Hematopathology Practice Questions

Q: Hemoglobin electrophoresis is used as a confirmatory test in which of the following anemias?

Sickle cell anemia. ### Explanation **Correct Option: D. Sickle cell anemia** Hemoglobin electrophoresis is the gold standard confirmatory test for hemoglobinopathies like Sickle cell anemia and Thalassemia. It works on the principle of differential migration of hemoglobin variants in an electric field based on their net molecular charge. In Sickle cell anemia (HbSS), the substitution of glutamic acid (negative charge) by valine (neutral) at the 6th position of the beta-globin chain makes the hemoglobin less negative [1]. Consequently, **HbS moves slower** toward the anode compared to normal HbA. **Why other options are incorrect:** * **A. Iron deficiency anemia:** This is a microcytic hypochromic anemia diagnosed via a **Serum Iron Profile** (low ferritin, low serum iron, high TIBC). Electrophoresis is normal in isolated IDA. * **B. Polycythemia:** This is an increase in red cell mass. Diagnosis involves checking hemoglobin/hematocrit levels, **JAK2 mutation** analysis, and serum erythropoietin levels. * **C. Hereditary spherocytosis:** This is a red cell membrane defect (ankyrin/spectrin deficiency). The confirmatory test is the **Osmotic Fragility Test** or the more specific **EMA Binding test** (flow cytometry). **NEET-PG High-Yield Pearls:** * **Mnemonic for migration (Fastest to Slowest):** **A** Fat **S**anta **C**laus (**A** > **F** > **S** > **C**). HbA moves the fastest toward the anode. * **Alkaline Electrophoresis (pH 8.6):** The initial screening method using cellulose acetate. * **Acid Electrophoresis (pH 6.0):** Used to differentiate HbS from HbD and HbG, which co-migrate on alkaline media. * **Sickling Test:** Uses Sodium metabisulfite; it is a screening test, not a confirmatory one. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 598-599.

Question 1

Which statement is true regarding Hemophilia A?

Accepted Answer

Increased partial thromboplastin time

Answer

Increased bleeding time

Answer

Increased prothrombin time

Answer

Increased platelet count

Question 2

A 42-year-old man presents with chronic fatigue. His hemoglobin is 11.5 g/dL, and the blood film shows hypochromic and microcytic red blood cells. Laboratory findings include increased serum iron, normal total iron-binding capacity (TIBC), increased ferritin, and decreased HbA2. What is the most likely diagnosis for this patient's hypochromic microcytic anemia?

Accepted Answer

Sideroblastic anemia

Answer

Iron deficiency anemia

Answer

Beta-thalassemia trait

Answer

Anemia of chronic disease

Question 3

Leukocytosis is seen in all conditions except?

Accepted Answer

Typhoid

Answer

Brucellosis

Answer

Acute MI

Answer

Diphtheria

Question 4

Schistocytes are seen in:

Accepted Answer

Microangiopathy

Answer

Hereditary spherocytosis

Answer

Thalassemia

Answer

Sickle cell anemia

Question 5

All of the following are true of disseminated intravascular coagulation (DIC) except:

Accepted Answer

Decreased fibrin degradation products

Answer

Platelet aggregation

Answer

Fibrin deposition in microcirculation

Answer

Release of tissue factor

Question 6

In which of the following conditions does neutropenia occur?

Accepted Answer

Aplastic Anemia

Answer

Vasculitis

Answer

Myeloproliferative neoplasm

Answer

Exercise

Question 7

Which is the most common cause of spherocytosis?

Accepted Answer

Autoimmune hemolytic anemia (AIHA)

Answer

Hereditary spherocytosis

Answer

G6PD deficiency

Answer

Paroxysmal nocturnal hemoglobinuria (PNH)

Question 8

Which investigation can distinguish between pregnancy-acquired hemophilia A and lupus anticoagulant?

Accepted Answer

Dilute Russell's viper venom time (dRVVT)

Answer

Factor 8 assay

Answer

von Willebrand Factor assay

Answer

Activated partial thromboplastin time (aPTT)

Question 9

In G6PD deficiency, which red blood cells are more prone to hemolysis?

Accepted Answer

Older red cells

Answer

Young red cells

Answer

Reticulocytes

Answer

All are susceptible

Question 10

Hemoglobin electrophoresis is used as a confirmatory test in which of the following anemias?

Accepted Answer

Sickle cell anemia

Answer

Iron deficiency anemia

Answer

Polycythemia

Answer

Hereditary spherocytosis

Hematopathology — MCQs

Hematopathology — MCQs

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