Hematopathology Practice Questions

Q: What is the most common cytogenetic abnormality in Multiple myeloma?

Deletion 13q. **Explanation:** Multiple Myeloma (MM) is characterized by a complex landscape of genetic alterations. Understanding the distinction between the "most common" and "prognostically significant" abnormalities is crucial for NEET-PG. **1. Why Deletion 13q is correct:** **Deletion 13q** is the most frequent cytogenetic abnormality in Multiple Myeloma, detected in approximately **50% of cases** by conventional cytogenetics and up to **80-90%** using Fluorescence In Situ Hybridization (FISH). It often involves the loss of the *RB1* (Retinoblastoma) gene and is considered an early event in the pathogenesis of the disease. **2. Analysis of Incorrect Options:** * **Trisomy 12:** This is the most common chromosomal abnormality in **Chronic Lymphocytic Leukemia (CLL)**, not Multiple Myeloma. MM is more commonly associated with odd-numbered trisomies (Hyperdiploidy), such as trisomies of chromosomes 3, 5, 7, 9, 11, and 15. * **t(11;14):** This translocation involves the *CCND1* (Cyclin D1) gene. While it is the most common **translocation** in MM (occurring in ~15% of cases), its overall frequency is lower than Deletion 13q. It is also the hallmark of Mantle Cell Lymphoma. * **t(4;14):** This involves the *FGFR3* and *MMSET* genes. It occurs in about 15% of patients and is significant because it indicates a **poor prognosis**, but it is not the most common. **Clinical Pearls for NEET-PG:** * **Most common overall abnormality:** Deletion 13q. * **Most common translocation:** t(11;14). * **Poor Prognostic Markers (High Yield):** del(17p) [loss of TP53], t(4;14), and t(14;16). * **Good Prognostic Markers:** Hyperdiploidy and t(11;14). * **CRAB Criteria:** Remember **C**alcium (high) [1], **R**enal insufficiency [1], **A**nemia [1], and **B**one lesions [1] for clinical diagnosis. **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. 608-609.

Question 1

Fanconi's anemia is classified as which of the following types of anemia?

Accepted Answer

Constitutional anemia

Answer

Hemolytic anemia

Answer

Iron deficiency anemia

Answer

Autoimmune anemia

Question 2

Which of the following are characteristic markers for Hodgkin's Lymphoma?

Accepted Answer

CD15 and CD30

Answer

CD15 and CD45

Answer

CD30 and CD68

Answer

CD15 and CD3

Question 3

Pancytopenia with a cellular bone marrow is seen in which of the following conditions?

Accepted Answer

Paroxysmal nocturnal hemoglobinuria (PNH)

Answer

Glucose-6-phosphate dehydrogenase (G6PD) deficiency

Answer

Acquired aplastic anemia

Answer

Thalassemia

Question 4

The classification proposed by the International Lymphoma Study Group for non-Hodgkin's lymphoma is known as?

Accepted Answer

REAL classification

Answer

Kiel classification

Answer

WHO classification

Answer

Rappapo classification

Question 5

What is the most common cytogenetic abnormality in Multiple myeloma?

Accepted Answer

Deletion 13q

Answer

Trisomy 12

Answer

Translocation t(4;14)

Answer

Translocation t(11;14)

Question 6

Prominent reticulocytosis is a feature of which type of anemia?

Accepted Answer

Hemolytic Anemia

Answer

Aplastic Anemia

Answer

Nutritional Anemia

Answer

Anemia of chronic disease

Question 7

A 59-year-old male presents with multiple neck swellings, fever, and weight loss. He has a history of hypertension. Examination reveals painless lymphadenopathy in the neck, and blood investigations show anemia. Lymph node biopsy shows characteristic 'owl eye' shaped cells. What is the most probable diagnosis for this patient?

Accepted Answer

Hodgkin’s lymphoma

Answer

Multiple myeloma

Answer

Non-Hodgkin’s lymphoma

Answer

Burkitt’s lymphoma

Question 8

Which of the following immunohistochemical stains is used for the diagnosis of lymphomas?

Accepted Answer

Leukocyte common antigen

Answer

S-100

Answer

HMB-45

Answer

Cytokeratin

Question 9

Massive transfusion in a previously healthy adult male can cause hemorrhage due to which of the following mechanisms?

Accepted Answer

Dilutional thrombocytopenia

Answer

Increased tissue plasminogen activator (tPA) activity

Answer

Vitamin K deficiency

Answer

Decreased fibrinogen levels

Question 10

Paroxysmal nocturnal hemoglobinuria (PNH) is associated with a deficiency of which of the following?

Accepted Answer

All of the above

Answer

Decay-accelerating factor (DAF)

Answer

Membrane inhibitor of raft-like proteins (MIRL)

Answer

Glycosylphosphatidylinositol (GPI) anchored proteins

Hematopathology — MCQs

Hematopathology — MCQs

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