Hematopathology Practice Questions

Q: Which of the following statements is incorrect regarding Hemophilia A?

APTT is decreased. ### Explanation **1. Why Option A is the Correct (Incorrect Statement):** Hemophilia A is a deficiency of **Factor VIII**, which is a key component of the **intrinsic pathway** of the coagulation cascade. In clinical practice, the **Activated Partial Thromboplastin Time (APTT)** measures the integrity of the intrinsic and common pathways [4]. Therefore, a deficiency in Factor VIII leads to a **prolonged (increased) APTT**, not a decreased one [4]. Bleeding time and PT (Prothrombin Time) remain normal in isolated Hemophilia A. **2. Analysis of Other Options:** * **Option B (Factor VIII is decreased):** This is the hallmark of Hemophilia A (an X-linked recessive disorder) [1]. * **Option C (Factor IX is normal):** Factor IX deficiency characterizes Hemophilia B (Christmas Disease). In Hemophilia A, Factor IX levels are unaffected [2]. * **Option D (VWF is normal):** While Factor VIII circulates bound to Von Willebrand Factor (VWF), Hemophilia A is a primary genetic defect of Factor VIII itself. VWF levels and function (Ristocetin cofactor activity) are normal, which helps distinguish it from Von Willebrand Disease (VWD) [5]. **3. NEET-PG High-Yield Clinical Pearls:** * **Inheritance:** X-linked recessive (affects males; females are typically asymptomatic carriers) [1]. * **Clinical Presentation:** Characterized by deep tissue bleeding, **hemarthrosis** (bleeding into joints, most commonly the knee), and delayed postsurgical bleeding [3]. * **Mixing Study:** If APTT is prolonged, a mixing study is performed. If the APTT **corrects** with normal plasma, it confirms a factor deficiency (like Hemophilia) [4]. If it does not correct, an inhibitor (antibody) is present. * **Treatment:** Recombinant Factor VIII concentrate. Desmopressin (DDAVP) can be used in mild cases to release stored Factor VIII from endothelial cells [2].

Q: SAG M is an abbreviation for which of the following formulations?

Sodium citrate, Adenine, Glucose anhydrate, Mannitol. **Explanation:** **SAGM** is a specialized additive solution used in blood banking to extend the shelf life of packed Red Blood Cells (RBCs) after the plasma has been removed. 1. **Why Option B is Correct:** The abbreviation stands for **S**odium citrate, **A**denine, **G**lucose anhydrate, and **M**annitol. Each component serves a specific physiological purpose: * **Sodium citrate:** Acts as an anticoagulant and buffer [1]. * **Adenine:** Maintains high levels of ATP, ensuring the survival of RBCs. * **Glucose (Dextrose):** Provides the substrate for glycolysis to maintain cell metabolism. * **Mannitol:** Acts as an osmotic stabilizer to prevent hemolysis and protect the RBC membrane. 2. **Analysis of Incorrect Options:** * **Option A & D:** These list **Sodium chloride**. While saline is often the base of additive solutions, the "S" in the standardized SAGM nomenclature specifically refers to the citrate component used in the initial collection and stabilization. * **Option C:** Lists **Adenosine**. This is incorrect; **Adenine** is the specific nucleobase required for ATP synthesis in stored erythrocytes. * **Option D:** Lists **Gelatin**, which is a plasma expander and has no role in the metabolic preservation of stored blood. 3. **Clinical Pearls for NEET-PG:** * **Shelf Life:** The addition of SAGM extends the storage life of RBCs to **42 days** (compared to 35 days with CPDA-1). * **Storage Temperature:** Blood with SAGM is stored at **2°C to 6°C**. * **Hematocrit:** SAGM units typically have a lower hematocrit (approx. 50-70%) compared to CPDA-1 units because the additive solution makes the blood less viscous and easier to infuse.

Question 1

All of the following are good prognostic factors for acute lymphoblastic leukemia except?

Accepted Answer

+ (9;22), + (8;14)

Answer

Age of onset between 2-8 years

Answer

Hyperdiploidy, trisomy of chromosomes 4, 7 and 10 and + (12;21)

Answer

Initial WBC count less than 50000

Question 2

A student presents for evaluation of anemia. His RDW was observed to be 13.5 while the MCV was 62.5 fl. What is the likely diagnosis?

Accepted Answer

Anemia of chronic disease

Answer

Hemoglobin D Punjab (HB-D Trait)

Answer

Thalassemia Major

Answer

Iron Deficiency Anemia

Question 3

Which of the following features is characteristic of megaloblastic anemia?

Accepted Answer

Megaloblastic anemia

Answer

Aplastic anemia

Answer

Iron deficiency anemia

Answer

Leukemia

Question 4

Which of the following is NOT typically seen in multiple myeloma?

Accepted Answer

Anion gap raised

Answer

Lytic bone lesion

Answer

Polyarticular pains

Answer

M spike present with polyarticulopathy

Question 5

A 36-year-old man from China presents with increasing fatigue. He has a 3-year history of tuberculosis, and CBC shows a mild microcytic anemia. Blood work-up demonstrates low serum iron, low iron-binding capacity, and increased serum ferritin. What is the most likely underlying mechanism for the anemia in this patient?

Accepted Answer

Impaired utilization of iron from storage sites

Answer

Clonal stem cell defect

Answer

Hypoxemia

Answer

Synthesis of structurally abnormal globin chains

Question 6

Which of the following is an immune response cause of anemia?

Accepted Answer

Hemolytic disease of the newborn

Answer

Diamond Blackfan anemia

Answer

Hereditary spherocytosis

Answer

Glucose-6-phosphate dehydrogenase deficiency

Question 7

Which of the following statements is incorrect regarding Hemophilia A?

Accepted Answer

APTT is decreased

Answer

Factor VIII is decreased

Answer

Factor IX is normal

Answer

Von Willebrand Factor (VWF) is normal

Question 8

Alkaline phosphatase is specific to which of the following cells?

Accepted Answer

Neutrophils

Answer

Eosinophils

Answer

Polymorphs

Answer

Basophils

Question 9

SAG M is an abbreviation for which of the following formulations?

Accepted Answer

Sodium citrate, Adenine, Glucose anhydrate, Mannitol

Answer

Sodium chloride, Adenine, Glucose anhydrate, Mannitol

Answer

Sodium citrate, Adenosine, Glucose anhydrate, Mannitol

Answer

Sodium chloride, Adenine, Gelatin, Mannitol

Question 10

A 50-year-old man presents with a pruritic rash of several years' duration, characterized by erythematous, eczematoid patches and raised plaques distributed asymmetrically over the chest and abdomen. Biopsy reveals atypical CD4+ T cells with cerebriform nuclei. Further marker studies confirm a diagnosis of mycosis fungoides. Which of the following is true of this disease?

Accepted Answer

The disease eventually disseminates to lymph nodes and internal organs.

Answer

The neoplastic cells most commonly display cell markers of CD19 and CD20.

Answer

The skin rash most commonly disappears over time.

Answer

This disease is caused by a chronic fungal infection in the skin.

Hematopathology — MCQs

Hematopathology — MCQs

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