Hematopathology Practice Questions

Q: Most of the ALLs have which of the following origin?

B-cell origin. Explanation: Acute Lymphoblastic Leukemia (ALL) is a malignant neoplasm of lymphoid progenitors (lymphoblasts) [1]. It is primarily a disease of childhood, representing the most common pediatric cancer [1]. 1. Why B-cell origin is correct: Approximately 85% of ALL cases are of B-cell origin (B-ALL) [1]. These typically manifest as childhood acute leukemias where the bone marrow is heavily involved [1]. They are characterized by the expression of B-cell markers such as CD19, CD10 (CALLA), and CD22. The peak incidence is around 3 years of age. 2. Why other options are incorrect: * T-cell origin (T-ALL): These account for the remaining 15% of cases [1]. T-ALL typically presents in adolescent males as a mediastinal mass (thymic involvement) and is often associated with a high white blood cell count [1]. Common markers include CD3 and CD7. * NK cell origin: Malignancies of Natural Killer (NK) cells are extremely rare in the context of acute lymphoblastic leukemia/lymphoma and do not constitute a significant percentage of ALL cases [1]. Clinical Pearls for NEET-PG: * Most common subtype: B-ALL is more common than T-ALL [1]. * Cytogenetics & Prognosis: * Good Prognosis: t(12;21) involving ETV6-RUNX1 (most common in children) and hyperdiploidy (>50 chromosomes) [1]. * Poor Prognosis: t(9;22) Philadelphia chromosome (more common in adults) and hypodiploidy [1]. * CNS/Testis Involvement: ALL has a propensity to infiltrate the Central Nervous System and testes; hence, these sites require "sanctuary site" prophylaxis during treatment. * Morphology: Lymphoblasts are PAS positive and TdT positive (a marker for primitive lymphoid cells) [1]. **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. 596-600.

Question 1

Acanthocytosis on peripheral smear is a feature of which of the following conditions?

Accepted Answer

Abetalipoproteinemia

Answer

Uremia

Answer

Thalassemia trait

Answer

Paroxysmal nocturnal hemoglobinuria

Question 2

A patient presents with Hb of 6 gm%, TLC of 1200, platelets of 60,000, and an MCV of 12 fl. What is the diagnosis?

Accepted Answer

Myelofibrosis

Answer

Aplastic anemia

Answer

Megaloblastic anemia

Answer

PNH

Question 3

The RBC in beta-thalassemia are typically:

Accepted Answer

Microcytic and hypochromic.

Answer

Microcytic and normochromic.

Answer

Normocytic and normochromic.

Answer

Macrocytic and hypochromic.

Question 4

Bence Jones proteins are composed of?

Accepted Answer

Light chains

Answer

Heavy chains

Answer

Cryoglobulins

Answer

Constitutive enzyme

Question 5

Most of the ALLs have which of the following origin?

Accepted Answer

B-cell origin

Answer

T-cell origin

Answer

NK cell origin

Answer

None of the above

Question 6

Which of the following conditions does NOT cause a prolonged PTT?

Accepted Answer

Idiopathic Thrombocytopenic Purpura (ITP)

Answer

Hemophilia A

Answer

Von Willebrand disease

Answer

Christmas disease

Question 7

Aplastic anemia can progress to which of the following conditions?

Accepted Answer

Pure red cell aplasia

Answer

Acute myeloid leukemia (AML)

Answer

Myelodysplastic anemia

Answer

Paroxysmal nocturnal hemoglobinuria

Question 8

The direct globulin test is positive in which of the following conditions?

Accepted Answer

Paroxysmal cold hemoglobinuria

Answer

Paroxysmal nocturnal hemoglobinuria (PNH)

Answer

Sickle cell anemia

Answer

Thalassemia

Question 9

Which of the following statements is NOT true regarding idiopathic thrombocytopenic purpura?

Accepted Answer

Antibodies of IgM class

Answer

Autoantibodies to Gp IIb/IIIa or Ib/IX

Answer

Increased megakaryocytes in the bone marrow

Answer

Spleen is normal in size

Question 10

After an accident, a male patient presented for routine evaluation. His RBCs showed Cabot's rings. What is the likely condition responsible?

Accepted Answer

Post-splenectomy state

Answer

Acquired hemolytic anemia

Answer

Hemochromatosis

Answer

Thalassemia

Hematopathology — MCQs

Hematopathology — MCQs

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