstone of induction therapy that induces differentiation of malignant promyelocytes?

Accepted Answer

All-trans retinoic acid (ATRA)

Answer

ATRA targets the PML-RARA fusion protein in APL, promoting differentiation of malignant promyelocytes and is combined with arsenic trioxide or anthracyclines for induction.

Question 4

A patient with newly diagnosed AML has a FLT3-ITD mutation. What is the clinical significance of this finding?

Accepted Answer

It is associated with poor prognosis and warrants addition of a FLT3 inhibitor such as midostaurin

Answer

FLT3-ITD mutations in AML are associated with high relapse rates and poor overall survival; adding midostaurin (a FLT3 inhibitor) to standard induction chemotherapy improves outcomes.

Question 5

Which of the following is the most accurate description of a complete cytogenetic response (CCyR) to imatinib therapy in CML?

Accepted Answer

No Philadelphia chromosome-positive cells detected in cytogenetic analysis (0% Ph+ metaphases)

Answer

Complete cytogenetic response (CCyR) is defined as 0% Philadelphia chromosome-positive metaphases on conventional cytogenetic analysis of bone marrow.

AOCNP - Advanced Oncology Certified Nurse Practitioner Practice Test

AOCNP - Advanced Oncology Certified Nurse Practitioner Practice Test

AOCNP Hematologic Malignancies 1