Question 1

Which feature on peripheral blood smear is characteristic of MM?

Accepted Answer

Rouleaux formation

Answer

Atypical lymphocytes

Answer

Target cells

Answer

Burr cells

Question 2

What is the defining feature of osteolytic lesions in MM?

Accepted Answer

No new bone formation

Answer

Mixed lytic-sclerotic lesions

Answer

Subperiosteal bone resorption

Answer

Increased new bone formation

Question 3

What percentage of MM patients present with extramedullary disease (EMD) at diagnosis?

Accepted Answer

10%

Answer

1–2%

Answer

15%

Answer

5%

Question 4

Which premalignant stage often precedes Multiple Myeloma?

Accepted Answer

Monoclonal gammopathy of undetermined significance (MGUS)

Answer

Waldenström's macroglobulinemia

Answer

Polycythemia vera

Answer

Smoldering lymphoma

Question 5

What is the annual risk of progression from MGUS to MM?

Accepted Answer

1%

Answer

3%

Answer

5%

Answer

0.5%

Question 6

Which cytogenetic abnormalities in MGUS predict higher progression risk to MM?

Accepted Answer

t(4;14), del(17p), gain(1q)

Answer

Isochromosome 17q

Answer

Trisomy 21

Answer

t(9;22) translocation

Question 7

What is one of the myeloma-defining events (MDEs)?

Accepted Answer

Clonal plasma cells ≥60%

Answer

Serum calcium <8 mg/dL

Answer

Platelet count >450 × 10⁹/L

Answer

Hemoglobin >14 g/dL

Question 8

What is the threshold for serum free light chain (FLC) ratio to define MM?

Accepted Answer

≥100

Answer

≥75

Answer

≥150

Answer

≥50

Question 9

Which diagnostic test is best for detecting small bone lesions in MM?

Accepted Answer

MRI

Answer

Ultrasound

Answer

Conventional X-ray

Answer

Low-dose whole-body CT (WB-CT)

Question 10

What is the significance of t(11;14) in MM?

Accepted Answer

Associated with poor prognosis

Answer

Predicts resistance to therapy

Answer

Indicates extramedullary disease

Answer

Standard risk cytogenetic abnormality

Question 11

Which molecular abnormality defines high-risk MM?

Accepted Answer

del(17p)

Answer

t(11;14)

Answer

Trisomies of odd-numbered chromosomes

Answer

Hyperdiploidy

Question 12

What is the definition of 'double-hit' myeloma?

Accepted Answer

Two high-risk cytogenetic abnormalities

Answer

Presence of hyperdiploidy and t(11;14)

Answer

Relapse after first-line therapy

Answer

Concurrent MGUS and MM

Question 13

Which imaging modality is most sensitive for detecting focal bone lesions in Smoldering Multiple Myeloma (SMM)?

Accepted Answer

MRI

Answer

PET-CT

Answer

Low-dose WB-CT

Answer

Skeletal survey

Question 14

What biochemical marker is used to assess bone turnover in MM?

Accepted Answer

Serum CrossLaps (CTX)

Answer

Uric acid

Answer

Serum creatinine

Answer

LDH

Question 15

What feature on bone marrow biopsy is highly specific for MM?

Accepted Answer

Plasma cells with cytoplasmic vacuoles (Mott cells)

Answer

Myeloblast clusters

Answer

Increased reticulin fibrosis

Answer

Abundant adipocytes

Question 16

What is the role of bisphosphonate therapy in MM?

Accepted Answer

Reduces skeletal-related events

Answer

Increases bone marrow cellularity

Answer

Improves renal function

Answer

Enhances chemotherapy response

Question 17

What is the median overall survival for transplant-eligible MM patients with current therapies?

Accepted Answer

>10 years

Answer

5 years

Answer

2 years

Answer

15 years

Question 18

Which cytogenetic abnormality in MM is associated with t(4;14)?

Accepted Answer

NSD2 gene

Answer

CCND1

Answer

MAFB

Answer

MYC rearrangement

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