Hematopathology Practice Questions

Q: Platelets are stored at what temperature?

20-24°C. **Explanation:** **Correct Answer: A. 20-24°C** Platelets are stored at **room temperature (20-24°C)** under continuous agitation. This specific temperature range is critical to maintain platelet viability and metabolic activity. Agitation (using a platelet agitator) is necessary to prevent aggregation and to facilitate gas exchange ($O_2$ and $CO_2$), which prevents a drop in pH that would otherwise lead to the loss of platelet function (the "storage lesion"). **Analysis of Incorrect Options:** * **B. 2-6°C:** This is the storage temperature for **Whole Blood and Packed Red Blood Cells (PRBCs)**. Refrigerating platelets at this temperature causes irreversible structural changes (cold-induced activation and "chilling injury"), leading to rapid clearance from the recipient's circulation by hepatic macrophages. * **C. 37°C:** This is normal body temperature. Storing blood components at this temperature would promote rapid bacterial proliferation and protein denaturation. * **D. -2 to -4°C:** This is below the freezing point for blood components. Freezing without specialized cryoprotectants (like glycerol) causes ice crystal formation, which ruptures cell membranes. (Note: Fresh Frozen Plasma is stored at **-18°C or colder**). **High-Yield Clinical Pearls for NEET-PG:** * **Shelf Life:** Platelets have the shortest shelf life of all blood components—only **5 days**—due to the risk of bacterial contamination at room temperature. * **Transfusion Dose:** One unit of Random Donor Platelets (RDP) typically increases the platelet count by **5,000–10,000/µL** in an average adult. * **Apheresis:** Single Donor Platelets (SDP) are equivalent to 6–8 units of RDP. * **Best Indicator of Viability:** The "swirling phenomenon" observed when a platelet bag is held against light indicates healthy, discoid platelets.

Q: Burr cells are seen in which condition?

Uremia. **Burr cells**, also known as **Echinocytes**, are mature red blood cells characterized by multiple, short, blunt, and evenly spaced circumferential projections. **1. Why Uremia is correct:** In **Uremia** (chronic kidney disease), the accumulation of metabolic waste products and toxins in the plasma alters the osmotic environment and the lipid composition of the RBC membrane [1]. This leads to an expansion of the outer leaflet of the lipid bilayer relative to the inner leaflet, resulting in the characteristic "spiculated" appearance. Burr cells are a classic peripheral smear finding in renal failure and are reversible if the cells are placed in healthy serum [2]. **2. Why the other options are incorrect:** * **Gastric Carcinoma:** While not the primary association, gastric carcinoma is classically associated with **Acanthocytes** (Spur cells) or microangiopathic hemolytic anemia (MAHA) if disseminated, but not specifically Burr cells. * **Hepatocellular & Ovarian Carcinoma:** These do not typically present with Burr cells. Liver disease is more commonly associated with **Target cells** (Codocytes) or **Acanthocytes** (due to abnormal cholesterol metabolism). **3. High-Yield Clinical Pearls for NEET-PG:** * **Burr Cells vs. Acanthocytes:** Burr cells have *regular, even* projections; Acanthocytes have *irregular, finger-like* projections. * **Common Causes of Burr Cells:** Uremia (most common), Pyruvate Kinase deficiency, and Hypophosphatemia. * **Acanthocytes (Spur Cells)** are seen in Abetalipoproteinemia and severe Liver Disease. * **Schistocytes** (Fragmented cells) are seen in MAHA (DIC, HUS, TTP). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Pancreas, pp. 902-905. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 539-540.

Q: A 3-year-old child presented with anemia and thrombocytopenia. On examination, there was massive splenomegaly. A bone marrow aspiration revealed specific cellular findings. What is the diagnosis?

Gaucher disease. ***Gaucher disease*** - The combination of **anemia**, **thrombocytopenia**, and **massive splenomegaly** with specific cellular findings on bone marrow aspiration strongly suggests Gaucher disease. - Bone marrow reveals pathognomonic **Gaucher cells** with characteristic **wrinkled tissue paper cytoplasm** due to **glucocerebrosidase deficiency** leading to glucocerebroside accumulation. *Mucopolysaccharidosis* - Typically presents with **coarse facial features**, **hepatosplenomegaly**, and **developmental delay** rather than isolated hematological abnormalities. - Bone marrow shows **foamy macrophages** filled with **glycosaminoglycans**, not the characteristic wrinkled cytoplasm seen in Gaucher cells. *Acute Leukemia* - Would show **blast cells** on bone marrow aspiration with high **white blood cell count** and **lymphadenopathy**. - The **specific cellular findings** mentioned in the question point toward storage cells rather than malignant blasts. *Thalassemia* - Primarily causes **anemia** with **target cells** and **nucleated RBCs** on peripheral smear, but **thrombocytopenia** is uncommon. - Bone marrow shows **erythroid hyperplasia** rather than the specific storage cells characteristic of lysosomal storage disorders.

Question 1

CD-10 is seen in which of the following conditions?

Accepted Answer

Acute Lymphoblastic Leukemia (ALL)

Answer

Chronic Lymphocytic Leukemia (CLL)

Answer

Hairy Cell Leukemia (HCL)

Answer

Chronic Myeloid Leukemia (CML)

Question 2

Platelets are stored at what temperature?

Accepted Answer

20-24°C

Answer

2-6°C

Answer

37°C

Answer

-2 to -4°C

Question 3

Translocation of the bcr-abl gene is characteristically seen in which of the following conditions?

Accepted Answer

Chronic myeloid leukemia

Answer

Acute myeloid leukemia

Answer

Chronic lymphatic leukemia

Answer

Acute lymphatic leukemia

Question 4

Burr cells are seen in which condition?

Accepted Answer

Uremia

Answer

Hepatocellular carcinoma

Answer

Gastric carcinoma

Answer

Ovarian carcinoma

Question 5

Gandy Gamma bodies are seen in which of the following conditions?

Accepted Answer

Sickle cell anemia

Answer

Thalassemia

Answer

Hereditary spherocytosis

Answer

Vitamin B12 deficiency

Question 6

Disseminated intravascular coagulation (DIC) is commonly seen in which of the following conditions?

Accepted Answer

Acute promyelocytic leukemia

Answer

Acute myelomonocytic leukemia

Answer

Chronic myeloid leukemia

Answer

Autoimmune hemolytic anemia

Question 7

In megaloblastic anemia, what is the characteristic cell morphology?

Accepted Answer

Macrocytic normochromic

Answer

Macrocytic hyperchromic

Answer

Macrocytic hypochromic

Answer

None of the above

Question 8

A 3-year-old child presented with anemia and thrombocytopenia. On examination, there was massive splenomegaly. A bone marrow aspiration revealed specific cellular findings. What is the diagnosis?

Accepted Answer

Gaucher disease

Answer

Mucopolysaccharidosis

Answer

Acute Leukemia

Answer

Thalassemia

Question 9

What is the investigation of choice to confirm sickle cell disease?

Accepted Answer

High-performance liquid chromatography

Answer

Tandem mass spectrometry

Answer

Gel electrophoresis

Answer

Naked eye single tube red cell osmotic fragility test

Question 10

What type of antibodies are typically found in Idiopathic Thrombocytopenic Purpura (ITP)?

Accepted Answer

IgG

Answer

IgM

Answer

IgE

Answer

IgD

Hematopathology — MCQs

Hematopathology — MCQs

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