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01. Anemias

Questions

02. Myeloproliferative Disorders

03. MDS/MPD
04. Myelodysplastic Syndrome

05. Acute Myeloid Leukemia

06. Acute Lymphoblastic Leukemia
07. Hodgkin and Non Hodgkin
lymphoma
08. Mature B Cell Neoplasms
09. Mature T Cell and NK Cell
neoplasms
10. Histiocytic and Dendritic Cell
Neoplasms
11. Mastocytosis
12. Immunodeficiency Associated
Lymphoproliferative Disorders
13. Coagulation disorders
14. Platelet Disorders
15. Missellaneous Diseases
16. http://sites.
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1. Haemolysis in patients deficient in G-6PD

occurs due to formation of
A. Dohle bodies
B. Heinz bodies
C. Howell jolly bodies
D. Pappenheimer bodies

2. All are True of Sickle cell anemia Except

A, Hemolysis is Extravascular
B. Is due to a Defective point mutation
C. Sickling test is confirmatory
D. RBC have a life span of 10-20 days

3. Which of the following is least likely to be

found in multiple myeloma
A. Hypercalcemia
B. Hypergammaglobulinemia
C. Plasma cell leukemia
D. High ESR

4. Majority of NHL are of

A. B cell type

B. T cell type
C. Histiocytic type.
D. Mixed cell type

5. Pancytopenia with 10% myeloblasts and

several dyserythroporetic normoblasts in the
marrow will be called
A. Erythroleukemia.
B. Cong. Dyserythropoietic anemia
C. Subleukemic leukemia
D. Myelodysplastic syndrome

6. All are conditions causing macrocytic

anaemia EXCEPT
A. Pernicious anaemia
B. Chronic liver disease
C. Post hemorrhagic state
D. G6 PD deficiency

7. A 58 year old female has a decreased serum

iron and total iron binding capacity (TIBC. in
association with an increased serum ferritin.
These findings are most indicative of
A. Malabsorption
B. Anemia of chronic disease
C. Auto immune hemolytic anemia
D. Vit B 12 deficiency
E. Chronic blood loss

8. Burr cells are

A. Fragmented cells in uraemia
B. RBC with Howell-jolly bodies
C. Stippled RBCs
D. Parasited RBCs

9. Of the following conditions, the one most

likely to cause massive splenomegaly (3000gm.
is:
A. Myelofibrosis

B. Sickle cell anemia

C. Portal hypertension
D. Infectious mononucleosis E. Hemochromatosis

10. Pelger-Huet like cells are seen in all except

A. MDS
B. AML with dysplastic maturation
C. CML
D. ALL

11. Monocytosis in peripheral blood is seen in

all conditions except
A. Tuberculosis
B. Chrons disease
C. AML-M5
D. Chronic myelomonocytic
Infectious mononucleosis

leukemia

E.

12. Increasing basophil count in an already

diagnosed CML patient is suggestive of
A. Severe infection
B. Good prognostic indicator
C. Going for accelerated phase
D. Bleeding diathesis

13. Condition in which the platelet lack

granules and have a ghost like appearance on
stained blood film is
A. Bernard-soulier syndrome
B. Chediak Higashi syndrome
C. Thrombasthenia
D. Grey platelet syndrome

14. All are romanowsky stains except

A. Leishmann
B. Jenners
C. Giemsa

D. Wrights
E. Mason fontanna

15. A 15-year-old girl has menorrhagia and

tendency to bleed from minor cuts and
wounds. PTT and bleeding times are
prolonged. She is likely to be having
A. F-XIII deficiency
B. Heamophilia A
C. Platelet function defect
D. Von Williebrands disease

16. The test most likely to be useful in the

diagnosis of AML M5 on a blood smear is
staining by
A. Non specific esterase
B. PAS
C. Sudan black
D. TRAP

17. Which of the following represents a

favourable prognosis in childhood ALL
A. Age by six yrs
B. TLC of 80,000/camm
C. Philadelphia chromosome
D. Hb 14 gms/ dl

18. The acute leukemia most likely to lead to

DIC
A. AML-M2
B. AML-M3
C. AML-M4
D. AML-M5
E. ALL

19. The normal myeloid erythroid ratio is

A. 1:1
B. 2:1
C. 3:1

D. 10:1

20. Of the following which finding rules out

diagnosis of Aplastic anaemia
A. Neutropenia
B. Thrombocytopenia
C. Reduced haemoglobin level
D. Absence of splenomegaly
E. Presence of nucleated red cell (normoblast. in
peripheral smear

