WBC, Lymph node & Spleen UG

LONG ESSAY(10 MARKS)
1.A 40 year old male was admitted with easy fatiguability, anorexia, weakness, weight loss, night sweats and dragging sensation in the abdomen due to splenomegaly. His total WBC count WAS 2,50,000/mm3
           a. What is the provisional diagnosis
          b. Describe the chromosomal abnormality of the disease
          c. Describe the blood and bone marrow picture 
          d. Mention the various phases of disease
                               (Answer – CML )                                       (Dr NTRUHS Dec 2022)
2. A 32 year old man is admitted with history of weakness and dragging sensation on left side of abdomen. On examinationhis liver is enlarged to 3 cms below costal margin and spleen is enlarged to 15cms below costal margin. His TLC is incraesed to 2,30,000/cumm
  1. What is the possible diagnosis/ What is likely to be the differential leukocyte count
  2. What is the diagnostic genetic abnormality in this condition
  3. To which group of disease this entity belong. Name the other condition
  4. Give the clinical picture of this disease
                               (Answer – CML )                                       (Dr NTRUHS Feb 2020)
3. A 22 year old male presented with fatigue and breathlessness developing over 1 week. On examination he had gum bleeding, epistaxis with petechiae, lymphadenopathy and spleenomegaly. CT scan showed presence of mediastinal mass.
           a. Give the possible diagnosis
           b. Give the peripheral blood and bone marrow findings
           c. Give the cytochemical staining properties
           d. What are the prognostic factors
         (Answer: ALL)                       (DR NTRUHS July 2019)
4. A 25 year old female presented with fatigue, pallor, purpuric rash, intermittent respiratory infections, cervical lymphadenopathy and spleenomegaly for a duration of 2 months. Laboratory investigations showed hemoglobin- 7gm/dl. TLC 50,000/mm³, platelet count 45,000/mm³. Bone marrow revealed myeloblasts with numerous auer rods.
    1. What is the probable diagnosis
    2. What are the characteristic peripheral smear and bone marrow finding 
    3. What are the characteristic cytochemical findings
    4. Enumerate some of the prognostic factors of the condition 
          (Answer : AML )           (Pondicherry university 2018)
5. A 35 year old man admitted with gradual weakness with dragging sensation left side of abdomen. His liver is 2 cms and spleen is 15cms enlarged below costal margin. His Hb is 9.3gm% ;TLC – 2,50,000/cumm and platelet count is 3,80,000/cumm
               a. What is the probable diagnosis
               b. Give the blood picture and molecular abnormality in this disease
               c. How will you differentiate it from Leukamoid reaction
               d. Give five causes of massive spleenomegaly
             (Answer: Chronic Myeloid Leukemia)                 (NTRUHS 2018)
  6. A 3 years old child admitted with fever and petechial hemorrhages for 2 weeks. on examination child is pale, no liver/spleen enlargement. cervical lymphnodes are enlarged. TLC – 50,000/cumm. peripheral smear shows blast cells.
                 a. What is the probable diagnosis ?
                 b. What is the bone marrow picture in this disease?
                 c. Enumerate the various prognostic factors.
                 d. Tabulate the differences between Lymphoblast and Myeloblast.
         (Answer : Acute Lymphoblastic Leukemia)              (NTRUHS January 2014)
7.A male child aged 8 yrs presented with fever, fatigue, generalized lymphadenopathy, bone pain, petechial  hemorrhages over the skin, pallor, enlarged testis and features of meningism
                a. What is your provisional diagnosis
                b. Describe blood and bone marrow picture
                c. Other investigations to confirm the diagnosis
                d. Discuss the prognosis of the same
                    (Answer : Acute Lymphoblastic Leukemia)              (NTRUHS January 2014)
8.  A 35 years old male was admitted with easy fatiguability, anorexia, weakness, weight loss, night sweats and dragging sensation in the abdomen due to massive splenomegaly. His total WBC count was 2,00,000 cell/mm3
               a. What is the provisional diagnosis
               b. Describe the blood and bone marrow picture
               c. Describe the chromosomal abnormality of the disease
               d. Mention various phases of the disease
                   (Answer : Chronic Myeloid Leukemia)           (NTRUHS July 2013
9. A 4 year old male child presented with fatigue, fever, epistaxis, bleeding gums, bone pains and CNS manifestations from meningeal involvement. Physical examination revealed petechial and echymoses of skin and mucous membrane, generalized lymphadenopathy and testicular enlargement. The leukocyte and differential                         counts are abnormal
              a. What is the provisional diagnosis
              b. Discuss various main laboratory investigations to make a final diagnosis
              c. Describe peripheral blood and bone marrow picture
              d. Discuss the molecular pathogenesis of disease
                   (Answer : Acute Lymphoblastic Leukemia)       (NTRUHS January 2012)
 
10. A 35 year old male patient presented with high fever , fatigue, pallor, skin petechiae, swollen gums and bone pains. His total WBC count was 1,oo,ooo/µL
              a. What is the provisional diagnosis
              b. Describe the blood and bone marrow picture of the above case
              c. Discuss the prognosis of the disease
                  (Answer : Acute Myeloid Leukemia)           (NTRUHS August 2009)
11. A 2 year old child presented with fatigue, fever, epistaxis, bleeding gums and bone pain. On examination, generalized lymphadenopathy and hepatosplenomegaly was noted. Total leukocyte count was 1,50,000/µL
              a. What is the probable diagnosis
              b. Describe the cytogenetics of the disease
              c. Describe the peripheral blood smear and bone marrow finding of the same
              d. Describe the prognostic factors of the disease
                  (Answer : Acute Lymphoblastic Leukemia)           (NTRUHS May 2007)
12. 36 year old female came with swollen gums, fatigue and weight loss. She gives the history of repeated upper respiratory tract infections. On examination pallor, fever and hepatosplenomegaly present.
