Hematopathology Practice Questions

Q: Perioral pallor and Dennie's line are seen in which of the following conditions?

Atopic dermatitis. **Explanation:** **Atopic Dermatitis (AD)** is a chronic, relapsing inflammatory skin condition characterized by a defective skin barrier (often due to **Filaggrin mutations**) and Type I hypersensitivity [1]. The diagnosis is primarily clinical, based on the **Hanifin and Rajka criteria**. * **Why Option A is correct:** Perioral pallor and Dennie-Morgan lines are classic "minor criteria" for Atopic Dermatitis. * **Dennie-Morgan Line:** An infraorbital fold or wrinkle caused by chronic edema and inflammation of the lower eyelid. * **Perioral Pallor:** A characteristic paleness around the mouth, often contrasting with the erythematous, eczematous patches on the cheeks (especially in infants). * **Why other options are incorrect:** * **Chronic Actinic Dermatitis:** A photosensitive disorder occurring on sun-exposed areas; it does not typically present with infraorbital folds. * **Blood Dyscrasia:** While anemia (a dyscrasia) causes general pallor [1], it does not specifically cause localized perioral pallor or Dennie-Morgan lines. * **Perioral Contact Dermatitis:** This usually presents with erythema, scaling, and papules *around* the mouth, rather than a distinct zone of pallor. **High-Yield Clinical Pearls for NEET-PG:** * **Filaggrin (FLG) Gene:** The most common genetic association with AD. * **Atopic March:** The progression from Atopic Dermatitis → Food Allergy → Allergic Rhinitis → Asthma. * **Hertoghe’s Sign:** Thinning or loss of the lateral third of the eyebrows due to chronic rubbing (common in AD). * **Pityriasis Alba:** Hypopigmented, slightly scaly patches on the face; another minor criterion for AD. * **Serum IgE:** Typically elevated in the extrinsic type of Atopic Dermatitis. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 634-636.

Q: Cabot's rings are features of which condition?

Pernicious anaemia. **Explanation:** **Cabot’s rings** are thin, red-purple, thread-like strands found inside erythrocytes. They typically appear in the shape of a loop or a "figure-of-eight." Morphologically, they are remnants of the **mitotic spindle** (microtubules) or fragments of the nuclear membrane, indicating a defect in erythrocyte production. **Why Pernicious Anaemia is correct:** Cabot’s rings are most characteristically seen in conditions of **severe dyserythropoiesis** (abnormal RBC formation). Pernicious anaemia, a form of Megaloblastic anaemia caused by Vitamin B12 deficiency, leads to significant maturation defects in the bone marrow [1]. Other conditions where they may be seen include lead poisoning and homozygous thalassemia. **Why other options are incorrect:** * **Multiple Myeloma:** This is a plasma cell dyscrasia. The classic peripheral smear finding is **Rouleaux formation** (stacking of RBCs) due to high paraprotein levels, not nuclear remnants. * **Burkitt’s Lymphoma:** This is a high-grade B-cell lymphoma. The hallmark is the **"Starry sky appearance"** on lymph node biopsy and "hand-mirror" cells or vacuolated blasts on a blood film, rather than Cabot's rings. **High-Yield Clinical Pearls for NEET-PG:** * **Howell-Jolly Bodies:** DNA remnants (seen in post-splenectomy/hyposplenism). * **Basophilic Stippling:** Ribosomal RNA precipitates (seen in Lead poisoning and Thalassemia). * **Pappenheimer Bodies:** Siderotic (iron) granules (seen in Sideroblastic anaemia). * **Heinz Bodies:** Denatured hemoglobin (seen in G6PD deficiency; visualized with supra-vital stains like Crystal Violet). **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 592-593.

Question 1

Perioral pallor and Dennie's line are seen in which of the following conditions?

Accepted Answer

Atopic dermatitis

Answer

Chronic actinic dermatitis

Answer

Blood dyscrasia

Answer

Perioral contact dermatitis

Question 2

In thromboasthenia, what defect is present?

Accepted Answer

Platelet aggregation

Answer

Platelet adhesion

Answer

Decreased ADP release

Answer

Disordered platelet secretion

Question 3

A 12-year-old girl who underwent a bone marrow transplant as part of therapy for ALL presents with pulmonary complaints and neurologic findings. Lung biopsy reveals a granulomatous vasculitis with associated atypical lymphocytes. Clonality studies reveal a monoclonal B cell population with associated polyclonal T cells. What infectious agent is related to this diagnosis?

Accepted Answer

EBV

Answer

CMV

Answer

HPV

Answer

HHV-8

Question 4

The t(15;19) translocation is associated with which of the following conditions?

Accepted Answer

Chronic neutrophilic leukemia

Answer

Chronic myelogenous leukemia

Answer

Chronic eosinophilic leukemia

Answer

Essential thrombocytosis

Question 5

Cabot's rings are features of which condition?

Accepted Answer

Pernicious anaemia

Answer

Multiple myeloma

Answer

Burkitt's lymphoma

Answer

All of the above

Question 6

The RBC morphology in a peripheral blood smear in thalassemia trait resembles that of which condition?

Accepted Answer

Iron deficiency anemia

Answer

Vitamin B12 deficiency anemia

Answer

Folate deficiency anemia

Answer

Hereditary spherocytosis

Question 7

The Philadelphia chromosome is characteristically seen in which of the following conditions?

Accepted Answer

Both CML and ALL

Answer

Chronic Myeloid Leukemia (CML)

Answer

Acute Lymphoblastic Leukemia (ALL)

Answer

Neither CML nor ALL

Question 8

Cyclin D1/IgH gene rearrangement is associated with which of the following malignancies?

Accepted Answer

Mantle cell lymphoma

Answer

Hairy cell leukemia

Answer

Follicular lymphoma

Answer

Diffuse large B-cell lymphoma

Question 9

Sideroblasts are seen in all conditions except?

Accepted Answer

Thalassemia

Answer

Myelofibrosis

Answer

Alcoholism

Answer

Iron overload

Question 10

Neoplastic giant cells characteristically seen in Hodgkin's lymphoma are:

Accepted Answer

Reed-Sternberg cells

Answer

Warthin-Finkeldey cells

Answer

Russell bodies

Answer

Mikulicz cells

Hematopathology — MCQs

Hematopathology — MCQs

On this page

Practice by Chapter

Want unlimited practice?