Patho of Hema Q&a

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Patho of hema
Descriptive (435 Questions)
Q1. What is Polycythemia?
Ans: Polycythemia, or erythrocytosis, is an increase in the blood concentration of red

cells, which usually correlates with an increase in the hemoglobin concentration. It
can be either relative, caused by a decrease in plasma volume, or absolute, when
there is an increase in the total red cell mass.
Q2. What is Hereditary Spherocytosis?
Ans: Hereditary Spherocytosis is an inherited (intrinsic) defect in the red cell

membrane that renders the cells spheroidal, less deformable, and vulnerable to
splenic sequestration and destruction. It is an autosomal dominant trait, and is
usually associated with anemia, splenomegaly, and jaundice.
Q3. What is small lymphocytic lymphoma/chronic lymphocytic leukemia?
Ans: Small lymphocytic lymphoma/chronic lymphocytic leukemia is a type of

lymphoid neoplasm which is morphologically, phenotypically, and genotypically
identical. It is characterized by an absolute lymphocytosis of small, mature-looking
lymphocytes, and is usually asymptomatic at presentation.
Q4. What are the common hemolytic anemia?
Ans: Common hemolytic anemias include Hereditary Spherocytosis and Sickle Cell
Anemia.
Q5. What is Hematopoietic Disorders?
Ans: Hematopoietic Disorders is a disorder that affects the production of blood cells,
which can lead to anemia, polycythemia, or other blood diseases.
Q6. What is acute nonspecific lymphadenitis?
Ans: Acute nonspecific lymphadenitis is a form of lymphadenitis that may be

localized to a group of nodes draining a focal infection, or be generalized in systemic
bacterial or viral infections.
Q7. What is the result of iron deficiency anemia?
Ans: The result of iron deficiency anemia is relatively mild. The red cells are
microcytic and hypochromic. For unclear reasons, iron deficiency is often
accompanied by an increase in the platelet count. Extramedullary hematopoiesis is
uncommon.
Q8. What is pernicious anemia?
Ans: Pernicious anemia is a form of vitamin B12 deficiency resulting from inadequate
gastric production or defective function of intrinsic factor. Symptoms referable to
the alimentary tract are common and often severe, unlike in vitamin B12 deficiency,
neurologic abnormalities do not occur.
Q9. What is Anemia of Blood Loss?
Ans: Anemia of Blood Loss is an anemia caused by excessive bleeding or hemorrhage.

It is usually marked by a normocytic and normochromic anemia, hemodilution, and a
rise in erythropoietin level.
Q10. What is diffuse large B cell lymphoma?
Ans: Diffuse large B cell lymphoma is a type of non-Hodgkin's lymphoma which is

characterized by a B cell phenotype, a diffuse growth pattern, and an aggressive
clinical history. It typically presents with a rapidly enlarging, often symptomatic mass
at one or several sites, and may be associated with Epstein-Barr virus.
Q11. What is Burkitt lymphoma?
Ans: Burkitt lymphoma is a type of non-Hodgkin's lymphoma which is endemic in

some parts of Africa, and sporadic in other areas including the United States. It is
usually seen in children and young adults, and is characterized by extranodal
presentations, aggressive and fatal behavior, and a high grade tumor.
Q12. What is the percentage of childhood NHLs in the United States

associated with EBV?
Ans: Approximately 30% of childhood NHLs in the United States are associated with
EBV.
Q13. What is aplastic anemia?
Ans: Aplastic anemia is a disorder in which multipotent myeloid stem cells are
suppressed, leading to marrow failure and pancytopenia. Causes include Idiopathic,
myelotoxic agents, viral infections, and autoreactive T cells. Splenomegaly is
characteristically absent in aplastic anemia. The red cells are normocytic and
normochromic.
Q14. What is the WHO classification of lymphoid neoplasms?
Ans: The WHO classification of lymphoid neoplasms considers the morphology, cell
of origin (determined in practice by immunophenotyping), clinical features, and
genotype (e.g., karyotype, presence of viral genomes) of each entity, and segregates
them on the basis of origin into three major categories.
Q15. What are the possible etiologies of AML?
Ans: : The possible etiologies of AML include heredity (trisomy 21), radiation
exposure, chemicals (e.g. benzene), and drugs (e.g. alkylating agents).
Q16. What are the three patterns of chronic nonspecific
lymphadenitis?
Ans: The three patterns of chronic nonspecific lymphadenitis are follicular

