COCN COCN Hematologic Malignancies 2 — Questions and Answers
Question 1: Which finding on a peripheral blood smear is characteristic of chronic myeloid leukemia (CML)?
- Blast crisis only
- Auer rods
- Left shift with cells at all stages of myeloid maturation (Correct answer)
- Smudge cells
Correct answer: Left shift with cells at all stages of myeloid maturation
CML shows a left shift with myeloid cells at all maturation stages, reflecting uncontrolled granulocyte production.
Question 2: A patient with Hodgkin lymphoma reports drenching night sweats, unexplained fever, and 12% weight loss. These are classified as:
- A symptoms
- B symptoms (Correct answer)
- C symptoms
- Constitutional grade I
Correct answer: B symptoms
B symptoms (fever >38°C, drenching night sweats, >10% weight loss) indicate systemic disease and affect staging in lymphoma.
Question 3: Which medication class is the standard first-line treatment for CML targeting the BCR-ABL oncoprotein?
- Alkylating agents
- Tyrosine kinase inhibitors (TKIs) (Correct answer)
- Anthracyclines
- Anti-CD20 monoclonal antibodies
Correct answer: Tyrosine kinase inhibitors (TKIs)
TKIs such as imatinib, dasatinib, and nilotinib directly inhibit BCR-ABL kinase activity in CML.
Question 4: Reed-Sternberg cells are pathognomonic for which lymphoma type?
- Diffuse large B-cell lymphoma
- Follicular lymphoma
- Hodgkin lymphoma (Correct answer)
- Mantle cell lymphoma
Correct answer: Hodgkin lymphoma
Large binucleated Reed-Sternberg cells with prominent owl-eye nucleoli are the defining histologic feature of Hodgkin lymphoma.
Question 5: Which electrolyte imbalance is NOT a feature of tumor lysis syndrome (TLS)?
- Hyperkalemia
- Hyperphosphatemia
- Hypercalcemia (Correct answer)
- Hyperuricemia
Correct answer: Hypercalcemia
TLS causes hypocalcemia (not hypercalcemia) due to phosphate binding calcium as phosphate is released from lysed cells.
Question 6: A patient with multiple myeloma has a serum calcium of 12.8 mg/dL. Which nursing intervention is the priority?
- Restrict oral fluids to 1L/day
- Administer IV normal saline hydration (Correct answer)
- Encourage a high-calcium diet
- Apply warm compresses to the extremities
Correct answer: Administer IV normal saline hydration
Aggressive IV hydration with normal saline is the first-line treatment for hypercalcemia to promote renal calcium excretion.
COCN COCN Hematologic Malignancies 2
Which finding on a peripheral blood smear is characteristic of chronic myeloid leukemia (CML)?