Hematopathology Practice Questions

Q: One unit of fresh blood raises the Hb% concentration by approximately how much?

1 gm%. **Explanation:** The standard clinical expectation for a blood transfusion in an average-sized adult (approx. 70 kg) is that **one unit of Packed Red Blood Cells (PRBC) or fresh whole blood will increase the Hemoglobin (Hb) level by 1 gm/dL** and the Hematocrit (Hct) by approximately 3%. This occurs because a standard unit of blood contains roughly 200mg of iron and enough red cell mass to significantly boost the oxygen-carrying capacity of the recipient's intravascular volume, provided there is no ongoing active hemorrhage or hemolysis. **Analysis of Options:** * **Option A (0.1 gm%):** This value is negligible and does not reflect the therapeutic impact of a transfusion. * **Option B (1 gm%):** **Correct.** This is the physiological standard used in clinical practice to calculate transfusion requirements. * **Option C & D (2 gm% & 2.2 gm%):** These values are overestimations for a single unit. While a 2 gm/dL rise might be seen in a very small pediatric patient, it is not the standard for an adult unit. **High-Yield Clinical Pearls for NEET-PG:** * **The 1:3 Rule:** 1 unit of blood = ↑ 1 gm/dL Hb = ↑ 3% Hematocrit. * **Pediatric Dosing:** In children, a transfusion of 10 mL/kg of PRBCs typically raises the Hb by 2–3 gm/dL. * **Transfusion Trigger:** In stable, non-bleeding patients, the restrictive threshold for transfusion is generally an **Hb < 7 gm/dL**. * **Storage:** Fresh blood is preferred in specific scenarios (like exchange transfusions) to avoid the "storage lesion" (decreased 2,3-DPG and increased potassium).

Q: What is the main abnormality in beta-thalassemia minor?

Increased HbA2. **Explanation:** **Beta-thalassemia minor** (also known as Beta-thalassemia trait) is caused by a heterozygous mutation in the beta-globin gene, resulting in a partial reduction in beta-chain synthesis [1]. **Why Option A is correct:** In beta-thalassemia, the deficiency of beta-globin chains leads to a relative excess of alpha-chains. To compensate, the body increases the production of delta-chains, which combine with alpha-chains to form **HbA2 (α2δ2)**. An elevated HbA2 level (typically **3.5% to 8%**) is the diagnostic hallmark of beta-thalassemia minor and is used to differentiate it from iron deficiency anemia. **Why other options are incorrect:** * **Option B:** While HbA2 is increased, it is rarely "severely" increased. Levels seldom exceed 8%. If HbA2 is extremely high, other hemoglobinopathies should be considered. * **Option C:** HbF (α2γ2) may be slightly elevated (1–5%) in beta-thalassemia minor, but it is the predominant hemoglobin in **Beta-thalassemia major**, not minor. Furthermore, beta-thalassemia minor typically presents with **mild** asymptomatic anemia or is discovered incidentally, unlike the severe, transfusion-dependent anemia seen in the major form [1]. **High-Yield Clinical Pearls for NEET-PG:** * **Mentzer Index:** (MCV/RBC count) 13 suggests Iron Deficiency Anemia. * **Peripheral Smear:** Shows microcytic hypochromic cells with **target cells** and basophilic stippling. * **RBC Count:** Characteristically **increased** (polycythemia) despite low hemoglobin, which is a key clue in MCQ stems. * **Gold Standard Diagnosis:** Hemoglobin electrophoresis or HPLC. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Red Blood Cell and Bleeding Disorders, pp. 646-647, 650.

Question 1

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 2

Clinical Hemophilia is characterized by which of the following laboratory findings?

Accepted Answer

Normal bleeding time and prothrombin time, and prolonged partial thromboplastin time

Answer

Prolonged prothrombin time and normal bleeding time

Answer

Prolonged bleeding time, prothrombin time, and partial thromboplastin time

Answer

Prolonged bleeding time and normal clotting time, prothrombin time, and partial thromboplastin time

Question 3

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

Accepted Answer

Splenomegaly

Answer

Mucosal bleeding

Answer

Thrombocytopenia

Answer

Increased megakaryocytes

Question 4

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

Accepted Answer

Spherocytosis

Answer

Elliptocytosis

Answer

Poikilocytosis

Answer

Sickle cell disease

Question 5

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 6

One unit of fresh blood raises the Hb% concentration by approximately how much?

Accepted Answer

1 gm%

Answer

0.1 gm%

Answer

2 gm%

Answer

2.2 gm%

Question 7

Hereditary spherocytosis is due to deficiency of which of the following proteins?

Accepted Answer

Spectrin

Answer

Invertin

Answer

Cytokeratin

Answer

Ankyrin and Band 3 (represented by 'All of the above' in original, assuming it was a distractor)

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

What is the main abnormality in beta-thalassemia minor?

Accepted Answer

Increased HbA2

Answer

Severely increased HbA2

Answer

HbF (Fetal Hemoglobin) and severe anemia

Answer

All of the above

Hematopathology — MCQs

Hematopathology — MCQs

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