hyperplasia, paracortical hyperplasia, and sinus histiocytosis.
Q17. What are the morphological changes seen in Sickle Cell Anemia?
Ans: : Morphological changes seen in Sickle Cell Anemia include the presence of
bizarre elongated, spindled, or boat shaped irreversibly sickled red cells in peripheral
smears, moderate splenomegaly caused by congestion of the red pulp, and systemic
hemosiderosis.
Q18. What are the components of the casts found in the myelomatous
nephrosis?
Ans: The casts found in the myelomatous nephrosis consist of Bence Jones proteins,
complete immunoglobulins, Tamm Horsfall protein, and albumin.
Q19. What are the three general categories of myeloid neoplasia?
Ans: The three general categories of myeloid neoplasia are: (1) Acute Myelogenous
Leukemia, (2) Chronic Myeloproliferative Disorders, and (3) Myelodysplastic
Syndromes.
Q20. What is Non-Hodgkin's Lymphoma?
Ans: Non-Hodgkin's Lymphoma (NHL) is a group of malignant tumors of the lymphoid

tissue that originate from B cells, T cells, and natural killer cells. It is characterized by
an uncontrolled proliferation of lymphocytes, and can cause symptoms such as
fatigue, weight loss, and anemia.
Q21. What are the clinical signs and symptoms of acute myelogenous
leukemia?
Ans: The clinical signs and symptoms of acute myelogenous leukemia closely
resemble those produced by ALL and are usually related to marrow failure caused by
the replacement of normal marrow elements by leukemic blasts. These include
fatigue and pallor, abnormal bleeding, and infections. Splenomegaly and
lymphadenopathy are in general less prominent than in ALL.
Q22. How is recovery from blood loss anemia enhanced?
Ans: Recovery from blood loss anemia is enhanced by a rise in the erythropoietin
level, which is marked by reticulocytosis. With chronic blood loss, iron stores are
gradually depleted, which can lead to a chronic anemia of underproduction.
Q23. What are the characteristics of Hodgkin lymphoma?
Ans: Hodgkin lymphoma is characterized by a distinctive group of neoplasms that

arise almost invariably in a single lymph node or chain of lymph nodes and spread
characteristically in a stepwise fashion to the anatomically contiguous nodes. It is
morphologically characterized by the presence of distinctive neoplastic giant cells
called Reed Sternberg (RS) cells, which are admixed with reactive, nonmalignant
inflammatory cells. It is often associated with somewhat distinctive clinical features,
including systemic manifestations such as fever.
Q24. What are the distinctive red staining rodlike structures that
may be found in AML?
Ans: The distinctive red staining rodlike structures found in AML are called Auer rods
and may be present in myeloblasts or more differentiated cells. These are
particularly prevalent in the progranulocytes found in acute promyelocytic leukemia.
Q25. What is the etiology of Hodgkin lymphoma?
Ans: Hodgkin lymphoma is a neoplasm arising from germinal center B cells and the
EBV genome is present in the RS cells in as many as 70% of cases of the mixed
cellularity type and a smaller fraction of the nodular sclerosis type.
Q26. What are the common modes of presentation of NHL in African
patients?
Ans: In African patients, involvement of the maxilla or mandible is the common

mode of presentation of NHL.
Q27. What are the non-neoplastic disorders of white cells?
Ans: Non-neoplastic disorders of white cells include leukopenias and proliferations,

which may be reactive or neoplastic. Leukopenia usually results from a decrease in
granulocytes, while lymphopenias are much less common and are associated with
congenital immunodeficiency diseases or are acquired, such as advanced HIV
infection or treatment with corticosteroids. Neutropenia/Agranulocytosis is
characteristically a reduction in the total white cell count to 1000 cells/L or as few as
200 to 300 cells/L, rendering the person highly susceptible to bacterial and fungal
infections. Reactive leukocytosis is common in a variety of reactive inflammatory
states.
Q28. What is Sickle Cell Anemia?
Ans: Sickle Cell Anemia is a group of hereditary disorders that are defined by the
presence of structurally abnormal hemoglobins. It is caused by a mutation in the
globin chain gene that creates sickle hemoglobin (HbS). It is the most common form
of familial hemolytic anemia and has two major consequences: producing a chronic
extravascular hemolytic anemia and producing widespread microvascular
obstructions.
Q29. What are the pathogenesis and clinical picture of Burkitt

lymphoma?
Ans: : The pathogenesis of Burkitt lymphoma is thought to be associated with

