1020

Dec3 Room

INI-CET NOV ..2023 RECALL

PATHOLOGY
 Bone marrow aspirate
needles
Salah Needle

Klima
EMA
Needle
malemide
Eosin 5

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Q) A 43-year-old Caucasian female complaining of reduced energy and fatigue is
TMEBoxind
found to have hypochromic, microcytic anemia. Her past medical history is
significant for stable angina treated with metoprolol and aspirin. Iron
Do stain with
supplementation is prescribed. Several weeks later, a peripheral blood smear
demonstrates numerous enlarged red blood cells taking a positive
supravital stains. The bluish color of these red blood cells is best explained by the
presence of which of the following?
a) Hemoglobin precipitates
b) Nuclear membranes
c) Ribosomal RNA
d) Histones ROD
Sen PF
sys
Heng
sixth
Q. A 32-year-old female presents for a routine physical examination. Her CBC
shows the following:
Hb 9 g/dL, MCV 72, RBC 6.4, RDW 12.8%. What is the most likely diagnosis?
a. Iron - deficiency anemia
b. Thalassemia
c. Megaloblastic anemia
d. Autoimmune hemolytic anemia

l
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A 5-year-old child was bought to the outpatient department by his mother with the
complaint of inactivity and difficulty in weight gain. On history taking, it was found
that they have a relative with some “blood illness”. On physical examination, the
child is underweight for his age, and pallor is positive on the skin, arms and

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conjunctiva. The doctor ordered Hb electrophoresis, and HBA2 was found positive.
What is the diagnosis? DE SCREW
a. Beta thalassemia trait
b. Sickle cell anaemia
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7
c. Hereditary spherocytosis
d. G6PD deficiency
long
SCREW

Hi psis
TBIA CHILD
Thalassemia

EP
● Nestroft test
N
E
S
T
R
O
F
Q. Based on the iron profile what is the most likely diagnosis?
Serum iron decreased, ferritin decreased, transferrin saturation decreased,

O
TIBC increased?
Iron - deficiency anemia

D
a.

O
b. Thalassemia
c. Sideroblastic anemia RETICULUM
d. AOCD
of
rRN

RETI Woo TE
SINESUPRAVITIAL STAIN DIEGEL
New Methylene Blue
Brilliant Cresyl Blue
A 49-year-old woman known case of rheumatoid arthritis presented to the emergency
MICROCYTIC S
department with complaints of exertional shortness of breath, malaise, A
and easy L
42
fatigability for the past three months. Complete blood counts revealed haemoglobin:
7.7 gm/dL, mean corpuscular volume (MCV): 5139 fL, mean80
78MCV 100ft
corpuscular haemoglobin
(MCH):23 pg, total white cell count: 9.0 × 10 9MCH 27
/L, and platelet 32
count: 227 × 10 9/L.

pg
Serum iron is reduced and serum ferritin increased. What is the most probable
diagnosis?
garoyts ME 33 37
gldl
a. Iron deficiency anaemia RDW 11.5 14 5
alESSemia
45133 IE
b. Anaemia of chronic disease
c. MENTZER INDEX
Thalassemia minor
d. Lead poisoning 11.25
1,3 174
Thalassemia
Confirm HPLC
Hb A2 3 5
ANEMIA FEATURES
MICROCYTIC S I T A L
HYPOCHROMIC

Feature

Serum Iron
IDA

HPLC HBA
P
Anemia of chronic
disease

a
SIDEROBLASTIC

3.5
ANEMIA

Transferrin
Saturation

Ferritin

TIBC
Total iron binding
capacity
Anemia Of Chronic Disease
seeing
AKED Blood t 0 31 NO
YE
INGIE That Tough
OBE
ed cell I OF
emici
smote
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agility
t lines
bent
An 11-year-old boy presents in the outpatient department with a complaint of
fatigue and weakness for 3 months; it is also associated with breathlessness while
walking and running. On history taking, the patient told the doctor that he is a
vegetarian and doesn't eat meat or eggs. On physical examination, pallor is noted
on palms, skin and conjunctiva. Image of the patient is also shown below. Which of
the following features are the characteristics of the type of anaemia the boy is
suffering from?
a. Heinz bodies
b. Hypersegmented neutrophils
c. Normal thrombocytes and leukocytes
d. Low serum ferritin
 ANEMIA FEATURES

