Hematopathology Practice Questions

Q: One of the following leukemias almost never develops after radiation?

Chronic lymphocytic leukemia. The relationship between ionizing radiation and leukemogenesis is well-established; however, **Chronic Lymphocytic Leukemia (CLL)** is the notable exception. **1. Why CLL is the Correct Answer:** Extensive epidemiological studies (including data from Hiroshima and Nagasaki survivors and patients receiving therapeutic radiation) have consistently shown no significant increase in the incidence of CLL following radiation exposure. The underlying pathophysiology of CLL involves the accumulation of mature B-cells due to defective apoptosis [1] rather than the specific DNA-breakage patterns typically induced by ionizing radiation. Therefore, CLL is considered **non-radiogenic**. **2. Why Other Options are Incorrect:** * **Acute Myeloblastic Leukemia (AML) & Acute Lymphoblastic Leukemia (ALL):** These are the most common acute leukemias associated with radiation. There is a dose-dependent increase in risk, typically peaking 5–10 years after exposure. * **Chronic Myeloid Leukemia (CML):** CML was the first leukemia linked to radiation. The ionizing radiation can induce the reciprocal translocation $t(9;22)$, leading to the formation of the Philadelphia chromosome. **3. High-Yield NEET-PG Pearls:** * **Most common leukemia after radiation:** AML (specifically types related to MDS). * **Leukemia with NO association with radiation:** CLL (and Hairy Cell Leukemia). * **Other factors NOT associated with CLL:** It is also not linked to specific chemicals (like benzene) or viruses (unlike HTLV-1 and ATLL). * **Genetic predisposition:** While radiation doesn't cause CLL, it has the strongest **familial/genetic predisposition** among all leukemias. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 612-613.

Question 1

In sickle cell anemia, the sickle shape of red blood cells occurs due to the polymerization of which of the following?

Accepted Answer

Deoxyhemoglobin

Answer

Oxyhemoglobin

Answer

Methoxyglobin

Answer

Carboxy hemoglobin

Question 2

The Ham test is primarily used to diagnose which of the following conditions?

Accepted Answer

Paroxysmal Nocturnal Hemoglobinuria (PNH)

Answer

Megaloblastic anemia

Answer

Sickle cell anemia

Answer

Thalassemia

Question 3

Thalassemia is inherited as an?

Accepted Answer

Autosomal recessive

Answer

Autosomal dominant

Answer

X-linked recessive

Answer

X-linked dominant

Question 4

Which of the following blood components is expected to increase in disseminated intravascular coagulation?

Accepted Answer

Fibrin degradation products

Answer

Factor V

Answer

Fibrinogen

Answer

Plasminogen

Question 5

One of the following leukemias almost never develops after radiation?

Accepted Answer

Chronic lymphocytic leukemia

Answer

Acute myeloblastic leukemia

Answer

Chronic myeloid leukemia

Answer

Acute lymphoblastic leukemia

Question 6

What is the best prognostic type of Hodgkin's lymphoma?

Accepted Answer

Lymphocytic predominant

Answer

Lymphocytic depletion

Answer

Mixed cellularity

Answer

Nodular sclerosis

Question 7

Hereditary spherocytosis is due to which of the following?

Accepted Answer

Spectrin deficiency

Answer

Integrin defect

Answer

Collagen defect

Answer

Defect with glycoprotein

Question 8

Which of the following conditions can cause fragmented red blood cells in peripheral blood?

Accepted Answer

Microangiopathic hemolytic anemia

Answer

Disseminated intravascular coagulation

Answer

Hemophilia A

Answer

Malignant hypertension

Question 9

Disseminated intravascular coagulation (DIC) in association with giant hemangiomas is seen in which of the following conditions?

Accepted Answer

Kasabach-Merritt syndrome

Answer

Waterhouse-Friderichsen syndrome

Answer

Hemolytic Uremic Syndrome

Answer

Type 2 von Willebrand disease

Question 10

Multiple punched-out lesions in the skull are characteristically seen in which of the following conditions?

Accepted Answer

Multiple Myeloma

Answer

Thalassemia

Answer

Rickets

Answer

Osteoporosis

Hematopathology — MCQs

Hematopathology — MCQs

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