              a. What is the provisional diagnosis
              b. Mention various investigations to make a final diagnosis
              c. Emphasis on peripheral blood and bone marrow picture 
                  (Answer : Acute Myeloid Leukemia)           (NTRUHS May 2006)
13 . A 30 year old male patient came with moderate anemia, easy fatigablity, weakness, weight loss, anorexia, dragging sensation in the abdomen due to extreme splenomegaly. Chromosomal analysis revealed the presence of Philadelphia chromosome .
              a. What is the provisional diagnosis
              b. Describe the lab investigations to make a final diagnosis
              c. Describe the blood and bone marrow picture of the disease 
                  (Answer : Chronic Myeloid Leukemia)           (NTRUHS May 2004)
14. Classify acute leukemias. Discuss laboratory diagnosis of acute leukemia. (RGUHS- Jul 2012)
15. Classify leukemias. Discuss chronic myeloid leukemia in detail. (RGUHS- Jan 2008)
16. Describe pathology, blood and bone marrow picture of chronic myeloid leukemia. (RGUHS- Jun 2009)
17. Classify leukemias. Write the clinical features, FAB classification and the diagnostic methods used in the diagnosis of ALL. (RGUHS- Jul 2012)
18. Classify leukemias. Discuss lab diagnosis of AML. Describe the bone marrow findigs in AML including special stains. (RGUHS- Dec 2009)
19. What are myeloproliferative disorders? Write in detail about the laboratory investigations and clinical features of Chronic myeloid leukemia. (RGUHS- Jan 2008)
 
SHORT QUESTIONS (4 MARKS)
  1. Hodgkins disease (Pondicherry university June 2019)
  2. Pathogenesis, smear and marrow finding in chronic myeloid leukemia (Pondicherry university June 2019)
  3. Enlist the types of plasma cell dyscrasias. Discuss in detail bone marrow findings of multiple myeloma (Pondicherry university June 2019)
  4. Laboratory diagnosis of Chronic myeloid leukemia (NTRUHS Feb 2019, RGUHS- Dec 2013)
  5. Leukemoid reaction (RGUHS Dec 2018, NTRUHS- July 2016,April 2005)(RGUHS- Jan 2008, Dec 2009)
  6. Peripheral blood picture in Acute myeloid leukemia (RGUHS Dec 2018)
  7. Enumerate the causes of massive spleenomegaly. Discuss the gross and microscopy of congestive splenomegaly (Pondicherry university 2018)
  8. Classify chronic myeloproliferative disorders. Give blood picture and diagnostic test in a case of chronic myeloid leukemia (NTRUHS July 2017)
  9. Cytochemistry in differentiation of acute leukemias (NTRUHS- Jan 2016)
  10. Morphology of Hodgkin’s Lymphoma (NTRUHS- Sept 2003)
  11. Burkitt’s Lymphoma. (NTRUHS- 8th April 2000,JAN 2014)(RGUHS- Jan 2009, Jun 2009, Dec 2010)
  12. Tabulate the differences between myeloblast and lymphoblast (RGUHS- Dec 2012)
  13. Peripheral blood picture in Acute lymphoblastic leukemia (RGUHS- Dec 2013)
  14. Fab Classification Of Acute MyeloidLeukaemia (NTRUHS Jan 2015, RGUHS- Jun 2009, Jun 2010)
  15. Peripheral smear in Chronic myeloid leukemia (RGUHS- Jul 2012)
  16. Philadelphia chromosome (RGUHS- Dec 2010)
  17. Hairy cell leukemia (RGUHS- Jun 2008)
  18. Multiple myeloma (RGUHS- Jun 2013)
  19. Laboratory diagnosis of multiple myeloma (RGUHS- Jan 2008, Jun 2011, Dec 2013)
  20. Radiological appearance of skull in multiple myeloma (RGUHS- Jun 2010)
  21. Classification of HodgkinLymphoma (RGUHS- Dec 2011)
  22. HodgkinDisease/ Lymphoma (RGUHS- Jun 2012, Dec 2013)
  23. Morphology of Hodgkin’s Lymphoma – Mixed cellularity type. (RGUHS – Dec 2009)
  24. Morphology of Hodgkin’s Lymphoma – Nodular sclerosis (RGUHS – Jan 2008)
  25. B cell lymphoma (RGUHS- Jun 2010)
