Hematopathology Practice Questions

Q: Which anticoagulant is used in coagulation studies?

Trisodium citrate. **Explanation:** **Trisodium citrate (3.2%)** is the anticoagulant of choice for coagulation studies (PT, APTT, and Fibrinogen levels). It works by **chelating calcium ions**, which are essential cofactors in the coagulation cascade. It is preferred because its action is easily reversible by adding calcium back to the plasma during testing. For accurate results, a precise **blood-to-anticoagulant ratio of 9:1** must be maintained; underfilling the tube leads to excess citrate, which falsely prolongs clotting times [1]. **Why other options are incorrect:** * **EDTA (Ethylenediaminetetraacetic acid):** While it is a potent calcium chelator, it is unsuitable for coagulation studies because it irreversibly inhibits certain clotting factors (like Factor V and VIII) and interferes with the end-point detection of fibrin formation. It is primarily used for CBC and peripheral smears. * **Calcium citrate:** This is not an anticoagulant; in fact, adding calcium to citrated plasma is the standard way to initiate the clotting process in a laboratory setting. * **Sodium bromide:** This has no role as a clinical anticoagulant. Historically, bromides were used as sedatives or antiepileptics. **High-Yield Clinical Pearls for NEET-PG:** * **Tube Color:** Trisodium citrate is found in the **Light Blue** top tube. * **Concentration:** 3.2% (0.109 mol/L) is the standard recommendation by the CLSI. * **Polycythemia Correction:** If a patient’s hematocrit is **>55%**, the volume of citrate must be adjusted (decreased) because there is less plasma relative to the anticoagulant, which can cause falsely elevated PT/APTT [1]. * **Platelet Function:** Citrate is also used for Platelet Aggregation Studies. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 625-626.

Question 1

Which anticoagulant is used in coagulation studies?

Accepted Answer

Trisodium citrate

Answer

Calcium citrate

Answer

EDTA

Answer

Sodium bromide

Question 2

A 60-year-old male patient presents with complaints of weakness and abdominal pain. General physical examination reveals marked splenomegaly and moderate hepatomegaly. Histopathologic findings are suggestive of leukoerythroblastosis. What condition is this patient most likely suffering from?

Accepted Answer

Primary myelofibrosis

Answer

Intestinal infarction

Answer

Sickle cell anemia

Answer

Chronic myeloid leukemia

Question 3

Mean corpuscular hemoglobin concentration (MCHC) is normal in all of the following conditions except?

Accepted Answer

Iron deficiency anemia

Answer

Megaloblastic anemia

Answer

Hemolytic anemia

Answer

Aplastic anemia

Question 4

All of the following are true regarding G-6PD deficiency except?

Accepted Answer

Females are commonly affected

Answer

A recessive X-linked trait

Answer

Oxidative stress causes hemolysis

Answer

Protective against Plasmodium falciparum malariae

Question 5

A WBC count of more than 1,00,000 cells/cc of blood indicates which of the following?

Accepted Answer

Leukemia

Answer

Leukopenia

Answer

Leukoplakia

Answer

Leukocytosis

Question 6

Increased bleeding time is seen in all of the following conditions except:

Accepted Answer

Hemophilia

Answer

Thrombocytopenia

Answer

Von Willebrand disease

Answer

Ehlers-Danlos syndrome

Question 7

The presence of small-sized platelets on peripheral smear is characteristic of which of the following conditions?

Accepted Answer

Wiskott-Aldrich syndrome

Answer

Idiopathic thrombocytopenic purpura

Answer

Bernard Soulier syndrome

Answer

Disseminated intravascular coagulation

Question 8

Which stain is used for demonstrating Auer rods in blasts?

Accepted Answer

Myeloperoxidase

Answer

Periodic Acid Schiff (PAS)

Answer

Leucocyte alkaline phosphatase

Answer

Non-specific esterase

Question 9

What is the characteristic marker for BCL-2 in hematologic malignancies?

Accepted Answer

Follicular lymphoma

Answer

Mycosis fungoides

Answer

B-cell lymphoma

Answer

Mantle cell lymphoma

Question 10

Thrombocytopenia due to increased platelet destruction is seen in which of the following conditions?

Accepted Answer

Systemic lupus erythematosus

Answer

Aplastic anemia

Answer

Cancer chemotherapy

Answer

Acute leukemia

Hematopathology — MCQs

Hematopathology — MCQs

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