Hematopathology Practice Questions

Q: Cabot's ring is seen in which of the following conditions?

Megaloblastic anemia. **Explanation:** **Cabot’s Rings** are thin, red-purple, thread-like strands found inside red blood cells. They typically appear in the shape of a loop, a figure-of-eight, or a ring. **1. Why Megaloblastic Anemia is Correct:** Cabot’s rings are remnants of the **mitotic spindle** (microtubules) or remnants of the nuclear membrane. They occur in conditions characterized by **dyserythropoiesis** (defective red cell production). In Megaloblastic Anemia (Vitamin B12 or Folate deficiency), there is a defect in DNA synthesis leading to nuclear-cytoplasmic asynchrony [1]. This abnormal maturation results in nuclear remnants like Cabot’s rings and Howell-Jolly bodies being left behind in the cytoplasm [1]. **2. Why Other Options are Incorrect:** * **Sickle Cell Disease:** Characterized by sickle-shaped cells and Howell-Jolly bodies (due to autosplenectomy), but Cabot’s rings are not a classic hallmark. * **Iron Deficiency Anemia:** Typically shows microcytic hypochromic cells, pencil cells, and target cells. It does not involve the nuclear maturation defects required to form Cabot’s rings. * **Autoimmune Anemia:** Primarily presents with microspherocytes and polychromasia due to reticulocytosis, rather than nuclear remnants. **3. High-Yield Clinical Pearls for NEET-PG:** * **Differential Diagnosis:** Besides Megaloblastic anemia, Cabot’s rings are also seen in **Lead poisoning** (along with coarse basophilic stippling) and post-splenectomy states. * **Stain:** They are best visualized using **Romanowsky stains** (e.g., Leishman, Giemsa, or Wright stain). * **Mnemonic:** Remember **"C"** for **C**abot’s rings, **C**oarse basophilic stippling, and **C**yanide/Lead (Lead poisoning). **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 593-594.

Question 1

What is the biochemical marker of lymphocytic leukemia?

Accepted Answer

Periodic acid-Schiff (PAS) stain

Answer

Enolase

Answer

Peroxidase

Answer

Choline esterase

Question 2

Alpha thalassemia is due to which of the following?

Accepted Answer

Alpha chain deficiency

Answer

Alpha chain excess

Answer

Beta chain deficiency

Answer

Beta chain excess

Question 3

A 15-year-old boy presented with a one-day history of bleeding gums, subconjunctival bleed, and purpuric rash. Investigations revealed the following results: Hb-6.4 gm/dL, TLC-26,500/mm3, Platelet - 35,000 mm3, Prothrombin time-20 sec (control of 13 sec), Partial thromboplastin time-50 sec, and Fibrinogen 10 mg/dl. Peripheral smear was suggestive of acute myeloblastic leukemia. Which of the following is the most likely diagnosis?

Accepted Answer

Promyelocytic leukemia

Answer

Myeloblastic leukemia without maturation

Answer

Myeloblastic leukemia with maturation

Answer

Myelomonocytic leukemia

Question 4

Which functional test assesses primary hemostasis?

Accepted Answer

Bleeding time

Answer

Activated partial thromboplastin time

Answer

Platelet count

Answer

Prothrombin time

Question 5

Which laboratory test is considered the gold standard for diagnosing Paroxysmal Nocturnal Hemoglobinuria (PNH)?

Accepted Answer

Flow cytometry

Answer

Ham test

Answer

Haptoglobin

Answer

Sucrose Lysis test

Question 6

What is the most common cause of beta thalassemia?

Accepted Answer

Mutations leading to aberrant RNA splicing.

Answer

Mutations lie within the β-globin promoter and lower the rate of β-globin gene transcription.

Answer

Mutations involve the coding regions of the β-globin gene.

Answer

All of the above are equally common.

Question 7

Schistocytes are found in all of the following conditions EXCEPT?

Accepted Answer

Immune thrombocytopenic purpura (ITP)

Answer

Severe iron deficiency anemia

Answer

March hemoglobinuria

Answer

Disseminated intravascular coagulation (DIC)

Question 8

Which of the following is the most important prognostic factor in ALL?

Accepted Answer

Response to steroids

Answer

Hyperdiploidy

Answer

Total leukocyte count greater than 50,000

Answer

Age

Question 9

All of the following are true regarding the diagnosis of hemolytic anemia except:

Accepted Answer

Low lactate dehydrogenase (LDH) in the blood

Answer

Elevated unconjugated bilirubin in the blood

Answer

Haptoglobin levels are decreased

Answer

Direct Coombs test is positive

Question 10

Cabot's ring is seen in which of the following conditions?

Accepted Answer

Megaloblastic anemia

Answer

Sickle cell disease

Answer

Iron deficiency anemia

Answer

Autoimmune anemia

Hematopathology — MCQs

Hematopathology — MCQs

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