Hematopathology Practice Questions

Q: A 9-year-old boy with elevation in both prothrombin time (PT) and activated partial thromboplastin time (APTT) is diagnosed with what?

Defect in common pathway. ***Defect in common pathway*** - Elevation in both **prothrombin time (PT)** and **activated partial thromboplastin time (APTT)** indicates a problem in the **common pathway**, affecting factors I, II, V, X [1]. - This defect can result from conditions such as **vitamin K deficiency** or **liver dysfunction**, which impact multiple coagulation factors. *Platelet function defect* - Typically presents with **prolonged bleeding times** but does not affect PT or APTT, which remain normal. - Symptoms often include **petechiae** or **easy bruising**, rather than the coagulation profile observed here. *Defect in extrinsic pathway* - Primarily affects **PT** only, not APTT, as this pathway involves factors VII and tissue factor [1]. - Conditions like **vitamin K deficiency** can cause prolonged PT, but APTT would not be elevated simultaneously in isolation. *Defect in intrinsic pathway* - Affects **APTT** primarily, causing a prolonged APTT while PT remains normal [1]. - Common conditions include **Hemophilia A or B**, but the simultaneous elevation of both PT and APTT rules this out. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Hemodynamic Disorders, Thromboembolic Disease, and Shock, pp. 128-130.

Q: Maximum erythrocyte sedimentation rate (ESR) is seen in:

Multiple myeloma. ***Multiple myeloma*** - In **multiple myeloma**, the presence of an abundance of abnormal **monoclonal paraproteins** (immunoglobulins) in the blood significantly reduces the zeta potential of red blood cells [1]. - This reduction in electrostatic repulsion causes red blood cells to **aggregate much faster**, leading to a dramatic increase in **ESR** [1]. *Polycythemia vera* - **Polycythemia vera** is characterized by an overproduction of red blood cells, increasing **blood viscosity**. - A higher red blood cell count causes increased collisions and slower aggregation, leading to a **reduced** or normal ESR. *Sickle cell anemia* - In **sickle cell anemia**, the abnormally shaped **sickle cells** do not rouleaux well (stack up like coins) [2]. - This inhibits the normal sedimentation process, often resulting in a **decreased** or normal ESR despite inflammation [2]. *Congestive heart failure (CHF)* - While **CHF** can be associated with some inflammatory markers and a mildly elevated ESR, it does not typically cause the **extremely high ESR values** seen in conditions like multiple myeloma. - The elevation is usually moderate and related to the inflammatory state associated with the disease, not direct effects on red blood cell aggregation.

Question 1

A 9-year-old boy with elevation in both prothrombin time (PT) and activated partial thromboplastin time (APTT) is diagnosed with what?

Accepted Answer

Defect in common pathway

Answer

Platelet function defect

Answer

Defect in the extrinsic pathway

Answer

Defect in the intrinsic pathway

Question 2

Maximum erythrocyte sedimentation rate (ESR) is seen in:

Accepted Answer

Multiple myeloma

Answer

Polycythemia vera

Answer

Sickle cell anemia

Answer

Congestive heart failure (CHF)

Question 3

Which of the following is a characteristic finding in hereditary spherocytosis?

Accepted Answer

Increased Osmotic Fragility

Answer

Increased Reticulocyte Count

Answer

Splenomegaly

Answer

Negative Direct Coombs Test

Hematopathology — MCQs

Hematopathology — MCQs

On this page

Practice by Chapter

Want unlimited practice?