Hematopathology Practice Questions

Q: Auer rods are seen in which of the following cells?

Myeloblast. **Explanation:** **Auer rods** are pathognomonic morphological features of the **myeloid lineage** [1]. They are elongated, needle-like, pink or red-staining cytoplasmic inclusions formed by the fusion and crystallization of primary (azurophilic) granules [2]. 1. **Why Myeloblasts are correct:** Auer rods contain peroxidase, lysosomal enzymes, and crystalloid mucopolysaccharides. Since these granules are specific to the granulocytic series, Auer rods are found in **myeloblasts** and occasionally in promyelocytes (especially in APL) [1], [2]. Their presence definitively excludes a diagnosis of Acute Lymphoblastic Leukemia (ALL). 2. **Why other options are incorrect:** * **Lymphoblasts:** These cells belong to the lymphoid lineage, which lacks azurophilic granules and peroxidase; therefore, they never contain Auer rods [2]. * **Erythroblasts & Megakaryoblasts:** While these are part of the myeloid family (non-lymphoid), they do not typically form these specific crystalline inclusions. Auer rods are markers of **granulocytic differentiation** [1]. **High-Yield Clinical Pearls for NEET-PG:** * **Acute Promyelocytic Leukemia (AML-M3):** Characterized by "faggot cells," which contain bundles or clusters of numerous Auer rods [2]. * **Staining:** Auer rods are strongly **Myeloperoxidase (MPO)** positive and **Sudan Black B** positive. * **Diagnostic Significance:** If you see an Auer rod, the diagnosis is **AML** (Acute Myeloid Leukemia) until proven otherwise [1]. They are never seen in Chronic Myeloid Leukemia (CML) unless it has entered a "myeloid blast crisis." **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, p. 620. [2] 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. 621-622.

Q: Which of the following conditions is not transmitted familially?

Factor V Leiden mutation. **Explanation:** The correct answer is **Factor V Leiden mutation**. While this condition is a genetic disorder, the question asks which is not "transmitted familially" in the context of classical Mendelian inheritance patterns typically seen in the other options. 1. **Factor V Leiden Mutation:** This is an autosomal dominant condition caused by a point mutation (G1691A) in the Factor V gene. While it is inherited, it is often categorized as a **thrombophilia** where environmental triggers (surgery, pregnancy, oral contraceptives) play a massive role in clinical expression. In many medical examinations, it is contrasted against classical hematologic "diseases" because it is a genetic risk factor rather than a guaranteed clinical disease state. *Note: If this question appears in a competitive exam, it is often a "best fit" answer or potentially a controversial recall, as all four options technically have genetic bases.* 2. **Thalassemia:** This is a classic **autosomal recessive** hemoglobinopathy caused by deficient synthesis of alpha or beta globin chains. It follows strict familial transmission patterns [1]. 3. **Hemophilia:** Hemophilia A and B are classic **X-linked recessive** disorders. They show a clear familial pattern, typically affecting males while females act as carriers. 4. **Sickle Cell Anemia:** This is an **autosomal recessive** disorder caused by a point mutation in the ̢-globin chain (glutamic acid replaced by valine) [1]. It is strictly transmitted from parents to offspring. **Clinical Pearls for NEET-PG:** * **Factor V Leiden** is the **most common** inherited cause of hypercoagulability (thrombophilia) in Caucasians. * The mutation makes Factor V resistant to inactivation by **Activated Protein C (APC)**. * **High-yield inheritance:** Hemophilia (X-linked), Thalassemia/Sickle Cell (Autosomal Recessive), Hereditary Spherocytosis (Autosomal Dominant) [2].

Question 1

In which condition is Thrombin time raised?

Accepted Answer

Afibrinogenemia

Answer

Hemophilia

Answer

Factor XII deficiency

Answer

von Willebrand's disease

Question 2

Auer rods are seen in which of the following cells?

Accepted Answer

Myeloblast

Answer

Lymphoblast

Answer

Erythroblast

Answer

Megakaryoblast

Question 3

What are the diagnostic criteria for Hodgkin's disease?

Accepted Answer

Atypical cells in a specific background milieu

Answer

Reed-Sternberg (RS) cells

Answer

Presence of a sclerosing pattern

Answer

CD30 positivity

Question 4

All of the following are true regarding Leukemoid reaction, EXCEPT:

Accepted Answer

Neutrophil count >= 11600/mL

Answer

Blast cells <5%

Answer

Platelet count 100,000/mL

Answer

Hemoglobin > 9 gm%

Question 5

Which of the following conditions is not transmitted familially?

Accepted Answer

Factor V Leiden mutation

Answer

Thalassemia

Answer

Hemophilia

Answer

Sickle cell anemia

Question 6

Which of the following statements about hematological disorders is true?

Accepted Answer

Both PT and aPTT are increased in DIC.

Answer

In Hemophilia B, cryoprecipitate is useful.

Answer

Desmopressin has no role in von Willebrand disease.

Answer

Hemorrhagic disease of the newborn is due to vitamin C deficiency.

Question 7

Which of the following findings is false regarding thrombotic thrombocytopenic purpura?

Accepted Answer

High ADAMTS13 activity

Answer

Renal failure

Answer

Schistocytes in peripheral smear

Answer

Transient neurological deficits

Question 8

Which of the following conditions is associated with necrotizing lymphadenitis?

Accepted Answer

Kikuchi disease

Answer

Hodgkin's disease

Answer

Kimura disease

Answer

Sarcoidosis

Question 9

Reticulocytosis is seen in all conditions EXCEPT:

Accepted Answer

Nutritional anemia

Answer

Paroxysmal nocturnal hemoglobinuria (PNH)

Answer

Hemolysis

Answer

Dyserythropoietic syndrome

Question 10

A 42-year-old man presents with chronic fatigue. His hemoglobin is 11.5 g/dL, and the blood film shows hypochromic and microcytic red blood cells. Laboratory findings include increased serum iron, normal total iron-binding capacity (TIBC), increased ferritin, and decreased HbA2. What is the most likely diagnosis for this patient's hypochromic microcytic anemia?

Accepted Answer

Sideroblastic anemia

Answer

Iron deficiency anemia

Answer

Beta-thalassemia trait

Answer

Anemia of chronic disease

Hematopathology — MCQs

Hematopathology — MCQs

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