Hematopathology Practice Questions

Q: All of the following are true about anticoagulants except?

Sodium diphosphate helps in the synthesis of ATP. This question tests the knowledge of blood preservation and the specific roles of additives in anticoagulant solutions. ### **Explanation of the Correct Option** **Option C is the incorrect statement (and thus the correct answer).** In blood preservation solutions like CPD (Citrate Phosphate Dextrose), **Sodium Acid Phosphate (NaH₂PO₄)** is added primarily as a **buffer** to maintain the pH of the stored blood. It prevents the excessive drop in pH caused by the accumulation of lactic acid (a byproduct of glycolysis). While ATP is vital for red cell survival, its synthesis is primarily supported by **Dextrose** (which provides the energy source) and **Adenine** (which provides the substrate for ATP synthesis). ### **Analysis of Other Options** * **Option A (CPDA-1):** Citrate Phosphate Dextrose Adenine-1 allows for a storage life of **35 days**. The addition of Adenine to the standard CPD solution improves ATP regeneration, extending the shelf life from 21 to 35 days. * **Option B (SAGM):** Saline-Adenine-Glucose-Mannitol is an additive solution used after removing plasma. It provides optimal nutrients and membrane stabilization (via Mannitol), extending the shelf life to **42 days**. * **Option D (Citrate):** Citrate (Sodium Citrate) is the primary anticoagulant in all standard blood bags. It works by **chelating (binding) ionized calcium**, which is Factor IV in the coagulation cascade, thereby preventing clot formation. ### **High-Yield Clinical Pearls for NEET-PG** * **Citrate:** Anticoagulant (Calcium chelator). * **Dextrose:** Energy source for glycolysis. * **Phosphate:** Buffer (maintains pH). * **Adenine:** Maintains high ATP levels (extends life to 35 days). * **2,3-DPG:** Levels decrease during storage, leading to an increased affinity of hemoglobin for oxygen (Left shift of the Oxygen Dissociation Curve). * **Storage Temperature:** Whole blood/PRBCs must be stored at **2–6°C**.

Q: Which of the following surface glycoproteins is most often expressed in human hematopoietic stem cells?

CD34. **Explanation:** **CD34** is a transmembrane phosphoglycoprotein and the hallmark surface marker for **human hematopoietic stem cells (HSCs)** and progenitor cells. It plays a critical role in cell-cell adhesion and mediates the attachment of stem cells to the bone marrow extracellular matrix. As HSCs differentiate into mature lineages, the expression of CD34 is lost; therefore, it is used clinically to identify, quantify, and isolate stem cells for peripheral blood stem cell transplantation [1]. **Analysis of Incorrect Options:** * **CD22:** This is a specific marker for **B-lineage cells**. It is expressed during the late pre-B cell stage and persists on mature B cells, but it is absent on hematopoietic stem cells. * **CD4:** This is a marker for **T-helper cells**, monocytes, and macrophages. It is a co-receptor for the T-cell receptor (TCR) and is not expressed on early undifferentiated stem cells. (Note: CD4D is likely a typo for CD4). * **CD15:** Also known as Lewis X, this is a carbohydrate adhesion molecule primarily expressed on **mature granulocytes** (neutrophils) and Reed-Sternberg cells in Hodgkin Lymphoma. **High-Yield Clinical Pearls for NEET-PG:** * **Stem Cell Harvest:** A minimum dose of **$2 \times 10^6$ CD34+ cells/kg** is generally required for successful engraftment in autologous transplants [1]. * **Flow Cytometry:** CD34 is essential for diagnosing **Acute Leukemias** (to identify the "blast" population), though it may be negative in Acute Promyelocytic Leukemia (M3). * **Other HSC Markers:** Along with CD34, HSCs are typically **CD38-negative** and **Lin-negative**. * **Vascular Marker:** CD34 is also expressed on **vascular endothelial cells** and is used as a marker for vascular tumors (e.g., Angiosarcoma, Kaposi Sarcoma). **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 584-586.

Question 1

Which test is most sensitive for disseminated intravascular coagulation (DIC)?

Accepted Answer

Serum levels of fibrin degradation products (FDP)

Answer

Serum fibrinogen levels

Answer

Prolonged PT and PTT

Answer

Thrombocytopenia

Question 2

Which of the following laboratory determinants is abnormally prolonged in ITP?

Accepted Answer

Bleeding time

Answer

APTT

Answer

Prothrombin time

Answer

Clotting time

Question 3

What is true regarding prothrombin time measurement?

Accepted Answer

Should be measured within 2 hours

Answer

Platelet-rich plasma is required

Answer

Activated with kaolin

Answer

Immediate refrigeration is necessary to preserve coagulation factor viability

Question 4

Heinz bodies are seen in:

Accepted Answer

G-6-PD deficiency

Answer

Sickle cell disease

Answer

Hereditary spherocytosis

Answer

PNH

Question 5

Which of the following is NOT a feature of intravascular hemolysis?

Accepted Answer

Thrombocytopenia

Answer

Hemosiderinuria

Answer

Decreased haptoglobin

Answer

Raised indirect bilirubin

Question 6

All of the following are true about anticoagulants except?

Accepted Answer

Sodium diphosphate helps in the synthesis of ATP

Answer

Maximum storage with CPDA-1 is 35 days

Answer

Maximum storage with SAGM is 42 days

Answer

Citrate prevents coagulation by chelating calcium

Question 7

The Philadelphia chromosome is consistently found in which of the following hematologic malignancies?

Accepted Answer

Chronic Myeloid Leukemia (CML)

Answer

Acute Myeloid Leukemia (AML)

Answer

Chronic Lymphocytic Leukemia (CLL)

Answer

All of the above

Question 8

Which of the following CD markers is NOT used for diagnostic criteria for systemic mastocytosis?

Accepted Answer

CD 20

Answer

CD 2

Answer

CD 25

Answer

CD 117

Question 9

Which of the following surface glycoproteins is most often expressed in human hematopoietic stem cells?

Accepted Answer

CD34

Answer

CD22

Answer

CD4D

Answer

CD15

Question 10

Which of the following is considered the most malignant form of Non-Hodgkin Lymphoma (NHL)?

Accepted Answer

Diffuse large B-cell lymphoma

Answer

Small cell lymphocytic lymphoma

Answer

Mantle cell lymphoma

Answer

Follicular lymphoma, large cell type

Hematopathology — MCQs

Hematopathology — MCQs

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