21. 40 year old man presented with marked

anaemia CBC revealed Hb 4 gm%, TC 1500/
cumm with marked neutropenia platelet
count 10,000/ cumm. Repeated bone marrow
aspirate yielded dry tap. A diagnosis is made
with
A. Serum electrophoresis
B. Trephine biopsy
C. Chromosomal studies
D. Hb electrophoresis

22. All are primary screening tests for

haemorhagic disorders except
A. Bleeding time
B. Clotting time
C. Platelet count
D. PT E. PTT

23. a Thalassemias are due to

A. Defects in transcription
B. Defects in processing or translation of bglobin m RNA
C. Gene deletion
D. Chromosomal translocations

24. Following complications can occur in the

course of sickle cell anaemia
A. Haemolytic crisis

B. Sequestration crisis
C. Aplastic crisis
D. Vaso occlusive crisis E. All of the above

25. The molecular pathology in hereditary

spherocytosis is due to
A. Spectrin deficiency
B. Point mutation
C. Gene deletions
D. Balanced chromosomal translocation

26. Warm antibody immune haemolytic

anaemia the antibody responsible is
A. Ig G
B. Ig M
C. Ig E
D. Ig A

27. Of this which is a milder disease

A. Hb S
B. Hb SC
C. Hb H
D. Hb Barts
E. Hb AS

28. Bcl2 over expression is seen in

A. Follicular B cell lymphoma
B. Burkitts lymphoma
C. Lymphoblasric lymphoma
D. Small lymphocytic lymphoma

29. All of the following conditions

characterised by a high ESR, except
A. Multiple myeloma
B. Rheumatic fever
C. Tuberculosis infection
D. Sickle cell anaemia

30. Reticulocytosis is not seen with

are

A. Hereditary spherocytosis
B. Following acute bleeding
C. Paroxysmal nocturnal hbnuria
D. Anaemia of CRF

31. Tart cell is a

A. Monocyte
B. LE cell
C. Atypical lymphocyte
D. A type of myeloblast

32. Immature white blood cells are rarely seen

in the peripheral blood in all of the following
conditions except:
A. Leukemoid reaction
B. Cml
C. Aml
D. All E. CLL

33. Which of the following statements is

incorrect
A. A peripheral blood smear that has target cells
is consistent with chronic alcoholism
B.
Howell-Jolly
bodies
suggest
previous
splenectomy
C. A leukoerythroblastic picture in the peripheral
blood suggests metastatic carcinoma to bone
D. Schistocytes on the peipheral smear suggest
iron deficiency anemia
E. Basophilic stippling suggests injury by a drug
or by a toxin

34. A peripheral blood smear was made when

a CBC was ordered on a 66 year old female
scheduled to undergo a hernia repair. Many
small, mature lymphocytes were seen. Her
Hgb was 12. 8, Hct 36. 9, MCV88, platelet count
179000 and WBC count 30500. The best
diagnosis is
A. Leukemoid reaction;

B. ALL
C. Infectious mononucleosis
D. CMV infection E. CLL

35. A 51 year old female has been feeling tired

for months. A CBC demonstrate the following:
Hb 9. 5, Hct 28. 1 and MCV 134. The
reticulocyte index is low. Hypersegmented
PMNs are seen on the peripheral blood smear.
Which of the following tests should be
ordered next
A. Serum B12 and folate
B. Bone marrow biopsy
C. Serum ferritin
D. Hb electrophoresis

36. A 16 year old male with hypochromic

anemia in association with splenomegaly and
hemochromatosis is most likely to have:
A. G6PD deficiency
B. Beta-Thalassemia
C. Sickle cell anemia
D. Hereditary spherocytosis
E. Malaria

37. A 61 year old male has bone pain, renal

failure and pneumococcal pneumonia. In this
setting, a bone marrow biopsy is most likely to
show many
A. Granulomas
B. Plasma cells
C. Small lymphocytes
D. Reed-Sternberg cells
E. Blasts

38. An abdominal ultrasound is performed on

a 35yr old male. In which of the following
conditions is the spleen most likely to appear
normal in size

A. Hemolytic anemia
B. Macronodular cirrosis
C. Myelofibrosis
D. ITP
E. Sickle cell anemia

39. Lymphadenopathy is a feature of all of the

following conditions except:
A. HIV infection
B. Toxoplasmosis
C. Multiple myeloma
D. Infectious mononucleosis
E. Non-Hodgkins lymphoma

40. A 45 year old male has skin infiltration by

neoplastic T lymphocytes. His condition is
known as:
A. Hodgkins disease
B. Mycosis fungoides
C. Burkitts lymphoma
D. ALL
E. Hairy cell leukemia

41. A 69 year old male with pancytopenia and

massive splenomegaly has increased numbers
of peripheral blood lymphocytes containing
tartrate resistant acid phosphatase. The
probable diagnosis is
A. CLL
B. HTLV-1 infection with leukemia
C. Hairy cell leukemia
D. Gauchers disease
E. Myelodysplasia

42. Which of the following is not part of

Langerhans cell histiocytosis
A. Eosinophilic granuloma of bone
B. Cytoplasmic HX bodies (Birbeck granules.

