Hematopathology Practice Questions

Q: Which of the following statements is not true about Von Willebrand disease?

Deficiency of VWF causes prolonged prothrombin time.. Explanation: **Why Option D is the correct (false) statement:** Von Willebrand Factor (VWF) is primarily involved in primary hemostasis (platelet adhesion) and the stabilization of Factor VIII. A deficiency in VWF leads to a prolonged **Bleeding Time (BT)** and potentially a prolonged **Activated Partial Thromboplastin Time (aPTT)** due to decreased Factor VIII levels [1]. However, it has no effect on the extrinsic pathway. **Prothrombin Time (PT)** measures the extrinsic and common pathways (Factors I, II, V, VII, X); since VWF does not interact with these factors, the PT remains **normal** in Von Willebrand Disease (vWD). **Analysis of other options:** * **Option A:** Correct. VWF is synthesized in **endothelial cells** (stored in Weibel-Palade bodies) and **megakaryocytes** (stored in α-granules of platelets). * **Option B:** Correct. VWF circulates in the plasma as multimers and is also present in the subendothelial connective tissue, where it awaits vascular injury to facilitate platelet binding. * **Option C:** Correct. VWF acts as a "bridge" between platelet GpIb receptors and subendothelial collagen (adhesion). It also serves as a carrier protein for **Factor VIII**, protecting it from rapid proteolytic degradation by Activated Protein C [1]. **High-Yield Clinical Pearls for NEET-PG:** * **Most Common:** vWD is the most common inherited bleeding disorder. * **Inheritance:** Most types (Type 1 and 2) are **Autosomal Dominant**, unlike Hemophilia (X-linked). * **Diagnostic Test:** The **Ristocetin Cofactor Assay** is the gold standard for functional assessment (measures VWF-dependent platelet agglutination) [1]. * **Treatment:** **Desmopressin (DDAVP)** is the treatment of choice for Type 1 as it releases endogenous VWF stores from endothelial cells [1].

Question 1

Which of the following is the only hemolytic anemia caused by an acquired intrinsic defect in the cell membrane?

Accepted Answer

Paroxysmal nocturnal hemoglobinuria (PNH)

Answer

Sickle cell anemia

Answer

Thalassemia

Answer

None of the above

Question 2

Translocation of t(8;14) is characteristic of which of the following malignancies?

Accepted Answer

Burkitt's lymphoma

Answer

Hairy cell leukemia

Answer

Mantle cell lymphoma

Answer

Follicular lymphoma

Question 3

What is the marker for granulocytic sarcoma?

Accepted Answer

CD117

Answer

CD33

Answer

CD38

Answer

CD137

Question 4

A 72-year-old man who has undergone aortic valve replacement presents with pallor and fatigue. Laboratory findings include a decreased red blood cell count, the presence of schistocytes on peripheral blood smear examination, and significantly elevated indirect (unconjugated) bilirubin. What is the likely cause of this patient's anemia?

Accepted Answer

Mechanical disruption of red cells

Answer

Cold agglutinin disease

Answer

Dietary deficiency

Answer

Hereditary spherocytosis

Question 5

All of the following are true for the Philadelphia chromosome, EXCEPT:

Accepted Answer

It is seen in plasma cell tumors.

Answer

It is an acquired genetic defect.

Answer

It is a marker of chronic myeloid leukemia (CML).

Answer

It results from a translocation of genetic material from chromosome 22 to chromosome 9.

Question 6

Which of the following is NOT a preliminary investigation for primary coagulation defects?

Accepted Answer

Prothrombin time

Answer

Bleeding time

Answer

Platelet count

Answer

Platelet aggregation studies

Question 7

Which of the following statements is not true about Von Willebrand disease?

Accepted Answer

Deficiency of VWF causes prolonged prothrombin time.

Answer

Von Willebrand factor (VWF) is synthesized by endothelial cells and megakaryocytes.

Answer

VWF may be located in the plasma and subendothelial tissue.

Answer

VWF causes platelet adhesion and prevents the degradation of factor VIII in plasma.

Question 8

A 26-year-old man has noted enlarging neck lumps for the past 6 months. Physical examination reveals enlarged, nontender right cervical lymph nodes. A biopsy of a lymph node microscopically shows macrophages, lymphocytes, neutrophils, eosinophils, and plasma cells. Scattered CD15+ large cells with multiple nuclei or a single nucleus with multiple nuclear lobes, each with a large inclusion-like nucleolus, are present. What is the most likely cell of origin and infectious agent for these large cells?

Accepted Answer

B lymphocyte, Epstein-Barr virus

Answer

CD4+ cell, human T lymphotropic virus

Answer

Endothelial cell, Kaposi sarcoma herpesvirus

Answer

Macrophage, human immunodeficiency virus

Question 9

Lacunar cells are seen in which subtype of Hodgkin's lymphoma?

Accepted Answer

Nodular sclerosis

Answer

Lymphocyte predominant Hodgkin's lymphoma

Answer

Lymphocyte depleted Hodgkin's lymphoma

Answer

Mixed cellularity

Question 10

Which of the following is NOT associated with Disseminated Intravascular Coagulation (DIC)?

Accepted Answer

Hyperfibrinogenemia

Answer

Thrombocytopenia

Answer

Prolonged Prothrombin Time (PT)

Answer

Increased Fibrin Degradation Products (FDP)

Hematopathology — MCQs

Hematopathology — MCQs

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