  26. Follicular lymphoma (RGUHS – Jun 2010)
  27. Hypersplenism (RGUHS- Jun 2012)
  28. Congestive splenomegaly (RGUHS- Jul 2012)
 
 
 VERYSHORT QUESTIONS(2 MARKS)
  1. Peripheral smear findings in accelerated phase of CML (RGUHS Feb 2023)
  2. Describe Reed sternberg cell and its variants (SVIMS Oct 2021)
  3. Describe peripheral smear findings in CLL (SVIMS Oct 2021)
  4. Write four clinical and lab features of Multiple myeloma (NTRUHS, Feb 2020)
  5. Classify Hodgkin’s disease (NTRUHS Feb 2020)
  6. Variants of Reed-Sternberg cell  (NTRUHS Feb 2019, RGUHS- Jul 2008, August 2009, Jun 2010, Jun 2011)
  7. Auer rods (RGUHS Dec 2018, Dec 2013)
  8. Reed-Sternberg Giant cells. (RGUHS Dec 2018, NTRUHS- July 2011,APRIL/MAY 2004)(RGUHS- Dec 2010, Jun 2011)
  9. Nodular sclerosis type of hodgkin’s lymphoma (NTRUHS- Feb 2018, May 2007)
  10. Staging of Hodgkins disease (NTRUHS July 2017)
  11. Mention 4 clinical features of Acute lymphoblastic leukemias (NTRUHS July 2017)
  12. Hodgkin Lymphoma – WHO classification (NTRUHS- July 2013)
  13. Causes of lymphadenopathy (NTRUHS- Sept/Oct 2007)
  14. Microscopic picture of Hodgkin’s Lymphoma (NTRUHS- Mar/Apr 2005)
  15. Hodgkin’s disease (NTRUHS- Oct/Nov 2002)
  16. Fab Classification Of Acute MyeloblasticLeukaemia (AML) (NTRUHS- Jan 2015)
  17. Name Four Subtypes Of Hodgkin Disease (NTRUHS- July 2016)
  18. Classification Of Lymphomas (NTRUHS- Jan 2013)
  19. Tabulate The Differences Between Leukemoid Reaction And Chronic Myeloid Leukemia. (NTRUHS- July / Aug 2014)
  20. Blood Picture And Bone Marrow Findings In CML (NTRUHS)
  21. Name Any Four Myeloproliferative Disorders (NTRUHS- July 2015)
  22. Draw A Diagram Of Reed Sternberg Cell (NTRUHS- July / Aug 2014)
  23. Mention 4 morphologic characteristic of Myeloblast. (NTRUHS- Jan 2013)
  24. Myeloblast Of AML3 (NTRUHS- March 2010)
  25. Juvenile chronic myeloid leukemia (NTRUHS 2008)
  26. LE. Cell (NTRUHS- October 2008) (RGUHS Dec 2013)
  27. Classification of Hodgkin Lymphoma (RGUHS- Jan 2009, Jun 2013)
  28. Appearance of diagnostic cell of Hodgkin Lymphoma (RGUHS- Jan 2009)
  29. Classic Reed-Sternberg cell (RGUHS- Jun 2008, Jan 2009, Jun 2009)
  30. Molecular pathogenesis of Follicular lymphoma (RGUHS – Dec 2013)
  31. Mycosis Fungoides (RGUHS- Jun 2010)
  32. Sezary syndrome (RGUHS- Jan 2008)
  33. Burkitt’s Lymphoma (RGUHS- Jul 2008)
  34. Write the bone marrow findings in multiple myeloma (RGUHS- Jan 2008)
  35. Morphology of plasma cells in Multiple myeloma (RGUHS- Jun 2009)
  36. Bence Jones proteins. Mention demonstration (RGUHS- Jul 2008, Dec 2009)
  37. Peripheral blood picture in Acute myeloid leukemia (RGUHS- Jun 2008)
  38. Peripheral blood picture in Acute leukemia (RGUHS- Jan 2008)
  39. Ann Arbor classification of lymphomas (RGUHS Dec 2013)
  40. Myelofibrosis (RGUHS- Jun 2011)
  41. Myelocyte (RGUHS- Jun 2008)
  42. Eosinophilia and its causes (RGUHS- Jun 2011, Dec 2013)
  43. Role of eosinophils in parasitic infections (RGUHS- Jun 2010)
  44. Enumerate transfusion reactions (RGUHS 2013)
  45. Definition and causes of leucocytosis (RGUHS- Jul 2008)
  46. Leukemoid reaction (RGUHS- Dec 2009, Jun 2011, Jun 2012, Dec 2013)
  47. Four causes of lymphocytosis (RGUHS – Dec 2013)
  48. Causes of dry tap in bone marrow aspiration (RGUHS – Jun 2011, Dec 2013)
  49. Absolute indications of bone marrow aspiration (RGUHS- Jun 2010)
  50. Absolute indications of bone marrow biopsy (RGUHS- Jun 2010)
  51. Agranulocytosis (RGUHS- Jan 2009, Dec 2009)
  52. Erythroleukemia (RGUHS- Jan 2009)
  53. Four (4) important causes of massive splenomegaly (RGUHS- Dec 2009, Dec 2013)