C. Hypothalamic infiltration and diabetes

insipidus
D. Epstein-Barr virus infection

43. Of the following findings which will be

most likely to occur with extra vascular,
rather than intravascular hemolysis
A. Splenomegaly
B. Increased retic count
C. Acute renal failure
D. Decreased serum haptoglobin
E. Jaundice

44.Serum protein electrophoretic pattern with

a large 4gm monoclonal gamma spike is
consistent with finding, all of the following
additional laboratory findings except:
A. Elevated BUN and creatinine
B. Increased sedimentation rate
C. Chromosomal translocation
D. Hypercalcemia
E. Normocytic anemia

45. The appearance of helmet cell (a type of

schistocytE. on examination of the peripheral
blood smear is most consistent with origin
from a patient who has
A. Beta-thalassemia
B. Septicemia with E-coli
C. Hereditary spherocytosis
D. Massive splenomegaly

46. The genetic distribution of sickle cell

anemia is based upon the presence of this
agent
A. Mycoplasma
B. Parvovirus
C. Plasmodium
D. Hepatitis virus
E. Babesia


47.HLA antigens have not been demonstrated
on
A. WBC
B. Platelet
C. RBC
D. Other body cells

48. Diagnostic test for thalassemia trait

A. HbA2
B. HbF
C. Fragility test
D.Coombs test

49. Earliest sign of megaloblastic anaemia

A. Increased MCV
B. Increased neutrophil segmentation
C. Altered ME ratio
D. Decreased Hb

50. Hypochromic red cells in the peripheral

smear is characteristic of all except
A. Aplastic anaemia
B. Iron def. Anaemia
C. Sideroblastic anaemia
D. Beta thalassemia

51. Erythroid hyperplasia in bone marrow is

seen in the following conditions except
A. Iron deficiency anaemia
B. Pernicious anaemia
C. Fanconis anaemia
D. Hereditary spherocytosis

52. At what stage of erythropoeisis dos Hb

appears
A. Early normo blast
B. Intermediate normo blast
C. Reticulocyte

D. Erythroblast

53. Autoimmune hemolytic anaemia is

commonly seen in:
A. CLL
B. AML
C. ALL
D. CML

54. The minimum number of blasts present in

Bone marrow, for acute leukemia diagnosis
is
A. 10%
B. 20%
C. 30%
D. 35%

55. The presence of lacunar cells are seen in

which type of Hodgkin disease
A. Lymphocyte predominance
B. Mixed cellularity
C. Nodular sclerosis
D. Lymphocyte depleted

56. Dutcher bodies are connected with

A. Plasma cell dyscrasia
B. acute myeloid leukemia
C. polycythemic Vera rubra
D. Myelofibrosis

57. Starry sky pattern is seen in

A. Small lymphocytic lymphoma
B. Burkitts lymphoma
C. Follicular lymphomas
D. Lymphoblastic lymphoma.

58. All trans retinoid acid is connected with

A. AML- M4
B. AML-M2
C. AML-M3
D. AML-M6 E. ALL-L3

59. All are predisposing to leukemia except:

A. Leukemoid reaction
B. Myelofibrosis
C. Poly cythemia vera
D. Myelodysplastic syndrome

60. How long blood can be stored with CPDA

A. 21 days
B. 28 days
C. 35 days
D. 42 days

61. Abeta lipoprotienemia is suggested by the

following findings except:
A. Acanthocytosis
B. Severe malnutrition
C. Hypercholesterolemia
D. Retinitis pigmentosa

62. Match the following: Anticoagulants of

choice
A. ESR EDTA
B. Ostmotic fragility Na Citrate 1:9
C. Coagulation test Heparin
D. Peripheral smear Na Citrate 1:4

63. Which of the following has a prominent

mediastinal involvement
A. B-ALL
B. T-ALL
C. Null cell type
D. CLL


64. Couple with a family history of beta
thalassemia major in a distant relative, has
come for counseling. The husband has HbA2
of 4. 8% and the wife has HbA2 of 2. 3%. the
risk of having a child with beta thalassemia
major is:
A. 50%
B. 25%
C. 5%
D. 0%

65. Routine fixative used in biopsy

A. 10% formalin
B. 20% formalin
C. 50% formalin
D. 40% formaldehyde

66. Popcorn cells are seen in

A. Lymphocyte predominant HD
B. Lymphocyte depleted
C. Nodular sclerosis
D. Mixed cellularity

67. Although more than 400 blood groups have

been identified, the ABO blood group system
remains the most important in clinical
medicine because :
A. It was the first blood group system to be
discovered.
B. It has four different blood groups A, b, AB, O
(H..
C. ABO (H. antigens are present in most body
tissues and fluids
D. ABO (H. antibodies are invariably present in
plasma
when
persons
RBC
lacks
the
corresponding antigen.

