Hematopathology Practice Questions

Q: Which of the following statements is NOT true regarding polycythemia vera?

There is a decrease in PCV.. **Explanation:** Polycythemia Vera (PV) is a **chronic myeloproliferative neoplasm** characterized by the autonomous, clonal production of hematopoietic cells. The hallmark of the disease is an absolute increase in red blood cell (RBC) mass. **Why Option D is the Correct Answer (The False Statement):** In Polycythemia Vera, there is a significant **increase** in the Packed Cell Volume (PCV) or Hematocrit, often exceeding 52% in men and 48% in women. PCV represents the proportion of blood volume occupied by RBCs; since RBC production is pathologically elevated, the PCV must rise, not decrease. **Analysis of Other Options:** * **Option A (Neoplastic condition):** PV is a primary polycythemia caused by a mutation in the hematopoietic stem cell (most commonly the **JAK2 V617F mutation**), making it a neoplastic process. * **Option B (Increase in RBC count):** This is the defining feature of the condition. The bone marrow produces excessive erythrocytes independent of erythropoietin levels. * **Option C (Blood viscosity increases):** As the concentration of RBCs (PCV) rises, the blood becomes thicker. This hyperviscosity slows blood flow and increases the risk of thrombosis. **NEET-PG High-Yield Pearls:** * **Molecular Marker:** >95% of cases are associated with the **JAK2 mutation**. * **Erythropoietin (EPO) Levels:** Characteristically **low** (a key diagnostic differentiator from secondary polycythemia). * **Clinical Sign:** **Aquagenic pruritus** (itching after a warm bath) is a classic symptom. * **Complications:** Increased risk of thrombotic events (strokes, MI) and potential transformation into myelofibrosis or Acute Myeloid Leukemia (AML).

Q: Iron deficiency anemia is characterized by which of the following red blood cell indices?

Microcytic hypochromic. **Explanation:** Iron Deficiency Anemia (IDA) is the most common cause of nutritional anemia worldwide. The correct answer is **Microcytic hypochromic** because iron is a critical component of heme. When iron stores are depleted, hemoglobin synthesis is impaired. 1. **Why Microcytic?** To maintain a constant concentration of hemoglobin, the erythroid precursors undergo additional divisions, resulting in smaller red blood cells (Reduced Mean Corpuscular Volume, **MCV < 80 fL** [1]). 2. **Why Hypochromic?** Since there is less hemoglobin per cell, the cells appear pale with an increased central pallor (Reduced Mean Corpuscular Hemoglobin Concentration, **MCHC < 32 g/dL** [1]). **Analysis of Incorrect Options:** * **Normochromic normocytic:** Characteristic of acute blood loss, anemia of chronic disease (early stages), or hemolytic anemias [2]. * **Normocytic hyperchromic:** This pattern is rarely seen; however, Spherocytosis may show a high MCHC, but cells are not "hyperchromic" in the traditional sense [2]. * **Macrocytic hypochromic:** Macrocytic cells (MCV > 100 fL) are typical of Vitamin B12 or Folate deficiency (Megaloblastic anemia), but these are usually normochromic. **High-Yield Clinical Pearls for NEET-PG:** * **First sign of IDA:** Decreased **Serum Ferritin** (most sensitive indicator) [1]. * **Earliest hematological change:** Increase in **RDW** (Red Cell Distribution Width/Anisocytosis). * **Mentzer Index:** MCV/RBC count. If ** 13**, it suggests IDA [3]. * **Pica and Koilonychia** (spoon-shaped nails) are specific clinical signs of chronic iron deficiency.

Question 1

Pancytopenia with cellular bone marrow is seen in all EXCEPT?

Accepted Answer

Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency

Answer

Megaloblastic Anemia

Answer

Myelodysplastic Syndrome (MDS)

Answer

Paroxysmal Nocturnal Hemoglobinuria (PNH)

Question 2

Which of the following agents is a prerequisite for Prothrombin time (PT) assay?

Accepted Answer

Tissue thromboplastin

Answer

Kaolin

Answer

Glass beads

Answer

Silica

Question 3

What is not true regarding Waldenstrom's macroglobulinemia?

Accepted Answer

Hypercalcemia

Answer

Lymphadenopathy is usually present

Answer

Blood viscosity is increased

Answer

IgM immunoglobulin is increased

Question 4

Which of the following statements is NOT true regarding polycythemia vera?

Accepted Answer

There is a decrease in PCV.

Answer

It is a neoplastic condition.

Answer

There is an increase in red blood cell count.

Answer

Blood viscosity increases.

Question 5

Increased fetal hemoglobin is seen in which of the following conditions?

Accepted Answer

Juvenile chronic myeloid leukemia

Answer

Congenital red cell aplasia

Answer

Hereditary spherocytosis

Answer

Acute myeloid leukemia

Question 6

Iron deficiency anemia is characterized by which of the following red blood cell indices?

Accepted Answer

Microcytic hypochromic

Answer

Normochromic normocytic

Answer

Normocytic hyperchromic

Answer

Macrocytic hypochromic

Question 7

A patient presents with fatigue, fever, anorexia, and weight loss. What is the most likely diagnosis?

Accepted Answer

Leukemia

Answer

Scurvy

Answer

Acquired immunodeficiency syndrome

Answer

Sarcoidosis

Question 8

Non-specific esterase is present in which of the following?

Accepted Answer

Acute Myeloid Leukemia (AML)

Answer

Megakaryocytic leukemia

Answer

Lymphocytic leukemia

Answer

Erythroleukemia

Question 9

Which subtype of Hodgkin's disease is histogenetically distinct from all other subtypes?

Accepted Answer

Lymphocyte predominant

Answer

Nodular sclerosis

Answer

Mixed cellularity

Answer

Lymphocyte depleted

Question 10

Which of the following is true about Von Willebrand's disease?

Accepted Answer

Increased platelet aggregation in response to Ristocetin

Answer

Increased bleeding time

Answer

Factor VIII C levels are decreased in circulation.

Answer

APTT is increased

Hematopathology — MCQs

Hematopathology — MCQs

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