Hematopathology Practice Questions

Q: Gamma-Gandy bodies are seen in which organ?

Spleen. **Explanation:** **Gamma-Gandy bodies** (also known as Siderofibrotic nodules) are small, firm, brownish-yellow nodules found in the **Spleen**. They represent organized areas of focal hemorrhage within the splenic parenchyma [1]. **Why Spleen is the correct answer:** The underlying mechanism is chronic venous congestion, most commonly due to **Portal Hypertension** (secondary to Cirrhosis) or Congestive Heart Failure [1]. The increased pressure leads to the rupture of small follicular arteries. As the blood extravasates, it undergoes organization, resulting in deposits of **hemosiderin** (iron), **calcium salts**, and **fibrous tissue** on the splenic connective tissue framework. On microscopic examination, these appear as characteristic "tobacco-leaf" or "bamboo-stick" shaped structures when stained with Perls’ Prussian Blue [1]. **Why other options are incorrect:** * **Liver:** While the liver is the primary site of pathology in portal hypertension (cirrhosis), Gamma-Gandy bodies are a sequela of the resulting splenic congestion, not a feature of the liver itself. * **Kidney & Lung:** These organs do not typically exhibit the specific fibro-siderotic organization seen in the spleen. While the lungs show "Heart Failure Cells" (hemosiderin-laden macrophages) in chronic congestion, they do not form organized Gamma-Gandy nodules. **High-Yield Clinical Pearls for NEET-PG:** * **Composition:** Iron (hemosiderin), Calcium, and Fibrous tissue. * **Stain:** Perls’ Prussian Blue (highlights the iron content). * **Classic Association:** Portal Hypertension and Sickle Cell Anemia (due to chronic congestion and infarcts) [1]. * **Imaging:** On MRI, they appear as "signal voids" (hypointense) due to the paramagnetic effect of iron. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, pp. 631-634.

Q: All the following conditions cause thrombocytopenia except?

Iron deficiency anemia. **Explanation:** The correct answer is **Iron deficiency anemia (IDA)** because it is typically associated with **reactive thrombocytosis** (an increase in platelet count) rather than thrombocytopenia. This occurs because erythropoietin, which is elevated in IDA, has a structural similarity to thrombopoietin, leading to cross-stimulation of megakaryocytes. **Analysis of Options:** * **Iron deficiency anemia (Option D):** In most cases, IDA presents with a normal or elevated platelet count. Thrombocytopenia is extremely rare in IDA and only occurs in cases of severe, long-standing nutritional depletion. * **Giant hemangioma (Option A):** This refers to **Kasabach-Merritt Syndrome**, where platelets are sequestered and consumed within the vascular channels of a large hemangioma, leading to consumptive thrombocytopenia [2]. * **Infectious mononucleosis (Option B):** Caused by the Epstein-Barr virus (EBV), it can cause thrombocytopenia through immune-mediated destruction (anti-platelet antibodies) or transient bone marrow suppression. * **HIV infection (Option C):** Thrombocytopenia is a common hematological manifestation of HIV [1]. It occurs via multiple mechanisms: direct infection of megakaryocytes, immune-mediated destruction (ITP-like picture), and hypersplenism [1]. **NEET-PG High-Yield Pearls:** 1. **Kasabach-Merritt Syndrome:** Triad of Giant Hemangioma + Thrombocytopenia + Consumptive Coagulopathy. 2. **Reactive Thrombocytosis:** Common causes include IDA, acute hemorrhage, inflammation, and post-splenectomy. 3. **HIV & Platelets:** Thrombocytopenia can be the initial presenting sign of an undiagnosed HIV infection. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Red Blood Cell and Bleeding Disorders, pp. 665-667. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 619-621.

Question 1

Which of the following statements about platelet function defects is true?

Accepted Answer

Normal platelet count with prolonged bleeding time

Answer

Thrombocytopenia with prolonged bleeding time

Answer

Thrombocytosis with prolonged bleeding time

Answer

Normal platelet count with normal bleeding time

Question 2

A 30-year-old male presents with cervical lymphadenopathy for 2 months. There is no past history of TB or TB contact. On examination, two lymph nodes measuring 1x1 cm are palpable, rubbery in consistency without matting. Histopathological biopsy findings were noted (image not provided, assume characteristic findings for the diagnosis). Based on the clinical presentation and likely histopathological findings, what is the most likely diagnosis among the subtypes of Hodgkin's lymphoma?

Accepted Answer

Nodular lymphocyte predominant Hodgkin's lymphoma

Answer

Mixed cellularity Hodgkin's lymphoma

Answer

Lymphocyte depleted Hodgkin's lymphoma

Answer

Nodular sclerosis Hodgkin's lymphoma

Question 3

Gamma-Gandy bodies are seen in which organ?

Accepted Answer

Spleen

Answer

Liver

Answer

Kidney

Answer

Lung

Question 4

Leucopenia is not seen in which of the following conditions?

Accepted Answer

Pyogenic bacterial infection

Answer

Viral infection

Answer

Malnutrition

Answer

Enteric fever

Question 5

Maximum magnitude of lymphocytosis is seen with which of the following conditions?

Accepted Answer

Infectious mononucleosis

Answer

Pulmonary tuberculosis

Answer

Typhoid fever

Answer

Bacterial pneumonia

Question 6

Sudden severe hemorrhage in a normal person causes all except:

Accepted Answer

Low MCV

Answer

Reticulocytosis

Answer

Low red cell mass

Answer

Thrombocytosis

Question 7

All the following conditions cause thrombocytopenia except?

Accepted Answer

Iron deficiency anemia

Answer

Giant hemangioma

Answer

Infectious mononucleosis

Answer

HIV infection

Question 8

Abnormally high LAP score is seen in?

Accepted Answer

Polycythemia vera

Answer

Chronic myeloid leukemia (CML)

Answer

Paroxysmal nocturnal hemoglobinuria (PNH)

Answer

All of the above

Question 9

A leukemic patient develops disseminated intravascular coagulation. Examination of the marrow reveals hypergranular promyelocytes, some of which contain multiple Auer rods. The diagnosis of acute promyelocytic leukemia is made. Which of the following translocations is associated with the development of this disorder?

Accepted Answer

t (15;17)

Answer

t (4;11)

Answer

t (6;9)

Answer

t (8;14)

Question 10

Crew haircut appearance on X-ray skull and Gandy gamma bodies are characteristic findings in which of the following conditions?

Accepted Answer

Sickle cell anemia

Answer

G-6-PD deficiency

Answer

Hodgkin's lymphoma

Answer

Hereditary spherocytosis

Hematopathology — MCQs

Hematopathology — MCQs

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