Hematopathology Practice Questions

Q: What is the most common plasma cell tumor?

Multiple myeloma. **Explanation:** **Multiple Myeloma (MM)** is the most common primary malignancy of the bone marrow and the most common plasma cell dyscrasia [1]. It is characterized by the neoplastic proliferation of a single clone of plasma cells (M-protein) that produce monoclonal immunoglobulins. It typically presents in older adults with the classic **CRAB** features: Hyper**C**alcemia, **R**enal insufficiency, **A**nemia, and **B**one lesions (lytic) [2]. **Analysis of Incorrect Options:** * **Plasmacytoma:** This refers to a localized collection of neoplastic plasma cells. It can be solitary (bone or extramedullary) but is significantly less common than the systemic involvement seen in Multiple Myeloma. * **Waldenstrom’s Macroglobulinemia:** This is a lymphoproliferative disorder characterized by **IgM** monoclonal gammopathy [1]. It involves lymphoplasmacytic cells rather than pure plasma cells and is clinically distinguished by hyperviscosity and lymphadenopathy rather than bone lesions. * **Primary Amyloidosis (AL):** While associated with plasma cell dyscrasias (deposition of light chain fragments), it is a systemic metabolic complication rather than the most common primary tumor itself. **High-Yield Clinical Pearls for NEET-PG:** * **Most common symptom:** Bone pain (usually involving the back/ribs). * **Diagnostic Hallmark:** Presence of >10% clonal plasma cells in bone marrow [2]. * **Peripheral Smear:** **Rouleaux formation** (due to decreased zeta potential from high globulins). * **Urine:** Bence-Jones proteins (detected by sulfosalicylic acid test, not by standard dipstick). * **Radiology:** "Punched-out" lytic lesions; **Skull X-ray** is a classic board favorite [2]. * **Note:** Bone scans are often negative in MM because they detect osteoblastic activity, whereas MM is primarily osteolytic. Use a Skeletal Survey or MRI instead.

Question 1

An adult patient presents with generalized lymphadenopathy and blood film shows 70% immature looking lymphocytes. What is the next best investigation?

Accepted Answer

Immunophenotyping

Answer

Genotyping/karyotyping

Answer

Bone marrow examination

Answer

Peripheral smear study

Question 2

Osmotic fragility of RBCs is increased in which of the following conditions?

Accepted Answer

Hereditary Spherocytosis

Answer

Sickle cell anemia

Answer

Thalassemia

Answer

Paroxysmal Nocturnal Hemoglobinuria (PNH)

Question 3

What is the most common plasma cell tumor?

Accepted Answer

Multiple myeloma

Answer

Plasmacytoma

Answer

Waldenstrom's macroglobulinemia

Answer

Primary amyloidosis

Question 4

Which of the following is NOT a condition affecting the vessel wall that leads to bleeding?

Accepted Answer

Autoimmune thrombocytopenic purpura

Answer

Henoch-Schonlein purpura

Answer

Cushing's syndrome

Answer

Scurvy

Question 5

Idiopathic thrombocytopenic purpura is associated with all of the following except?

Accepted Answer

Splenomegaly

Answer

Mucosal bleeding

Answer

Thrombocytopenia

Answer

Increased megakaryocytes

Question 6

Which is the most common red blood cell defect without hemoglobin abnormality?

Accepted Answer

Spherocytosis

Answer

Elliptocytosis

Answer

Poikilocytosis

Answer

Sickle cell disease

Question 7

Which of the following conditions is associated with the maximum Erythrocyte Sedimentation Rate (ESR)?

Accepted Answer

Multiple myeloma

Answer

Congestive Heart Failure (CHF)

Answer

Polycythemia vera

Answer

Sickle cell anemia

Question 8

Kaolin cephalin clotting time (KCT) is a test primarily used to assess which part of the coagulation cascade?

Accepted Answer

The intrinsic pathway

Answer

The extrinsic pathway

Answer

Common pathway

Answer

Platelet function

Question 9

The t(8;14) translocation is associated with the activation of which of the following genes?

Accepted Answer

c-myc

Answer

c-abl

Answer

bcl-2

Answer

bcl-I

Question 10

Prolonged prothrombin time is seen in which of the following conditions?

Accepted Answer

Factor VII deficiency

Answer

Haemophilia A

Answer

Haemophilia B

Answer

Thrombocytopenia

Hematopathology — MCQs

Hematopathology — MCQs

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