Hypersegmented Neutrophil

Howell jolly body

Ict Ronk
disease
Composition? Cabot ring

Seen in?
 A patient shows blood reports with decreased vitamin B12 and folic acid.
Based on the above profile which of the following peripheral smear
findings best correspond to the same?

I II fId his
KononYCHA D
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Tans
t t t

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storage
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FRA j
HIJACK

PIG
 Q. A 10-year-old Afro-American boy presents to the emergency department. On
physical examination, the patient has hepatosplenomegaly and skull X-ray
as shown below. Laboratory findings show reduced hemoglobin, elevated
lactate dehydrogenase (LDH), and red blood cells as observed in the
peripheral blood smear given below. Which of the following is the most
appropriate initial treatment for this patient?
a. Hydroxyurea therapy
b. Fresh blood transfusion B12
c. Phosphodiesterase-5 inhibitors
Knuckle Pign
d. Monoclonal antibody therapy

000
Veg I Biz
 lo bl 1312 FA D NEUROLOGICAL
Mega 55
Pgm B12 I
PKNUCKLE ACRoa

O
O Y N
O
i
f
o
single 8
DNA REMNANTS
An
Megaloblastic
Post splenectomy
27 year old primigravida shows the following blood
picture on peripheral smear analysis. How will you
investigate the patient further?

E Ans
O
a. Osmotic fragility testing- hereditary spherocytosis

0 8
ya
b. Coombs tests- AIHA
c. G6PD testing- ELISA
DO
d. Flow cytometry- PNH 91kg
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I of CBITEC.EU
16 year old boy presents with jaundice and splenomegaly.
There is a history similar complaints in the elder
Degmacyt GGPD SIEEs
brother as well as mother indicating an autosomal
GHEIIZ
dominant inheritance in the family. The following blood
BODIES
picture is seen on peripheral smear analysis. How will you
Drepanocyte
investigate the patient further?
 HEREDITARY SPHEROCYTOSIS

ORoman sty O
TO O
G6PD deficiency
ECHINOLYTE
BURR cell
spurt

IT
I ACANTHOCYTE
betalipoprot
Targetcells
Iorns hernia y
That
Q. A 24-year-old caucasian woman presented to her primary care physician for
evaluation of new coffee - coloured urine noticed intermittently over the past five
days. Her last menstrual cycle was two weeks ago, and they have been occurring
regularly. There is no history of fever, melena, or hemoptysis. Her vital signs were
unremarkable. On initial evaluation, CBC, urinalysis, and renal ultrasound were

0
normal and urine pregnancy test was negative. A few days later, she developed
jaundice with abdominal pain. Repeat testing at that time showed the following: WBC
PHDF
EFFIE
count 3600/mm3, hemoglobin 4g/dl, platelet count 189,000/mm3, MCV 75 fl, RDW 28,
reticulocyte count 10.9 %, total serum bilirubin 7.5 mg/dl, indirect bilirubin 5.5 mg/dl.
The urinalysis showed hemoglobinuria. Flow cytometry of peripheral blood showed
affinity
Iq
absent expression of CD55 and CD59 on 78% of red blood cells. Based on the flow
X sickle cell
cytometry results, what do you think is most appropriate drug to use in this condition
a. Rituximab
b. Alemtuzumab
c. Eculizumab

go
d. Mepolizumab
CASE OF RED COLOR URINE
PASSED AT NIGHT?
DISEASE ? DEFECT?

