Hematopathology Practice Questions

Q: Hemophilia A results due to deficiency of which of the factors?

VIII. **Explanation:** **Hemophilia A** (Classic Hemophilia) is an X-linked recessive bleeding disorder caused by a deficiency or functional defect of **Coagulation Factor VIII** [1]. Factor VIII serves as a critical cofactor for Factor IXa in the "tenase complex," which activates Factor X in the intrinsic pathway of the coagulation cascade. A deficiency leads to impaired fibrin clot formation, manifesting clinically as deep tissue bleeds and hemarthrosis [1]. **Analysis of Options:** * **Option C (Factor VIII):** Correct. Hemophilia A is the most common hereditary disease associated with life-threatening bleeding [1]. * **Option A (Factor II):** Prothrombin deficiency is extremely rare and usually presents as an autosomal recessive bleeding diathesis, not Hemophilia A. * **Option B (Factor VII):** Deficiency of Factor VII affects the extrinsic pathway (prolonged PT). It is not associated with Hemophilia. * **Option D (Factor XI):** Deficiency of Factor XI results in **Hemophilia C** (Rosenthal Syndrome), which is an autosomal recessive condition primarily seen in Ashkenazi Jews. **High-Yield Clinical Pearls for NEET-PG:** * **Inheritance:** X-linked recessive (affects males; females are typically asymptomatic carriers) [1]. * **Laboratory Findings:** Characterized by a **prolonged aPTT** (intrinsic pathway) with a **normal PT and Bleeding Time**. * **Mixing Study:** The prolonged aPTT corrects when the patient's plasma is mixed with normal plasma (distinguishes deficiency from inhibitors). * **Hemophilia B (Christmas Disease):** Caused by deficiency of **Factor IX**. * **Treatment:** Recombinant Factor VIII concentrate or Desmopressin (DDAVP) for mild cases (releases Factor VIII from Weibel-Palade bodies). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Red Blood Cell and Bleeding Disorders, pp. 670-671.

Question 1

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 2

Hemophilia A results due to deficiency of which of the factors?

Accepted Answer

VIII

Answer

II

Answer

VII

Answer

XI

Question 3

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 4

Which of the following causes hemolytic anemia?

Accepted Answer

Hereditary spherocytosis

Answer

Infection

Answer

Iron deficiency

Answer

Sickle cell anemia

Question 5

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)

Question 6

All of the following genetic mutations are associated with an increased risk of deep venous thrombosis, EXCEPT:

Accepted Answer

Glycoprotein 1b platelet receptor defect

Answer

Factor V Leiden mutation

Answer

Heterozygous protein C deficiency

Answer

Prothrombin 20210G mutation

Question 7

Which of the following statements is NOT true about Immune Thrombocytopenic purpura (ITP)?

Accepted Answer

Increased megakaryocytes in bone marrow

Answer

Autoimmune mediated

Answer

Massive splenomegaly

Answer

Intravenous immunoglobulin is given

Question 8

What is the commonest site of lytic lesion in multiple myeloma?

Accepted Answer

Vertebral column

Answer

Femur

Answer

Clavicle

Answer

Pelvis

Question 9

Decreased leukocyte alkaline phosphatase is seen in which condition?

Accepted Answer

Chronic myeloid leukemia (CML)

Answer

Acute myeloid leukemia (AML)

Answer

Polycythemia vera

Answer

Myelofibrosis

Question 10

Which of the following conditions is characterized by normal hemoglobin structure but reduced red blood cell volume?

Accepted Answer

Thalassemia

Answer

Chronic blood loss

Answer

Sickle cell anemia

Answer

Hemolytic anemia

Hematopathology — MCQs

Hematopathology — MCQs

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