Hematopathology Practice Questions

Q: What anticoagulant is added to blood for the estimation of prothrombin time?

Sodium citrate. **Explanation:** The correct answer is **Sodium Citrate (3.2%)**. **Why Sodium Citrate is the choice for PT:** Prothrombin Time (PT) and Activated Partial Hypothetical Time (aPTT) are coagulation studies. Sodium citrate acts as an anticoagulant by **chelating (binding) calcium ions**, which are essential cofactors in the coagulation cascade [1]. It is the preferred agent because its effect is easily reversible by adding calcium back to the plasma during the test [1]. For coagulation studies, a specific **ratio of 9:1 (Blood:Anticoagulant)** is maintained in a **light blue-top tube**. **Why other options are incorrect:** * **Heparin:** It acts by activating Antithrombin III, which inhibits Thrombin and Factor Xa. It is used for arterial blood gases (ABG) but interferes with coagulation assays and causes platelet aggregation. * **Oxalate:** While it also chelates calcium, it is more toxic and can distort cellular morphology. It is primarily used (as Potassium Oxalate) in grey-top tubes for glucose estimation (along with Sodium Fluoride). * **EDTA:** This is the gold standard for Hematology (CBC/ESR) because it preserves cell morphology. However, it is not used for PT because it irreversibly inhibits certain clotting factors (like Factor V and VIII) and interferes with the endpoint detection. **High-Yield Clinical Pearls for NEET-PG:** * **Concentration:** 3.2% (0.109 mol/L) sodium citrate is recommended over 3.8% to avoid falsely prolonged PT results in patients with high hematocrit. * **Polycythemia Correction:** If the patient's hematocrit is >55%, the amount of citrate in the tube must be reduced to ensure accurate results. * **Tube Color Coding:** Sodium Citrate = Light Blue; EDTA = Lavender; Heparin = Green; Fluoride/Oxalate = Grey. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Hemodynamic Disorders, Thromboembolic Disease, and Shock, pp. 128-130.

Question 1

A student presents for evaluation of anemia. His RDW was observed to be 13.5 while the MCV was 62.5 fl. What is the likely diagnosis?

Accepted Answer

Anemia of chronic disease

Answer

Hemoglobin D Punjab (HB-D Trait)

Answer

Thalassemia Major

Answer

Iron Deficiency Anemia

Question 2

Which of the following features is characteristic of megaloblastic anemia?

Accepted Answer

Megaloblastic anemia

Answer

Aplastic anemia

Answer

Iron deficiency anemia

Answer

Leukemia

Question 3

Which of the following is NOT typically seen in multiple myeloma?

Accepted Answer

Anion gap raised

Answer

Lytic bone lesion

Answer

Polyarticular pains

Answer

M spike present with polyarticulopathy

Question 4

Which of the following is an immune response cause of anemia?

Accepted Answer

Hemolytic disease of the newborn

Answer

Diamond Blackfan anemia

Answer

Hereditary spherocytosis

Answer

Glucose-6-phosphate dehydrogenase deficiency

Question 5

Gum hyperplasia is seen with which of the following hematological malignancies?

Accepted Answer

Acute Myeloid Leukemia (AML)

Answer

Chronic Myeloid Leukemia (CML)

Answer

Acute Lymphoblastic Leukemia (ALL)

Answer

Chronic Lymphocytic Leukemia (CLL)

Question 6

M protein on immunoelectrophoresis in multiple myeloma patients is most commonly formed by?

Accepted Answer

IgG

Answer

IgM

Answer

IgA

Answer

IgD

Question 7

Reed-Sternberg cells are seen in the histopathological examination of which condition?

Accepted Answer

Hodgkin's disease

Answer

African jaw lymphoma

Answer

Burkitt's lymphoma

Answer

Infectious mononucleosis

Question 8

Alkaline phosphatase is specific to which of the following cells?

Accepted Answer

Neutrophils

Answer

Eosinophils

Answer

Polymorphs

Answer

Basophils

Question 9

What anticoagulant is added to blood for the estimation of prothrombin time?

Accepted Answer

Sodium citrate

Answer

Heparin

Answer

Oxalate

Answer

EDTA

Question 10

A 50-year-old man presents with a pruritic rash of several years' duration, characterized by erythematous, eczematoid patches and raised plaques distributed asymmetrically over the chest and abdomen. Biopsy reveals atypical CD4+ T cells with cerebriform nuclei. Further marker studies confirm a diagnosis of mycosis fungoides. Which of the following is true of this disease?

Accepted Answer

The disease eventually disseminates to lymph nodes and internal organs.

Answer

The neoplastic cells most commonly display cell markers of CD19 and CD20.

Answer

The skin rash most commonly disappears over time.

Answer

This disease is caused by a chronic fungal infection in the skin.

Hematopathology — MCQs

Hematopathology — MCQs

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