DIAGNOSTIC TEST?
CREW WT

SICKLE CELL
 TESTS GCA
Hb electrophoresis
node
20444yd
Hb
Hbs cathode
If A

c
Iz
AAA HbAs
Hbs
SCT SCA
 CHAPTER- WBC
__________________
3-5 nuclear lobes M Cle AIKA
at
__________________
SPHEROCYTEI
ppg

fog
__________________
Kidney shaped
nucleus
__________________
Orange granules
Spectacle nucleus

__________________
Blue black granules
Q) A 5-year-old boy presents with a 1 month history of loss of
SPHEROCYTE
appetite, fatigability , unexplained irritability ,and intermittent low-
grade fever. The patient’s mother says he also often has bone pain,
especially in his lower limbs. Physical examination is significant for
the presence of generalized pallor, splenomegaly and generalized
lymphadenopathy.
Laboratory findings are significant for a hemoglobulin of 8.0 g/dL, a
total white blood cell count 21,900/mm3, and a platelet count of
90,000/mm3. Bone marrow biopsy is performed which demonstrates
30% of the bone marrow cells as a homogenous population of
lymphoblasts. Which of the following chromosomal abnormalities is
most commonly associated with in this patient?
a) Trisomy 4

Ig
b) Trisomy 10
c) Hyperdiploidy
d) t(9;22)
 t
I Ife mutation ANKYR

BITE DEGMACYTE
O Degree
I
I
stain on
CRYSTALVIOLET
Q) A 15-year-old boy presented with one boy history of bleeding gums,
subconjunctival bleed and purpuric rash. Investigation revealed the
following results.
Hb-6.4gm/dL; TLC-26,500/mm3, Platelet 35000 mm3; Prothrombin time -20

I
sec with a control of 13sec, partial thromboplastin time-50 sec.
Peripheral smears was suggestive of acute myeloblastic leukemia. Which of
the following is the most likely?
a) AML M2
b) AML M3
c) AML M4
d) AML M5
Hemolytic Anemia
D PIE
 PIGA defect CDE
P H gene

Flowtcytometry CDE

ELAER
Compilations 8D pm
3
Apfgsthmia Leukemia
THRIMBOTIC
R ECU LIZUMIB
 E

O 8
M MONOCYTE
Q) 45 year old patient complained of fatigue as well as dragging sensation
I Neutrophils steiney
in abdomen. Examination revealed massive splenomegaly. His blood work
up shows Hb- 6gm, TLC 1,75,000/mm3 and peripheral smear shows
Ifnegalob
hyperleukocytosis with shift to left. BM examination tgatnand
shows myeloblasts,
myelocytes, metamyelocytes, neutrophils and basophils. WhichE of the
following is the most likely diagnosis?
Lymphocyte

a) ALL
Monocytt Malaria
b) AMLD
c) CML
d) CLLA Eosinophils Allergy
parasitic

Basophils
J PC
 ALL
Q) 40 year old patient presents with cervical and inguinal
I
lymphadenopathy. He is also complaining of cough and significant
BAE
weightloss since the past 4 months. Excision biopsy of the cervical lymph
node reveals large atypical cells, with mirror image nuclei showing owl
eye appearance against a mixed background of eosinophils6 and plasma Eve
I for CD15, CD30. which of the following isCNs
cells. The large cells are positive

f
the most likely diagnosis?
A) HL- MIXED CELLULARITY BTested
medias t

B)HL- NODULAR SCLEROSIS

Lymphoblasti201P
C) HL – LYMPHOCYTE RICH
D)NLPHL

ILL
Acute leak 7201
HL RS CELL
CLASSICAL HL CD15,30, PAX5
NODULAR SCLEROSIS LACUNAR CELLS
1 I X
(most common world)
MIXED CELLULARITY CLASSICAL RS
(most common india) CELLS
LYMPHOCYTE RICH MONONUCLEAR
201 All
Myeloblast A CELL
Lymphoblast
1 AUER RODS
LYMPHOCYTE DEPLETED MUMMIFIED RS
CELL
E STAIN
Rods
AML
NON CLASSICAL HL
NODULAR LYMPHOCYTE POPCORN RS
PREDOMINANT CELL PAST
HODGKINS LYMPHOMA BLOCKT DOTT
Q. MOST SPECIFIC MARKER OF RS CELL?
a) CD15
b) CD45
C) CD30 D I T
d) PAX5

