Hematopathology Practice Questions

Q: Which of the following statements is true regarding the cytochemistry of ALL?

PAS positive (Block positivity). In Hematopathology, cytochemistry is a vital tool for differentiating Acute Lymphoblastic Leukemia (ALL) from Acute Myeloid Leukemia (AML). **1. Why Option A is Correct:** **Periodic Acid-Schiff (PAS)** stains glycogen. In ALL, the lymphoblasts often show a characteristic **"block positivity"** or "coarse granular" pattern. This occurs because the glycogen is clustered in large chunks within the cytoplasm against a clear background. This is a classic diagnostic hallmark for the L1 and L2 subtypes of ALL (FAB classification). **2. Why the Other Options are Incorrect:** * **Myeloperoxidase (MPO):** This is the most sensitive and specific marker for the **myeloid lineage**. It is found in the primary granules of myeloid cells. ALL is characteristically **MPO negative**. * **Sudan Black B (SBB):** This stain detects phospholipids and sterols in the membranes of primary and secondary granules. Like MPO, it is positive in AML and **negative in ALL**. * **Non-specific Esterase (NSE):** This stain (e.g., alpha-naphthyl acetate esterase) is used to identify cells of the **monocytic lineage**. It is strongly positive in Acute Monocytic Leukemia (AML-M4 and M5) but negative in ALL. **3. High-Yield Clinical Pearls for NEET-PG:** * **Gold Standard:** While cytochemistry is high-yield for exams, **Immunophenotyping (Flow Cytometry)** is the current gold standard for diagnosing ALL (look for TdT, CD10, CD19, and CD3) [1]. * **TdT (Terminal Deoxynucleotidyl Transferase):** A specialized DNA polymerase that is positive in >95% of ALL cases but negative in AML. * **Acid Phosphatase:** Shows **focal polar (paranuclear) positivity** specifically in **T-cell ALL** [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, pp. 596-600.

Question 1

In beta thalassemia, what change occurs to the beta and alpha globin chains?

Accepted Answer

Decrease in beta chain, increase in alpha chain

Answer

Increase in beta chain, decrease in alpha chain

Answer

Decrease in beta chain, decrease in alpha chain

Answer

Increase in beta chain, increase in alpha chain

Question 2

Which tumor is associated with polycythemia vera?

Accepted Answer

Cerebellar haemangioblastoma

Answer

Sarcoma

Answer

Pituitary adenoma

Answer

None of the above

Question 3

Which of the following types of anemia is associated with a raised MCV and normal MCHC?

Accepted Answer

Vitamin B12 and Folic acid deficiency

Answer

Sideroblastic anemia

Answer

Beta thalassemia

Answer

Iron deficiency anemia

Question 4

Which of the following statements is true regarding the cytochemistry of ALL?

Accepted Answer

PAS positive (Block positivity)

Answer

Myeloperoxidase positive

Answer

Sudan Black B positive

Answer

Non-specific esterase positive

Question 5

Proliferation and survival of myeloma cells are dependent on which of the following cytokines?

Accepted Answer

IL-6

Answer

IL-1

Answer

IL-2

Answer

IL-5

Question 6

Diagnosis of Hodgkin's disease is based on all of the following, except:

Accepted Answer

Atypical cells in background

Answer

Reed-Sternberg cells

Answer

Reactive cellular background

Answer

CD30 positivity

Question 7

What is the preservative used in coagulation studies?

Accepted Answer

EDTA

Answer

Calcium citrate

Answer

Sodium bromide

Answer

Thrombin

Question 8

A patient with previously normal hemoglobin suffered sudden massive acute hemorrhage. Which of the following changes is LEAST likely to occur?

Accepted Answer

Low mean corpuscular volume

Answer

High reticulocyte count

Answer

High neutrophil count

Answer

High packed cell volume

Question 9

Which X-linked recessive disease in males presents with a clotting defect?

Accepted Answer

Hemophilia A

Answer

Idiopathic Thrombocytopenic Purpura (ITP)

Answer

Von-Willebrand disease

Answer

None of the above

Question 10

Which of the following is NOT a B cell marker?

Accepted Answer

CD-15

Answer

CD-19

Answer

CD-21

Answer

CD-24

Hematopathology — MCQs

Hematopathology — MCQs

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