Epstein-Barr virus, and the clinical picture is characterized by median age of 60 years,
rapid enlarging and often symptomatic mass at one or several sites, extranodal
presentations, aggressive and fatal behavior, and a high grade tumor.
Q30. How is red cell indices measured?

Ans: Red cell indices are usually measured through the Mean Cell Volume (MCV),
Mean Cell Hemoglobin (MCH), Mean Cell Hemoglobin Concentration (MCHC), and
Red Cell Distribution Width (RDW).
Q31. What is acute lymphoblastic leukemia (ALL)?
Ans: Acute lymphoblastic leukemia (ALL) is a type of lymphoblastic tumor that is

characterized by an abrupt stormy onset, and symptoms related to depression of
normal marrow function. It is mostly found in children and young adults, and is often
accompanied by anemia, thrombocytopenia, and lymphadenopathy.
Q32. What are the three broad categories of neoplastic

proliferations of white cells?
Ans: The three broad categories of neoplastic proliferations of white cells are tumors
of B cells, tumors of T cells and NK cells, and Hodgkin lymphoma.
Q33. What are the six major variants of the plasma cell dyscrasias?
Ans: The six major variants of the plasma cell dyscrasias are: (1) multiple myeloma,
(2) localized plasmacytoma (solitary myeloma), (3) lymphoplasmacytic lymphoma, (4)
heavy chain disease, (5) primary or immunocyte associated amyloidosis, and (6)
monoclonal gammopathy of undetermined significance.
Q34. What is the classification of anemia based on the underlying

cause?
Ans: Classification of anemia based on the underlying cause includes Anemias of

Blood Loss, Hemolytic Anemia, and Anemia of Diminished Erythropoiesis.
Q35. What are some general features of hemolytic anemias?
Ans: General features of hemolytic anemias include an increased rate of red cell
destruction, a compensatory increase in erythropoiesis that results in reticulocytosis,
and the retention by the body of the products of red cell destruction, including iron.
Q36. What is the common mode of presentation for African patients
with NHLs?
Ans: Involvement of the maxilla or mandible is the common mode of presentation

for African patients with NHLs.
Q37. What are Auer rods?
Ans: Auer rods are distinctive neoplastic giant cells found in Hodgkin Lymphoma that
are admixed with reactive, nonmalignant inflammatory cells.
Q38. What is vitamin B12 deficiency anemia?
Ans: Vitamin B12 deficiency anemia, also known as pernicious anemia, is caused by
inadequate gastric production or defective function of intrinsic factor. It is
characterized by the same symptoms as other anemias, with the additional symptom
of symmetric numbness, tingling, and burning in the feet or hands. It can also cause
a demyelinating disorder involving the peripheral nerves.
Q39. What is the clinical course of Hereditary Spherocytosis?
Ans: The characteristic clinical features of Hereditary Spherocytosis are anemia,

splenomegaly, and jaundice. The anemia is usually moderate in severity and the
clinical course is often stable but may be punctuated by aplastic crises.

lymphadenitis?

Q41. What are the two categories of neutropenia?
Ans: Neutropenia is divided into two categories: inadequate or ineffective

granulopoiesis, and accelerated removal or destruction of neutrophils.
Q42. What is non-Hodgkin's lymphoma?
Ans: Non-Hodgkin's lymphoma (NHL) is a type of cancer that affects the lymphatic
system, which is part of the immune system. It is characterized by an abnormal
proliferation of lymphocytes, a type of white blood cell.
Q43. What are the different types of hemolytic anemias?
Ans: The different types of hemolytic anemias include intravascular hemolysis, which
can result from mechanical trauma or biochemical or physical agents; and
extravascular hemolysis, which takes place largely within the phagocytic cells of the
spleen and liver. Common types of hemolytic anemias include hereditary
spherocytosis and sickle cell anemia.
Q44. What type of cells are found in Myeloid Neoplasms?
Ans: : Myeloid Neoplasms are characterized by monoclonal proliferations of