I
Q. LACUNAR CELLS ARE SEEN IN ? Plt count 1 5 4.5 lac mms
a) NODULAR SCLEROSIS
b) MIXED CELLULARITY M PT 11 16 S
c) LYMPHOCYTE RICH
M A PTT 30 405
d)

me
I
LYMPHOCYTE DEPLETED

Tissue Hee
5
 MIC Leukemia I overAI
Down's Sx ALL

1 I
Amy
G Byrs
TI Mz 15 17
PML RARA fusion I
onylenedicCW
Trioxide
R ATRA
all trans retinoic dysgenic
Q) Which of the following is false with respect to amyloid
1) has properties of starch

Smudhecel a
2) beta pleated sheet configuration on electron microscopy
3) diameter 7.5-10nm on electron microscopy
4) stains salmon pink with Congo red on light microscopy

Options
A)Convent
1,4
school CLI
B) 1,3,4
C) 1 only girl
8992
D) 2 only
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Party
TLC 4000 11000 College Girl

mate
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Q. A 32-year-old female presents to the rheumatology clinic with complaints of
TfL
joint pain, fatigue, and a butterfly-shaped rash on her face. She also
149.22
mentions experiencing hair loss and mouth ulcers. On examination, she has
Qe 0 hands and wrists. Laboratory
tender and swollen joints, particularly in the
Bereafusion
investigations reveal the presence of antinuclear antibodies (ANA) and anti-
histone antibodies. The physician suspects an autoimmune disorder and
decides to further investigate the underlying pathophysiology. Which of the
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following drugs is most likely associated with the patient's condition?

a. Sulfonamides
Ied
b. Third generation cephalosporins
c. Treen
Amoxiclav
d. Chemotherapeutic drug therapy O
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SLE
Most sensitive
Jan 23
Most specific
9 Rs owl
Both sensitive and specific eye
Neonatal lupus
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yo
Drug induced lupus

S H I PWORST
DRUGS
It WE
I Roanosis

E3
IN Linc Fet
Prog
 PYG

NUCLEOLAR
HOMOGENOUS PERIPHERAL/ RIM
O_O

SPECKLED
CENTROMERIC
 PYD
Q. A 10-year-old male presents with a history of recurrent infections, easy
TURKI
bruising, and light sensitivity. On physical examination, he is noted to have
fair skin, light-colored hair, and nystagmus. Laboratory investigations reveal
prolonged bleeding time and the presence of large, coarse cytoplasmic
8 blood
granules in peripheral even cells. Genetic testing confirms a mutation in
ok
the LYST gene. Which of the following normal cellular processes is most
likely defective in this patient?
8
a. Endocytosis 22
BURKITT's
b.
t 8 21 AML
Phagosome-lysosome fusion
Ma
c. Rolling and adhesion
d. Apoptosis
D
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PSGN
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 Disease Defect Clinical features
LEUKOCYTE ADHESION Beta 2
DEFECT 1
Integrin
LEUKOCYTE ADHESION Sialyl
DEFECT 2
Lewis X

