Hematopathology Practice Questions

Q: Which of the following statements about coagulation factor VII is not true?

Deficiency is associated with prolonged APTT.. **Explanation:** Coagulation Factor VII is a key component of the **Extrinsic Pathway** of the coagulation cascade. Understanding its unique position is crucial for solving this question. **Why Option B is the correct answer (False statement):** The Activated Partial Thromboplastin Time (APTT) measures the integrity of the **Intrinsic** and **Common** pathways (Factors XII, XI, IX, VIII, X, V, II, and I). Factor VII is exclusively involved in the **Extrinsic Pathway**, which is measured by Prothrombin Time (PT). Therefore, a deficiency in Factor VII results in a **prolonged PT with a normal APTT** [1]. **Analysis of other options:** * **Option A:** Factor VII deficiency is indeed an **Autosomal Recessive** bleeding disorder, making this statement true. * **Option C:** Fresh Frozen Plasma (FFP) contains all coagulation factors, including Factor VII, and is a standard treatment for replacement in deficiency states. * **Option D:** Factor VII has the **shortest half-life** (approximately 4–6 hours) of all clotting factors. In contrast, Factor XII (Hageman factor) has a much longer half-life (approximately 48–52 hours). **High-Yield Clinical Pearls for NEET-PG:** * **Shortest Half-life:** Factor VII is the first factor to decrease in Vitamin K deficiency or liver disease, making PT the most sensitive indicator of liver synthetic function [1]. * **Isolated PT Prolongation:** Always consider Factor VII deficiency or early Vitamin K antagonism (Warfarin therapy) [1]. * **Treatment:** Recombinant activated Factor VII (rFVIIa) is often used for "inhibitor" patients in Hemophilia A/B and severe FVII deficiency. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 582-583.

Q: Arrange the following blood components in descending order of their shelf life:

Whole blood with CPD solution at 4 degrees C. To master blood banking for NEET-PG, it is essential to memorize the specific shelf lives determined by preservatives and storage temperatures. The shelf life of blood components is primarily dictated by the metabolic rate of cells and the biochemical stability of plasma proteins. ### **Analysis of Components (Descending Order of Shelf Life):** 1. **Fresh Frozen Plasma (FFP) at -18°C:** This has the longest shelf life of **1 year**. Freezing preserves coagulation factors (especially V and VIII) by halting enzymatic degradation. 2. **Whole Blood with CPDA-1 at 4°C:** The addition of **Adenine** to the Citrate Phosphate Dextrose (CPD) buffer allows for ATP regeneration, extending the shelf life to **35 days**. 3. **Whole Blood with CPD at 4°C:** Without adenine, the red cells exhaust their metabolic resources sooner, resulting in a shelf life of **21 days**. 4. **Platelets at 20-24°C:** These have the shortest shelf life of **5 days**. They must be stored at room temperature with constant agitation to maintain viability and prevent "storage lesions," but this increases the risk of bacterial growth. ### **Why the Question asks for the "Shortest" (Descending Order Logic):** The correct sequence from longest to shortest is: **FFP (1 year) > CPDA-1 (35 days) > CPD (21 days) > Platelets (5 days).** Therefore, in a descending list, **CPD (21 days)** is correctly placed after CPDA-1 and before Platelets. ### **High-Yield Clinical Pearls for NEET-PG:** * **SAGM (Saline-Adenine-Glucose-Mannitol):** Extends RBC shelf life to **42 days**. * **Cryoprecipitate:** Stored at -18°C for **1 year** (rich in Factor VIII, Fibrinogen, and vWF). * **Storage Lesion:** Refers to the decrease in pH, 2,3-DPG, and Sodium, and an **increase in Potassium** in stored blood. * **Temperature Check:** Platelets are the only routine component stored at room temperature (20-24°C).

Question 1

Which of the following statements about coagulation factor VII is not true?

Accepted Answer

Deficiency is associated with prolonged APTT.

Answer

Deficiency is inherited as an Autosomal Recessive trait.

Answer

Deficiency can be managed by Fresh Frozen Plasma.

Answer

Has a short half-life in comparison to Hageman factor (XII).

Question 2

Eighty-five percent of aggressive lymphomas exhibit which cell type?

Accepted Answer

Diffuse large cell lymphoma

Answer

Follicular small cleaved cell lymphoma

Answer

Diffuse small lymphocytic lymphoma

Answer

Adult T-cell leukemia-lymphoma

Question 3

Cyanosis cannot occur in severe anaemia because

Accepted Answer

It requires a critical concentration of reduced Hb in blood

Answer

Anaemic blood has a higher O2 carrying capacity per gram of Hb

Answer

Patient improves his alveolar oxygen as a compensation for anaemia

Answer

There is an increased blood flow through the skin

Question 4

According to the FAB classification, what is the minimum percentage of blast cells required for the diagnosis of Acute Myeloid Leukemia (AML)?

Accepted Answer

30%

Answer

20%

Answer

10%

Answer

40%

Question 5

Leukocytopenia is seen in which of the following conditions?

Accepted Answer

All of the above

Answer

Influenza

Answer

Agranulocytosis

Answer

Liver cirrhosis

Question 6

Arrange the following blood components in descending order of their shelf life:

Accepted Answer

Whole blood with CPD solution at 4 degrees C

Answer

Platelets at 20 degrees C

Answer

Fresh Frozen Plasma (FFP) at -18 degrees C

Answer

Whole blood with CPDA-1 solution at 4 degrees C

Question 7

Letterer-siwe disease is a disturbance of which of the following?

Accepted Answer

Histiocytic disorder

Answer

Protein metabolism

Answer

Mucopolysaccharide metabolism

Answer

Carbohydrate metabolism

Question 8

Disseminated Intravascular Coagulation (DIC) is typically seen in which subtype of Acute Myeloid Leukemia (AML)?

Accepted Answer

M3

Answer

M1

Answer

M2

Answer

M6

Question 9

What is the most common translocation found in follicular lymphomas?

Accepted Answer

t(14;18)

Answer

t(17;19)

Answer

t(11;14)

Answer

t(22;09)

Question 10

Mega platelets are characteristic findings in which of the following conditions?

Accepted Answer

Bernard-Soulier syndrome

Answer

Glanzmann thrombasthenia

Answer

Von Willebrand disease

Answer

Wiskott-Aldrich syndrome

Hematopathology — MCQs

Hematopathology — MCQs

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