68.

In

myeloma

associated

Amyloidosis

(Primary. Amyloid protein is made of

A. a heavy chain
B. m heavy chain
C. k light chain
D. l light chain

69. Cancer for which radiation is not a risk

factor
a. CML
B. ALL
C. AML,
D. CLL

70. Primary effusion lymphoma is associated

with which of the following agents
A. HHV-8
B. EBV
C. HIV
D. HPV

71. Following are pathognomonic forms of

Plamodium falciparum
A. Gametocyte
B. Accole forms
C. Multiple rings
D. Schizonts

72. Glitter cells are seen in

A. Pyelonephritis
B. Tuberculous meningitis
C. Nephrotic syndrome
D. Viral meningitis

73. Telescoped urinary sediment are seen in

A. End stage renal disease
B. Nephrotic syndrome
C. Acute on chronic glomerulo nephritis
D. All of the above


74. Fixed specific gravity of 1010 is due to
A. Acute renal failure
B. Chronic renal failure
C. Nephrotic syndrome
D. Acute glomerulonephritis

75. Eddis count is for quantification of

A. Coliforms in urine
B. Leucocytes in urine
C. Urinary sediments
D. RBCs

76. A cast which may present in ithe urine of a

healthy individual is
A. Granular cast
B. Hyaline cast
C. Red cell casts
D. Epithelial casts

77. All are urinary fixatives except

A. Formalin
B. Thymol
C. Absolute alcohol
D. Concentrated Hcl E. Boric acid

78. All are crystals formed in acidic urine

except,
A. Calcium oxalate
B. Uric acid
C. Triple phosphate
D. Cystine crystals

79. Adequecy of sputum is determined by

presence of
A. Squamous epithelial cells
B. Neutrophis
C. Alveolar leyden macrophages

D. bronchial epithelial cells

80.

Following

condition

protect

against

plasmodium falciparum
a. Lewis antigen positivity
B. Duffy antigen positivity
c. Duffy antigen negativity
D. Lewis antigen negativity

81. Aquired B antigen in a blood group A

person is seen all except
A. Gram negative septicemia
B. Carcinoma colon
C. Both of these
D. Leukemia

82. All of these can cause discrepancies in

blood grouping except
A. Whartons jelly
B. Rouleaux formation
C. A I H A
D. C- reactive protein

83. Du estimation is to done in these patients

A. Rh positive donor
B. Rh negative donor
C. Rh negative recipient
D. Rh positive recipient

84. In which of the following patient

descriptions would you expect the patient to
have a normocytic anemia with a corrected
reticulocyte count < 2%?
A. Patient with episodic hemoglobinuria in the
first morning void
B. Patient with chronic renal failure secondary to
type I diabetes mellitus
C. Patient with untreated long-standing peptic

ulcer disease
D. Patient with a positive sickle cell screen and a
normal peripheral smear
E. Patient with a family history of haemolytic
anemia after eating fava beans

85. Which of the following disorders will most

likely show a normal percentage of
eosinophils in the peripheral blood ?
A. Strongyloidiasis
B. Hookworm infestation
C. Drug allergy
D. Contact dermatitis
E. Addisons disease

86. Absolute lymphocytosis without atypical

lymphocytosis would be expected in :
A. Whooping cough
B. A cytomegalovirus infection
C. An Epstein Barr virus infectin
D. Toxoplasmosis

87. In a patient with pancytopenia, a normal

MCV, and a corrected reticulocyte count < 2%,
you would expect the mechanism of disease to
be :
A. Renal failure with reduction in erythropoietin
B. Suppression or destruction of the trilineage
myeloid stem cell
C. A DNA maturation defect
D. Chronic blood loss
E. Increased susceptibility of hematopoietic cells
to complement destruction

88. In a febrile 4 year old child with sickle cell

disease and a CBC exhibiting a normocytic
anemia, increased corrected reticulocyte
count, absolute leukocytosis, > 10% band
neutrophis, toxic ggranulation, sickle cells,
target cells, and Howell Jolly bodies, you

would strongly suspect :

