Advanced Clinical Pathology

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. All are conditions causing macrocytic anaemia EXCEPT

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

4. Burr cells are

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

5. All are romanowsky stains except

A. Leishmann
B. Jenner’s
C. Giemsa
D. Wrights
E. Mason fontanna

6. Thalassemia’s are due to

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

7. Following complications can occur in the course of sickle cell anaemia

A. Haemolytic crisis
B. Sequestration crisis
C. Aplastic crisis
D. All of the above

8. Of this which is a milder disease

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

9. All of the following conditions are characterised by a high ESR, except

A. Multiple myeloma
B. Rheumatic fever
C. Tuberculosis infection
D. Sickle cell anaemia

10. Reticulocytosis is not seen with

 Advanced Clinical Pathology

A. Hereditary spherocytosis
B. Following acute bleeding
C. Paroxysmal nocturnal hbnuria
D. Anaemia of Chronic Renal Failure

11. 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

12. Earliest sign of megaloblastic anaemia

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

13. 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

14. At what stage of erythropoeisis does Hb appears

A. Early normo blast
B. Intermediate normo blast
C. Reticulocyte
D. Erythroblast

15. Routine fixative used in biopsy

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

16. Which ONE of these statements is TRUE regarding normal adult bone marrow?

a. It is composed of 90% haemopoietic cells, 10% fat (Normal is 50 : 50.)

b. It has a myeloid : erythroid ratio of 1 : 2 (Normal myeloid : erythroid ratio 2 : 1 or greater
c. It is present in adults in the skull
d. It secretes erythropoietin

17. Which ONE of these is NOT TRUE concerning the haemopoietic stem cell

a. It is believed to represent approximately 1% of bone marrow cells

b. It is thought to have a CD34+CD38- phenotype
c. It resembles a small to medium sized lymphocyte
d. It is effectively transferred during stem cell transplantation

18. Which ONE of the following is NOT a significant component of bone marrow stroma

a. Endothelial cells
b. Adipocytes
c. Fibroblasts
d. Epithelial cells

19. Which ONE of these statements is TRUE about haemoglobin?

 Advanced Clinical Pathology

a. One molecule contains 1 atom of iron

b. It is broken down in macrophages
c. It is different in children and adults
d. It has a low level in blood at birth compared with adult life

20. Which ONE of these statements is TRUE about reticulocytes?

a. They contain DNA not RNA

b. They are raised in megaloblastic anaemia

c. They are raised 12 months after splenectomy

d. They are raised after haemorrhage

21. Which ONE of these statements is NOT TRUE concerning erythropoietin?

a. 90% of the hormone is made in the liver

b. It contains a hypoxia response gene

c. One stimulus to production is a low atmospheric oxygen level

d. Levels in blood are high if a tumour secreting erythropoietin is causing polycythaemia but are low in severe
renal disease or polycythaemia vera

22. Which ONE of these statements is NOT TRUE concerning the biochemistry of haemoglobin?

a. As the haemoglobin molecule loads and unloads O2 the individual globin chains in the haemoglobin
molecule move on each other

b. Hb is 70% saturated in arterial blood

c. When O2 is unloaded the β chains are pulled apart, permitting entry of the metabolite 2,3‐
diphosphoglycerate (2,3‐DPG) and resulting in a lower affinity of the molecule for O 2
d. The P50 (i.e. the partial pressure of O2 at which haemoglobin is half saturated with O2) of normal blood is
26.6 mmHg

23. Which ONE of these conditions is described by this phrase? ‘A clinical state in which circulating
haemoglobin is present with iron in the oxidized (Fe3+) instead of the usual Fe2+ state.’

a. Methaemalbuminuria

b. Methaemoglobinaemia

c. Congenital dyserythropoietic anaemia

d. Glucose‐6‐phosphate dehydrogenase deficiency

24. Which is not a type of granulocyte?

a. Eosinophils

b. Basophils
 Advanced Clinical Pathology

c. Neutrophil

d. Monophils

Q.1 Write down the importance of Polycythemia with reference to PCV.

Q.2 write down five possible normal and abnormal types of hemoglobin a patient can have.