Hematopathology Practice Questions

Q: Which of the following is characteristic of Pelger-Huet anomaly?

Most of the neutrophils are bilobed.. **Explanation:** **Pelger-Huet Anomaly (PHA)** is an autosomal dominant inherited condition characterized by a failure of normal nuclear segmentation in neutrophils. Despite the abnormal morphology, the cells function normally. 1. **Why Option A is correct:** The hallmark of PHA is the presence of **bilobed neutrophils** (often described as "pince-nez" or spectacle-like) or non-segmented (round/oval) nuclei. This occurs due to a mutation in the **Lamin B Receptor (LBR) gene**, which is essential for maintaining the nuclear envelope's integrity and shape during maturation. 2. **Why the other options are incorrect:** * **Option B & C:** PHA specifically affects the granulocytic lineage (primarily neutrophils). It does not typically involve the indentation of lymphocytic nuclei or the loss of segmentation in monocytes. * **Option D:** Hypersegmentation (5 or more lobes) is the opposite of PHA [1]. It is characteristic of **Megaloblastic Anemia** (Vitamin B12 or Folate deficiency) [1]. **High-Yield Clinical Pearls for NEET-PG:** * **Pseudo-Pelger-Huet Anomaly:** This is an *acquired* form seen in **Myelodysplastic Syndromes (MDS)** [2], Acute Myeloid Leukemia (AML), or certain drugs (e.g., Tacrolimus). It is a crucial marker for clonal myeloid disorders [2]. * **Morphology:** Look for coarse, clumped chromatin (pachychromatic) in the bilobed nucleus. * **Differentiation:** In the inherited form, nearly 100% of neutrophils are affected; in the acquired form, only a fraction of cells show the change. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Red Blood Cell and Bleeding Disorders, p. 654. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 613-614.

Question 1

Which of the following is characteristic of Pelger-Huet anomaly?

Accepted Answer

Most of the neutrophils are bilobed.

Answer

The lymphocytic nucleus becomes indented.

Answer

Monocytic nuclei lose their typical segmentation.

Answer

Neutrophils become hypersegmented.

Question 2

Which of the following is a poor prognostic factor in Acute Myeloid Leukemia (AML)?

Accepted Answer

Preceding Myelodysplastic Syndrome (MDS)

Answer

Inversion 16 (Inv 16)

Answer

Auer rods

Answer

Myelomonocytic leukemia (Type M4)

Question 3

What is the earliest change observed in iron deficiency anemia?

Accepted Answer

Decreased serum ferritin

Answer

Decreased serum iron

Answer

Decreased TIBC

Answer

Decreased hemoglobin

Question 4

Presence of >10% plasma cells with no lytic lesion and M protein in serum is seen in?

Accepted Answer

Smoldering myeloma

Answer

Multiple myeloma

Answer

Monoclonal gammopathy of unknown significance

Answer

Non-secretory myeloma

Question 5

Gum hypertrophy is seen in which of the following conditions?

Accepted Answer

Myelomonocytic leukemia

Answer

Myelogenous leukemia

Answer

Lymphocytic leukemia

Answer

None of the above

Question 6

P.N.H is associated with all of the following conditions, except?

Accepted Answer

Increased LAP scores

Answer

Aplastic anemia

Answer

Venous thrombosis

Answer

Iron deficiency anemia

Question 7

The HAM test is used to assess for which of the following?

Accepted Answer

G.P.I. anchor protein deficiency

Answer

Complement defect

Answer

Spectrin defect

Answer

Mannose binding protein deficiency

Question 8

Increased osmotic fragility is characteristic of:

Accepted Answer

Hereditary spherocytosis

Answer

Sickle cell anemia

Answer

Thalassemia

Answer

Iron deficiency anemia

Question 9

Which of the following are the histological features of classical Hodgkin's disease?

Accepted Answer

Both neoplastic and non-neoplastic cells are seen

Answer

Mixed cellularity seen in the background

Answer

Neoplastic cells more than non-neoplastic cells

Answer

CD15 and CD34 are seen

Question 10

Which of the following hematological malignancies resembles ALL L3?

Accepted Answer

Burkitt's lymphoma

Answer

Mantle cell lymphoma

Answer

MDS

Answer

AML

Hematopathology — MCQs

Hematopathology — MCQs

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