Hematopathology Practice Questions

Q: What is the characteristic marker for hairy cell leukemia?

CD103. **Explanation:** **Hairy Cell Leukemia (HCL)** is a rare, chronic B-cell lymphoproliferative disorder characterized by the proliferation of mature B-cells with hair-like cytoplasmic projections [1]. **Why CD103 is the correct answer:** CD103 (an alpha-E integrin) is considered the most specific immunophenotypic marker for HCL. The diagnosis is typically confirmed via flow cytometry showing a "bright" expression of mature B-cell markers (CD19, CD20, CD22) along with a specific quartet of markers: **CD103, CD11c, CD25, and annexin A1.** Among these, Annexin A1 is the most specific immunohistochemical marker, while CD103 is the classic flow cytometry hallmark. **Analysis of Incorrect Options:** * **CD30:** A marker for activated lymphocytes; it is the hallmark for **Hodgkin Lymphoma** (Reed-Sternberg cells) and **Anaplastic Large Cell Lymphoma (ALCL)**. * **CD1:** Specifically CD1a is a marker for **Langerhans Cell Histiocytosis (LCH)** and cortical thymocytes. * **CD4:** A marker for **T-helper cells**. It is expressed in T-cell lineages and is relevant in conditions like Mycosis Fungoides or Adult T-cell Leukemia/Lymphoma (ATLL). **High-Yield Clinical Pearls for NEET-PG:** * **Clinical Triad:** Splenomegaly (often massive), Pancytopenia, and "Dry tap" on bone marrow aspiration (due to increased reticulin fibrosis) [1]. * **TRAP Stain:** Historically diagnosed using Tartrate-Resistant Acid Phosphatase (TRAP) positivity. * **Genetic Mutation:** Virtually 100% of cases harbor the **BRAF V600E** mutation. * **Treatment:** Highly sensitive to purine analogs like **Cladribine** (Drug of choice). **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. 612.

Question 1

In the Ann Arbor staging system for Hodgkin's lymphoma, which stage is characterized by the involvement of lymph nodes on both sides of the diaphragm?

Accepted Answer

Stage III

Answer

Stage I

Answer

Stage II

Answer

Stage IV

Question 2

Chronic myeloid leukemia (CML) is characterized by all of the following except:

Accepted Answer

Increased Leukocyte alkaline phosphatase

Answer

Leukocytosis

Answer

Thrombocytosis

Answer

Increased serum Vitamin B12

Question 3

Which is the most common defectively produced antibody in multiple myeloma?

Accepted Answer

IgG

Answer

IgM

Answer

IgA

Answer

IgD

Question 4

All of the following are associated with Epstein-Barr virus (EBV), EXCEPT:

Accepted Answer

Lymphoplasmacytic lymphoma

Answer

Hodgkin's disease

Answer

Post-organ transplant lymphoma

Answer

Extranodal NK/T cell lymphoma, nasal type

Question 5

Prolonged prothrombin time (PT) and normal activated partial thromboplastin time (aPTT) may be seen in which of the following conditions?

Accepted Answer

Vitamin K deficiency

Answer

Thrombocytopenia

Answer

Disseminated Intravascular Coagulation (DIC)

Answer

Aspirin toxicity

Question 6

What is the characteristic marker for hairy cell leukemia?

Accepted Answer

CD103

Answer

CD30

Answer

CD1

Answer

CD4

Question 7

A patient presents with microcytic hypochromic anaemia. Laboratory investigations reveal reduced total serum iron, reduced percentage saturation of serum transferrin, and increased serum ferritin levels. What is the most likely diagnosis?

Accepted Answer

Anaemia of chronic disease

Answer

Iron deficiency anaemia

Answer

Sideroblastic anaemia

Answer

Pernicious anaemia

Question 8

Iron levels are decreased in all of the following conditions except:

Accepted Answer

Sideroblastic anemia

Answer

Anemia due to chronic infection

Answer

Anemia due to gastric ulcer (bleeding ulcer)

Answer

Hookworm anemia

Question 9

Which of the following disorders is least likely to be associated with a prolonged bleeding time?

Accepted Answer

Coagulation factor deficiencies

Answer

Thrombocytopenia

Answer

Platelet dysfunction

Answer

Disseminated Intravascular Coagulation (DIC)

Question 10

What condition is characterized by the presence of leptocytes in blood smears?

Accepted Answer

Thalassemia

Answer

Sickle cell anemia

Answer

Post splenectomy

Answer

Uremia

Hematopathology — MCQs

Hematopathology — MCQs

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