hematopoietic stem cells that replace normal bone marrow cells.
Q45. What is acute lymphoblastic leukemia?
Ans: Acute lymphoblastic leukemia (ALLs) is a type of cancer that affects the
lymphatic system, and is composed of immature lymphocytes (lymphoblasts). It is
most common in children and young adults, and is usually of pre-B cell origin.
Q46. What is hemosiderosis?
Ans: : Hemosiderosis is the accumulation of iron in the tissues of the body, which
occurs in long-standing cases of hemolytic anemias.
Q47. What is the median age for patients with Acute Myelogenous
Leukemia?
Ans: The median age for patients with Acute Myelogenous Leukemia is 50 years.
Q48. What are the six major variants of the plasma cell dyscrasias?
Ans: The six major variants of the plasma cell dyscrasias are multiple myeloma,
localized plasmacytoma, lymphoplasmacytic lymphoma, heavy chain disease,
primary or immunocyte associated amyloidosis, and monoclonal gammopathy of
undetermined significance.
Q49. What are the three major categories of lymphoid neoplasms?
Ans: The three major categories of lymphoid neoplasms are tumors of B cells, tumors
of T cells and NK cells, and Hodgkin lymphoma.
Q50. What is Hemoglobinopathy?
Ans: Hemoglobinopathy is a group of inherited disorders that are defined by the

presence of structurally abnormal hemoglobins. The most common type of
hemoglobinopathy is sickle cell anemia, which is caused by a mutation in the globin
chain gene that creates sickle hemoglobin (HbS).
Q51. What is erythroid hyperplasia?
Ans: Erythroid hyperplasia is a marked erythroid hyperplasia within the marrow that
is almost invariably associated with hemolytic anemias.
Q52. What is polycythemia?

can be either relative, due to a decrease in plasma volume, or absolute, when there
is an increase in the total red cell mass.
Q53. What are the consequences of sickle cell anemia?
Ans: The two major consequences of sickle cell anemia are producing a chronic
obstructions. These consequences lead to the formation of bizarre elongated,
spindled, or boat-shaped irreversibly sickled red cells, a chronic splenic erythrostasis,
and tissue ischemia and infarction.
Q54. What are the different types of anemia?
Ans: The different types of anemia include anemia of blood loss, hemolytic anemia,
anemia of diminished erythropoiesis, normocytic anemia, microcytic anemia, and
macrocytic anemia.
Q55. What is neutropenia?
Ans: Neutropenia, also known as agranulocytosis, is a type of leukopenia

characterized by a total white blood cell count of 1000 cells/L or fewer, in some
cases as few as 200 to 300 cells/L. It renders individuals extremely susceptible to
bacterial and fungal infections, which can be severe enough to cause death.
Ans: Aplastic anemia is a condition in which multipotent myeloid stem cells are
suppressed, leading to marrow failure and pancytopenia. Causes include idiopathic,
myelotoxic agents, viral infections, autoreactive T cells, and bone marrow
replacement by tumor or inflammatory cells. It is typically characterized by
splenomegaly, normocytic normochromic red cells, and extreme susceptibility to
infections.
Ans: : Burkitt lymphoma is a type of cancer that is endemic in some parts of Africa
and sporadic in other areas, including the United States. It is an aggressive and fatal
high-grade tumor that usually arises at extranodal sites, and is often associated with
Epstein-Barr virus infection.
Q58. What is megaloblastic anemia?

