Hematology — MCQs

Hematology Indian Medical PG Practice Questions and MCQs

Question 1211: Which of the following statements is MOST accurate regarding acute Immune Thrombocytopenic Purpura (ITP)?

A. Viral infections can trigger acute ITP.
B. Most children with acute ITP recover without developing chronic issues. (Correct Answer)
C. Diagnosis of acute ITP is based on clinical findings and exclusion of other causes.
D. Acute ITP is more common in children than in adults.

Explanation: ***Most children with acute ITP recover without developing chronic issues*** - **Acute ITP** in children is often self-limiting, with studies showing that a significant majority (up to 80%) recover spontaneously within 6 months, even without specific treatment. - This high rate of spontaneous resolution in children distinguishes it from adult ITP, which more frequently becomes **chronic**. *Diagnosis of acute ITP is based on clinical findings and exclusion of other causes* - While clinical findings and exclusion of other causes are crucial for diagnosing **ITP** [1], this statement is not the *most* accurate regarding the **prognosis** or typical course of acute ITP, especially in children. - The diagnosis typically involves identifying **isolated thrombocytopenia** in the absence of other systemic diseases or causative medications [1]. *Viral infections can trigger acute ITP* - **Viral infections** are indeed a common trigger for acute ITP, particularly in children, by acting as antigens that promote the formation of antibodies that cross-react with platelets. - However, this statement describes a potential cause rather than the most accurate characteristic of **acute ITP's overall course or prognosis**. *Acute ITP is more common in children than in adults* - While ITP occurs across all age groups, its incidence is bimodal, with peaks in **childhood** and older adulthood. - Therefore, stating it is "more common in children than in adults" is an oversimplification, as both populations experience significant incidence, and the **clinical course** differs.

Question 1212: Maximum erythrocyte sedimentation rate (ESR) is seen in:

A. Polycythemia vera
B. Multiple myeloma (Correct Answer)
C. Sickle cell anemia
D. Congestive heart failure (CHF)

Explanation: ***Multiple myeloma*** - In **multiple myeloma**, the presence of an abundance of abnormal **monoclonal paraproteins** (immunoglobulins) in the blood significantly reduces the zeta potential of red blood cells [1]. - This reduction in electrostatic repulsion causes red blood cells to **aggregate much faster**, leading to a dramatic increase in **ESR** [1]. *Polycythemia vera* - **Polycythemia vera** is characterized by an overproduction of red blood cells, increasing **blood viscosity**. - A higher red blood cell count causes increased collisions and slower aggregation, leading to a **reduced** or normal ESR. *Sickle cell anemia* - In **sickle cell anemia**, the abnormally shaped **sickle cells** do not rouleaux well (stack up like coins) [2]. - This inhibits the normal sedimentation process, often resulting in a **decreased** or normal ESR despite inflammation [2]. *Congestive heart failure (CHF)* - While **CHF** can be associated with some inflammatory markers and a mildly elevated ESR, it does not typically cause the **extremely high ESR values** seen in conditions like multiple myeloma. - The elevation is usually moderate and related to the inflammatory state associated with the disease, not direct effects on red blood cell aggregation.

Question 1213: Which of the following is a poor prognostic feature of Hodgkin lymphoma?

A. WBC count < 15000/mm3
B. Albumin level < 4 g/dL (Correct Answer)
C. Haemoglobin > 10.5 gm/dl
D. Absolute lymphocyte count > 600/ul

Explanation: ***Albumin level < 4 g/dL*** - A **low serum albumin level** (< 4 g/dL) is a recognized **poor prognostic indicator** in Hodgkin lymphoma, as it often reflects systemic inflammation or poor nutritional status. - This parameter is part of the **International Prognostic Score (IPS)** for advanced Hodgkin lymphoma. *Haemoglobin > 10.5 gm/dl* - A **haemoglobin level > 10.5 g/dl** is considered a **favorable prognostic factor** in Hodgkin lymphoma, indicating less severe disease or bone marrow involvement. - An **anaemia** (Hb < 10.5 g/dl) would be a poor prognostic indicator. *WBC count < 15000/mm3* - A **WBC count < 15,000/mm3** is generally considered a **favorable prognostic factor** in Hodgkin lymphoma. - A **leukocytosis** with a WBC count *> 15,000/mm3* is associated with a poorer prognosis. *Absolute lymphocyte count > 600/ul* - An **absolute lymphocyte count (ALC) > 600/ul** (or > 8% of the total WBC count) is typically considered a **favorable prognostic factor** in Hodgkin lymphoma. - **Lymphopenia** (ALC < 600/ul) is a significant **poor prognostic indicator**, reflecting impaired immune function. [1]

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Anemia Evaluation and Management

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Hemoglobinopathies

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Thalassemias

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Platelet Disorders

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Coagulation Disorders

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Thrombotic Disorders

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Leukemias

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Lymphomas

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Multiple Myeloma and Plasma Cell Disorders

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Myeloproliferative Neoplasms

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Transfusion Medicine

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Hematopoietic Stem Cell Transplantation

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Hematology — MCQs

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