Hematopathology Practice Questions

Q: Most of the ALLs (Acute Lymphoblastic Leukemia) have which of the following origins?

B-cell origin. **Explanation:** Acute Lymphoblastic Leukemia (ALL) is a malignant neoplasm of hematopoietic precursor cells (lymphoblasts) of either B-cell or T-cell lineage [1]. **1. Why B-cell origin is correct:** The vast majority of ALL cases—approximately **80% to 85%**—are of **B-cell origin (B-ALL)** [1]. These typically manifest as childhood leukemias, with a peak incidence around 3 years of age. They are characterized by the expression of B-cell markers such as CD19, CD22, and CD10 (CALLA). The predominance of B-cell lineage in clinical practice makes it the most common subtype. **2. Why other options are incorrect:** * **T-cell origin:** T-cell ALL (T-ALL) accounts for only about **15% to 20%** of cases [1]. It typically presents in adolescent males as a mediastinal mass (thymic involvement) and is often associated with a high white blood cell count [1]. * **NK cell origin:** Mature NK-cell leukemias or precursor NK-cell neoplasms are extremely rare and do not constitute a significant percentage of ALL cases [1]. **High-Yield Clinical Pearls for NEET-PG:** * **Most common childhood cancer:** ALL is the most common malignancy in children. * **Common ALL Antigen (CALLA):** Also known as **CD10**, it is a key marker for prognosis; CD10+ (Pre-B ALL) has a better prognosis than CD10- cases. * **Cytogenetics:** * **t(12;21):** Most common translocation in childhood B-ALL; carries a **good prognosis**. * **t(9;22):** Philadelphia chromosome; more common in adult B-ALL; carries a **poor prognosis**. * **Sanctuary Sites:** ALL has a predilection for the **CNS and Testes**, requiring specific prophylactic therapy. **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

Laboratory evaluation for the differential diagnosis of chronic myeloproliferative disorders includes all of the following except?

Accepted Answer

Flow-cytometric analysis

Answer

Chromosomal evaluation

Answer

Bone marrow aspiration

Answer

Determination of red blood cell mass

Question 2

Heavy chain disease is associated with which of the following in the urine?

Accepted Answer

Heavy chains

Answer

Seligman disease

Answer

Franklin disease

Answer

Waldenstrom macroglobulinemia

Question 3

Which of the following viruses is implicated in the pathogenesis of Hodgkin's disease?

Accepted Answer

Epstein-Barr Virus (EBV)

Answer

Hepatitis C Virus (HCV)

Answer

Human Papillomavirus (HPV)

Answer

Human Immunodeficiency Virus (HIV)

Question 4

A patient presents with persistent fever and significant weight loss for two months. Examination reveals cervical and axillary lymphadenopathy. Biopsy of cervical nodes is positive for Hodgkin's Lymphoma. What is the clinical stage of the patient?

Accepted Answer

Stage II B

Answer

Stage II A

Answer

Stage III A

Answer

Stage IV B

Question 5

Vitamin B12 deficiency results in which type of anemia?

Accepted Answer

Macrocytic anemia

Answer

Aplastic anemia

Answer

Iron deficiency anemia

Answer

Anemia of chronic disease

Question 6

Which one of the listed types of antibodies is the best example of a cold agglutinin associated with cold autoimmune hemolytic anemia?

Accepted Answer

An anti-I IgM antibody associated with infectious mononucleosis

Answer

An anti-AB IgM antibody associated with isoimmune blood transfusion reaction

Answer

An anti-I IgG antibody associated with rheumatoid arthritis

Answer

An anti-P IgG antibody associated with paroxysmal cold hemoglobinuria

Question 7

Most of the ALLs (Acute Lymphoblastic Leukemia) have which of the following origins?

Accepted Answer

B-cell origin

Answer

T-cell origin

Answer

NK cell origin

Answer

None of the above

Question 8

Lymphocytosis is seen in which type of infections?

Accepted Answer

Viral infections

Answer

Fungal infections

Answer

Bacterial infections

Answer

Protozoal infections

Question 9

All of the following are associated with Secondary Hemochromatosis except?

Accepted Answer

Paroxysmal Nocturnal Haemoglobinuria (PNH)

Answer

Thalassemia Major

Answer

Sideroblastic Anemia

Answer

Hereditary Spherocytosis

Question 10

Which of the following is not a finding in classical hemophilia (hemophilia A)?

Accepted Answer

Increased Prothrombin Time

Answer

Bleeding into soft tissues, muscles, and joints

Answer

Decreased factor VIII

Answer

Increased Partial Thromboplastin Time

Hematopathology — MCQs

Hematopathology — MCQs

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