Hematopathology Practice Questions

Q: The peripheral blood smear shown in the image is most suggestive of which of the following conditions?

Multiple myeloma. ***Multiple myeloma*** - **Rouleaux formation** (red blood cells stacked like coins) is the hallmark finding on peripheral blood smear, caused by increased plasma proteins. - Associated with **hypercalcemia**, **bone lesions**, and **monoclonal protein** (M-spike) on serum electrophoresis. *Hodgkin's lymphoma* - Diagnosis requires identification of **Reed-Sternberg cells** on lymph node biopsy, not peripheral blood smear findings. - Peripheral blood smear typically shows **reactive lymphocytes** and **eosinophilia**, but not rouleaux formation. *Burkitt's lymphoma* - Characterized by **starry-sky pattern** on tissue biopsy with **tingible body macrophages** scattered among malignant B-cells. - Peripheral blood smear may show **blast cells** but lacks the characteristic rouleaux formation seen in multiple myeloma. *Leukemia* - Peripheral blood smear typically shows increased **blast cells** (immature white blood cells) rather than rouleaux formation. - Associated findings include **thrombocytopenia**, **anemia**, and **leukocytosis** with abnormal cell morphology.

Q: Which of the following is not associated with the disorder characterized by findings on a peripheral blood smear?

Predisposition to malaria. ***Predisposition to malaria*** - Sickle cell disease/trait actually provides **protection against malaria**, not predisposition, due to the **hostile environment** for Plasmodium parasites in sickled red blood cells. - This protective effect is an evolutionary advantage in **malaria-endemic regions**, explaining the high prevalence of sickle cell trait in these areas. *Hand-foot syndrome* - Also known as **dactylitis**, this is a common complication of sickle cell disease caused by **vaso-occlusive crises** in small bones. - Results in painful swelling of hands and feet, particularly common in **infants and young children** with sickle cell disease. *Acute chest syndrome* - A serious complication of sickle cell disease involving **pulmonary vaso-occlusion**, infection, or fat embolism. - Presents with chest pain, fever, and **pulmonary infiltrates** on chest X-ray, requiring immediate medical attention. *Predisposition to Salmonella osteomyelitis* - Occurs due to **functional asplenia** from repeated splenic infarctions in sickle cell disease patients. - **Salmonella** species have particular tropism for infarcted bone tissue, making osteomyelitis more common than **Staphylococcus aureus** in these patients.

Question 1

A 6-year-old Afroamerican boy presented with abdominal pain, chronic hemolysis, and abnormal RBC shape on peripheral smear. What is the most likely underlying molecular disorder responsible for this condition?

Accepted Answer

Point mutation

Answer

Trinucleotide repeat

Answer

Antibody against RBC membrane

Answer

Genomic imprinting

Question 2

Which of the following is false regarding Transfusion-Related Acute Lung Injury (TRALI)?

Accepted Answer

All of the above

Answer

It is due to the release of mediators from neutrophils in the lungs.

Answer

It occurs within 6 hours of transfusion.

Answer

It occurs more commonly when the donor is a multiparous woman.

Question 3

Which of the following is not a B cell lymphoma?

Accepted Answer

Mycosis fungoides

Answer

CLL (Chronic Lymphocytic Leukemia)

Answer

Hairy cell leukemia

Answer

Mantle cell lymphoma

Question 4

Down syndrome predisposes to which type of cancer?

Accepted Answer

Acute Myeloid Leukemia (AML)

Answer

Chronic Myeloid Leukemia (CML)

Answer

Acute Lymphoblastic Leukemia (ALL)

Answer

Chronic Lymphocytic Leukemia (CLL)

Question 5

The peripheral blood smear shown in the image is most suggestive of which of the following conditions?

Accepted Answer

Multiple myeloma

Answer

Hodgkin’s lymphoma

Answer

Burkitt’s lymphoma

Answer

Leukemia

Question 6

Which virus is most commonly associated with Burkitt's lymphoma?

Accepted Answer

Epstein-Barr virus (EBV)

Answer

Human Herpesvirus (HHV)

Answer

Human Immunodeficiency Virus (HIV)

Answer

Human T-lymphotropic virus (HTLV)

Question 7

Which of the following can cause eosinophilia?

Accepted Answer

Miliary tuberculosis

Answer

Hodgkin's disease

Answer

Filariasis

Answer

HIV infection

Question 8

What is the most common mutation in hemophilia?

Accepted Answer

Intron 22 inversion

Answer

Intron 1 inversion

Answer

619 bp deletion

Answer

3.7 kb deletion

Question 9

A blood smear is best visualized at which pH?

Accepted Answer

6.8

Answer

7.2

Answer

6.6

Answer

7

Question 10

Which of the following is not associated with the disorder characterized by findings on a peripheral blood smear?

Accepted Answer

Predisposition to malaria

Answer

Hand-foot syndrome

Answer

Acute chest syndrome

Answer

Predisposition to Salmonella osteomyelitis

Hematopathology — MCQs

Hematopathology — MCQs

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