Hematopathology Practice Questions

Q: Which of the following is absent in cryoprecipitate?

Protein C. **Explanation:** Cryoprecipitate is the cold-insoluble fraction of plasma obtained by thawing Fresh Frozen Plasma (FFP) at 1–6°C. It is a concentrated source of specific coagulation proteins. **Why Protein C is the correct answer:** Protein C is a vitamin K-dependent natural anticoagulant [1]. Unlike the high-molecular-weight clotting factors that precipitate in the cold, Protein C remains in the supernatant (the "cryo-poor" plasma) during the production process. Therefore, it is **absent** (or present in negligible amounts) in cryoprecipitate. **Analysis of Incorrect Options:** * **Factor VIIIc:** Cryoprecipitate was historically developed as a treatment for Hemophilia A because it is highly enriched with Factor VIII [1]. * **von Willebrand factor (vWF):** It contains significant amounts of vWF, making it a secondary treatment option for von Willebrand disease when concentrates are unavailable. * **Factor XIII:** It is the only concentrated source of Factor XIII available for transfusion, used in cases of congenital or acquired deficiency [1]. * *Note:* **Fibrinogen (Factor I)** is the most abundant component of cryoprecipitate and is its most common clinical indication today. **High-Yield Clinical Pearls for NEET-PG:** * **Contents of Cryoprecipitate (The "Big 5"):** Fibrinogen, Factor VIII, Factor XIII, vWF, and Fibronectin. * **Storage:** Stored at -18°C or colder for up to 1 year. Once thawed, it must be used within 6 hours (or 4 hours if pooled). * **Primary Indication:** Hypofibrinogenemia (e.g., in DIC or massive hemorrhage). One unit of cryoprecipitate typically raises fibrinogen levels by 5–10 mg/dL. * **Dosage:** Usually administered as a "pool" of 10 units for an adult. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 582-584.

Q: A 30-year-old female with anemia, unresponsive to iron, folic acid, and B12 supplementation, underwent further evaluation. Her CBC profile showed Hb-4.7 g/dL, total WBC count-4,000/mm3, and platelet count-70,000/mm3. Peripheral smear findings are provided. Her bone marrow aspirate revealed a dry tap, and a bone marrow biopsy confirmed the diagnosis. Which of the following stains would have been useful in confirming the bone marrow biopsy findings?

Reticulin stain. ***Reticulin stain*** - **Reticulin stain** is the **gold standard** for demonstrating increased **reticulin fibers** in bone marrow, confirming **myelofibrosis** diagnosis. - The **WHO grading system** (MF-0 to MF-3) uses reticulin stain to assess **fibrosis severity** and guide treatment decisions. *Myeloperoxidase (MPO)* - **MPO stain** is used to identify **myeloid lineage cells** and differentiate **acute myeloid leukemia** from other hematologic malignancies. - Not useful for detecting **bone marrow fibrosis** or **reticulin fiber deposition** in myelofibrotic disorders. *Verhoeff-Van Gieson (VVG)* - **VVG stain** demonstrates **elastic fibers** and is primarily used in **cardiovascular pathology** and **connective tissue disorders**. - Does not specifically highlight **reticulin fibers** needed for diagnosing **bone marrow fibrosis**. *Prussian blue stain (for iron)* - **Prussian blue stain** detects **iron deposits** in tissues and is useful for diagnosing **iron overload** or **sideroblastic anemia**. - Cannot demonstrate **reticulin fibrosis** or help confirm **myelofibrosis** in bone marrow specimens.

Question 1

Which of the following is absent in cryoprecipitate?

Accepted Answer

Protein C

Answer

von Willebrand factor

Answer

Factor XIII

Answer

Factor VIIIc

Question 2

Microangiopathic hemolytic anemia is seen in all of the following diseases except?

Accepted Answer

Metallic cardiac valves

Answer

Antiphospholipid antibody syndrome

Answer

Thrombotic thrombocytopenic purpura

Answer

Microscopic polyangiitis

Question 3

Which syndrome is associated with an increased risk of leukemia?

Accepted Answer

Klinefelter syndrome

Answer

Plummer-Vinson syndrome

Answer

Sturge-Weber syndrome

Answer

Multiple hamartoma

Question 4

What is the most common cause of aplastic anemia?

Accepted Answer

Exposure to drugs

Answer

Viral hepatitis

Answer

Fanconi anemia

Answer

Fungal infection

Question 5

TRAP positivity is seen with which of the following hematologic malignancies?

Accepted Answer

Hairy cell leukemia

Answer

Chronic myeloid leukemia (CML)

Answer

Chronic lymphocytic leukemia (CLL)

Answer

Follicular lymphoma

Question 6

A 30-year-old female with anemia, unresponsive to iron, folic acid, and B12 supplementation, underwent further evaluation. Her CBC profile showed Hb-4.7 g/dL, total WBC count-4,000/mm3, and platelet count-70,000/mm3. Peripheral smear findings are provided. Her bone marrow aspirate revealed a dry tap, and a bone marrow biopsy confirmed the diagnosis. Which of the following stains would have been useful in confirming the bone marrow biopsy findings?

Accepted Answer

Reticulin stain

Answer

Myeloperoxidase (MPO)

Answer

Verhoeff-Van Gieson (VVG)

Answer

Prussian blue stain (for iron)

Question 7

An elderly male presents with headache, recurrent infections, and multiple punched-out lytic lesions on X-ray skull. Which of the following investigations will best help in establishing the diagnosis?

Accepted Answer

Protein electrophoresis

Answer

Serum calcium

Answer

Acid phosphatase levels

Answer

Alkaline phosphatase levels

Question 8

All the following MALT lymphomas are related to a specific organism except:

Accepted Answer

MALT lymphomas of skin - Bartonella henselae

Answer

MALT lymphomas of stomach - Helicobacter pylori

Answer

MALT lymphomas of eye - Chlamydophila psittaci

Answer

MALT lymphomas of small intestine - Campylobacter jejuni

Question 9

Pawn ball megakaryocytes are characteristic of which condition?

Accepted Answer

Myelodysplastic syndrome

Answer

Idiopathic thrombocytopenic purpura

Answer

Thrombotic thrombocytopenic purpura

Answer

Chloramphenicol toxicity

Question 10

Which of the following surface glycoproteins is most often expressed in human hematopoietic stem cells?

Accepted Answer

CD 34

Answer

CD 22

Answer

CD 40

Answer

CD 15

Hematopathology — MCQs

Hematopathology — MCQs

On this page

Practice by Chapter

Want unlimited practice?