A. A viral infection
B. Salmonella osteomyelitis
C. Streptococcus pneumoniae sepsis
D. Tuberculosis E. A systemic fungal infection

89. A 15 year old girl with severe anaemia

were found to have 80% blasts in the
peripheral smear. Positivity for which marker
indicates a relatively better prognosis?
A. 8 ; 14 translocation.
B. Bcr- abl fusion transcript.
C. MLL 1 fusion transcript
D. TEL AML 1 fusion transcript

90. Which of the following cytogenetic

abnormalities if detected in a solid
haemopoietic neoplasm indicates an indolent
course.
A. 9;22 translocation
B. 8;14 translocation
C. 14;18 translocation
D. 11;14 translocation

91. (A) 8 year old girl with anaemia and

bleeding manifestations. Smear showed large
granular cells with multiple auer rods. (B) 23
year old girl with anaemia and petechial
spots. The bone marrow showed more than
30% blasts , positive for non specific esterase.
Eosinophil constitute 35% of marrow cells. (C)
60 year old man presented with massive
splenomegaly.
The
WBC
count
is
2,20000/cumm. Hb 10. 8gm%. Platelet count
130,000/cumm.
A. Trisomy 8.
B. Inversion 16
C. 9; 22 translocation.
D. 15; 17 translocation.


92. Which of the following combination of
immunological
markers
when
positive
indicates diagnosis of biphenotypic leukemia
A. CD 3 and tdt
B. CD 10 and tdt
C. CD 3 and CD 22
D. CD 13 and MPO (myeloperoxidasE)

93. A 5cm tumour attatched to the wall of the

stomach was removed from a 52 year old man.
The oncologist wants to know if he needs
treatment with GLIVEC(IMATINIB., Positivity
for which marker will be decisive
A. CD 117
B. Cytokines
C. Desmin.
D. Vimentin

94. Which one of the following is not a

criterion for making a diagnosis of chronic
myeloid leukemia in accelerated phase:
A. Blasts 10-19% of WBCs in peripheral blood
B. Basophils 10-19% of WBCs in peripheral blood
C. Increasing spleen size unresponsive to
theraphy
D. Persistent thrombocytosis (>1000 X 109/L.
unresponsive to therapy.

95. CD 19 Positive, CD22 Positive,CD 103

positive Monoclonal B-Cells with bright kappa
positivity were found to comprise 60% of the
peripheral blood lymphoid cells on flow
cytometric analysis in a 55 year old man with
massive splenomegaly and a total leucocyte
count of 3. 3 x 109 /L . Which one of the
following is the most likely diagnosis?
A. Splenic lymphoma with villous lymphocytes.
B. Mantle cell Lymphoma.

C. B-Cell prolymphocytic leukemia.

D. Hairy cell leukemia.

96. A Four year old boy was admitted with a

history of abdominal pain and fever for two
months, maculopapular rash for ten days, and
dry cough dyspnea and wheezing for three
days. On examination, liver and spleen were
enlarged 4cm and 3cm respectively below the
costal margins. His hemoglobin was 10. 0g/dl,
Platelet count 37 x 109/L and total leukocyte
count 70 x 109 / L. which included 80%
eosinophils. Bone Marrow comprising 45%
blasts and 34%. Eosinophils and eosinophilic
precurosors. The blasts staind negative for
myeloperoxidase ans non specific esterase
and were positive for CD19,CD10,CD22 and
CD20. Which one of the following is the most
likely dignosis?
A. Biphhenotypic acute leukemia (Lymphoid and
eosinophil lineage)
B. Acute eosinophilic leukemia
C.
Acute
lymphoblastic
lekemis
with
hypereosinophilic syndrome.
D. Acute myeloid leukemia with eosinophilia

97. A 48 Year old women was admitted with a

history of weakness for two months. On
examination, cervical lymph nodes were
found enlarged and spleen was palpable 2cm
below the costal margin. Her hemoglobin was
10. 5 g/dl, platelei count 237 x 109/L and total
leukocyte count 40 x 109/L, which included
80% Mature lymphoid cells with coarse
clumped chromatin. Bone marrow revealed a
nodular lymphoid infiltrate. The peripherel
blood lymphoid cells were positive for CD 19,
CD5, CD20 and CD23 and were negative for
CD79B and FMC -7. Which one of the following
statements in not true about this disease?

A. Trisomy 12 correlates an aggressive clinical

course.
B. Abnormalities of 13q 14 are associated with
long term survival.
C. Cases with 11q22-23 deletion have excessive
lymphadenopathy.
D. t(11;14) translocation is present in most of the
cases

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