BRUTON’S HYPO- BOYS

GAMMAGLOBULINEMI B CELL DEFECT
A BTK GENE DEFECT

CHEDIAK HIGASHI LYST GENE DEFECT

SYNDROME

CHRONIC NADPH OXIDASE

GRANULOMATOUS
DISEASE
Q. A 5-year-old child presents with a high fever, cough, coryza, and
conjunctivitis. A few days later, the child develops a maculopapular rash
that starts on the face and spreads to the trunk and extremities. Laboratory
investigations show lymphopenia and elevated levels of measles-specific
IgM antibodies. A biopsy of the skin lesion is performed, and histological
examination reveals the following findings:
Which type of multinucleated giant cells is most likely seen in the skin
biopsy?

a. Langhans giant cells

b. Reed-Sternberg cells
c. Warthin-Finkeldey giant cells
d. Touton giant cells
 GIANT CELL

LANGHANS GC HORSE SHOE SHAPED nuclei

TOUTON GC WREATH LIKE nuclei

WARTHIN INCLUSIONS
FINKELDEY GC
t
Q. A 25-year-old male presents to the clinic with concerns about his physical
appearance and fertility. On examination, he is found to have tall stature,

O
long limbs, gynecomastia (enlarged breasts), and reduced body hair. He
mentions that he has always struggled with learning and has experienced
difficulties in school. To further evaluate his condition, a karyotyping test is
performed, and the following image is obtained:
Based on the provided karyotyping image, which of the following genetic
abnormalities is most likely present in this patient?

stare
a. Down syndrome
b. Turner syndrome
STAIN Congo
c. Klinefelter
Y
Red
syndrome
AMYLOID XY KIDNEY
d. EdwardsApple Green PolMicroscopy
syndrome

Salmon Pink HM
HM 7 5 10 n m DiameERML
p pleated X Ray crystallography
Diagnosis Of Genetic Disorders

ÉiA
Karyotyping EEEvic
J
BRONCHITIS

I Acal calcitonin
ATTR Quantity't age't't
D ATTR mutation quantPA
IBRAIN AB B plaque
G I
banding
Q
bandingignition
Q. A 25-year-old male presents with tall stature, long limbs, and hypermobility of joints. He also
has a family history of similar features, with his father and younger sister also exhibiting
similar physical characteristics. Echocardiography reveals aortic root dilatation. Which
pattern of inheritance is most likely associated with the observed features in this patient
and his family?

a. c.

DRM

b. d.
III
Rules
● Autosomal dominant - No Gender bias, ALL Generations affected (AT LEAST ONE
PARENT HAS TO BE AFFECTED)

CA SLED
● MALAR
Autosomal recessive - No Gender RASHskipped
bias, Generations

● X linked recessive - Usually Males affected, Females carrier

● X linked dominant - Dad to ALL daughters, Mother to 50% offsprings
● Y linked - Father to ALL sons

● Mitochondrial inheritance - Mother to all, Father to none

O
Anti nuclear Ab ANA
anti Smith Ab ASA
images
7 anti dsDNA Ab DOUBLE
O Rona anti Ro Ab
ANTI HISTONE Ab
Replace
deng
I Hdralazined Iapsone
1 Procainamide
sulfonamides INH
 ANA
CHEF881
O n
I I
00
Usually MALE diseased
FEMALES carrier

O 0

Is
Q. What is the storage temperature and shelf life of Fresh Frozen Plasma (FFP)?

a. Storage temperature: 4°C; Shelf life: 35 days

b. Storage temperature: -30°C; Shelf life: 1 year
c. Storage temperature: 20-24°C; Shelf life: 5 days
d. Storage temperature: Varies; Shelf life: Not applicable
 Component Temperature Shelf life

Whole blood/ PRBC

at
8,0 9
Albinismisilverygrayd
IIT gene PRP
CHEOPlatelet rich plasma HIGASHI Sx
1 ÉemonnageBIminity
I
FFP
nystagmus
Fresh frozen plasma
 Delayed Umb
o I cordedding
s
g infections
A Ago
y Bo ay ating Abt
Edo
Defective
If god IIgesptIgf opsonisan

MII enzforphago
I PHOX