Chapter 11: Malignant Disorders of White Blood Cells

Chapter 11: Malignant Disorders of White Blood Cells

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. The major cause of death from leukemic disease is
a. infection.
b. malnutrition.
c. hypovolemic shock.
d. kidney failure.
ANS: A
Infection is the most common cause of death in the immunocompromised patient, because it can become a life-threatening sepsis.
Malnutrition can be a side effect of the disease process or the treatment. Hypovolemic shock is not generally associated with
leukemic disease. There is no direct connection between kidney failure and death in leukemia, although kidney failure may occur as
a result of treatment.
REF: Pg. 218
2. A 58-year-old woman is seen in the clinic for reports of severe back pain. Her chest X-ray demonstrates generalized bone
demineralization and compression fracture. Blood studies demonstrate elevated calcium levels. The most likely diagnosis is
a. leukemia.
b. myeloma.
c. Hodgkin disease.
d. back trauma.
ANS: B
A diagnosis of plasma cell myeloma is confirmed by the presence of hypercalcemia, which can contribute to the compression
fracture. Patients with leukemia diagnoses do not exhibit bone demineralization or elevated calcium levels. Lymphadenopathy is a
more common manifestation of Hodgkin disease. Compression fractures can be the result of back trauma, but not in the presence of
the other radiographic and laboratory results.
REF: Pg. 225
3. Renal insufficiency is a common complication of which disease?
a. Chronic myeloid leukemia (CML)
b. Chronic lymphoid leukemia (CLL)
c. Myeloma
d. Hodgkin disease
ANS: C
Renal insufficiency is seen in approximately 50% of patients with plasma cell myeloma, due to hyperproteinemia, Bence Jones
protein, hypercalcemia, and hyperuricemia. Chronic myeloid leukemia is manifested by splenomegaly. Chronic lymphoid leukemia
is a disease that affects lymphoid tissues and bone marrow. Malignancy along lymphatic pathways is more typical of Hodgkin
disease.
REF: Pg. 225
4. The patient is a 12-year-old boy diagnosed with acute lymphoid leukemia (ALL). As part of treatment, the patient must undergo
several weeks of chemotherapy. The most serious complication of chemotherapy is
a. vomiting.
b. anemia.
c. alopecia.
d. infection.
ANS: D
Infection is the most troublesome complication of chemotherapy for the immunosuppressed patient, and infection is a major cause
of death in a leukemic patient. Nausea and vomiting are common findings in the treatment phase. While anemia is a common
complication of the disease and treatment, it is not as serious as immunosuppression. Alopecia is an unfortunate side effect of
chemotherapy, but is not a life-threatening complication.
REF: Pg. 218
5. While in the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most
appropriate action for this condition is
a. anticoagulant therapy.
b. chemotherapy.
c. activity restriction.
d. isolation.
ANS: C
Thrombocytopenia can produce a life-threatening hemorrhage. Patients with this condition should be protected from trauma and
placed on activity restriction to reduce the risk of bleeding. Anticoagulant therapy in a patient with thrombocytopenia could actually
cause the patient more bleeding. Thrombocytopenia is a complication of leukemia and chemotherapy. Chemotherapy is not an
appropriate treatment option for thrombocytopenia. Isolation is not effective in managing the risk of hemorrhage.