Ans: Megaloblastic anemia is a heterogeneous group of inherited disorders caused
by mutations that decrease the rate of synthesis of or globin chains. It is
characterized by an enlargement of erythroid precursors (megaloblasts) and
abnormally large red cells (macrocytes), as well as granulocyte precursors that
become enlarged (giant metamyelocytes) and yield highly characteristic
hypersegmented neutrophils.
Q59. What is iron deficiency anemia?
Ans: : Iron deficiency anemia is the most common form of nutritional deficiency,
affecting about 10% in developed countries and 25% to 50% in developing countries.
It is caused by a low intake of iron, malabsorption, increased dietary demands, or
chronic blood loss. It is characterized by microcytic and hypochromic red cells, an
increase in the platelet count, and nonspecific manifestations such as weakness and
pallor. It can also cause a neurobehavioral complication called pica.
Q60. What are the common clinical signs and symptoms of Acute
Myelogenous Leukemia?
Ans: The common clinical signs and symptoms of Acute Myelogenous Leukemia are
painless enlargement of the lymph node, unexplained weight loss, pruritus, and
anemia.
Q61. What is reactive leukocytosis?
Ans: Reactive leukocytosis is an increase in white blood cell count that is common in
a variety of reactive inflammatory states caused by microbial and nonmicrobial
stimuli.
Ans: Diffuse large B cell lymphoma is a type of non-Hodgkin's lymphoma that is

characterized by a B cell phenotype, a diffuse growth pattern, and an aggressive
clinical history. It is the most common type of lymphoma in adults, accounting for
approximately 50% of adult NHLs.
Q63. What are the two categories of absolute polycythemia?
Ans: The two categories of absolute polycythemia are primary and secondary.
Primary polycythemia is caused by an abnormal proliferation of myeloid stem cells,
with normal or low erythropoietin levels, while secondary polycythemia is caused by
increased erythropoietin levels due to appropriate lung disease, high altitude living,
cyanotic heart disease, or inappropriate erythropoietin secreting tumors.
Q64. What are the symptoms of acute lymphoblastic leukemia?
Ans: The symptoms of acute lymphoblastic leukemia include fatigue (due mainly to
anemia), fever (reflecting infections resulting from the absence of mature
leukocytes), bone pain and tenderness, generalized lymphadenopathy, splenomegaly,
and hepatomegaly. Additionally, central nervous system manifestations such as
headache, vomiting, and nerve palsies may be present.
Q65. What are the pathophysiological effects of small lymphocytic

lymphoma/chronic lymphocytic leukemia?
Ans: The pathophysiological effects of small lymphocytic lymphoma/chronic

lymphocytic leukemia include neoplastic B cells suppressing the function of normal B
cells, autoantibodies to B cells in some patients, breakdown in immune regulation,
and an absolute lymphocytosis of small, mature looking lymphocytes.
Q66. What is Hematopoiesis?
Ans: Hematopoiesis is the process of forming blood cells in the body. It is the process
by which the body produces all of the different types of blood cells: red blood cells,
white blood cells, and platelets.
Q67. What is the percentage of childhood NHLs in the United States

associated with EBV?
EBV.
Q68. What is reticulocytosis?
Ans: Reticulocytosis is a compensatory increase in erythropoiesis that results in an

increase in red cell production, which is marked by peripheral blood reticulocytosis.
Q69. What is the typical pattern for the spread of Hodgkin Lymphoma?
Ans: Hodgkin Lymphoma typically spreads in a stepwise fashion to the anatomically

contiguous nodes.
Q70. What type of tumors constitute 40% of the adult NHLs in the
United States?
Ans: Follicular lymphoma constitute 40% of the adult NHLs in the United States.
Q71. What is leukopenia?
Ans: Leukopenia is a decrease in white blood cell count. It most commonly results
from a decrease in granulocytes, while lymphopenia is much less common. It can be
associated with congenital immunodeficiency diseases or be acquired, such as
advanced HIV infection or treatment with corticosteroids.
Q72. What are red cell indices?
Ans: Red cell indices are measurements used to assess red blood cell health. They
include mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell
hemoglobin concentration (MCHC), and red cell distribution width (RDW).
Q73. What are the possible etiologies of Acute Myelogenous Leukemia?
Ans: The possible etiologies of Acute Myelogenous Leukemia include heredity

(trisomy 21), radiation exposure, and chemicals like benzene and alkylating agents.
Q74. What is small lymphocytic lymphoma/chronic lymphocytic leukemia?
Ans: Small lymphocytic lymphoma/chronic lymphocytic leukemia (CLL/SLL) is a type

of non-Hodgkin's lymphoma that is morphologically, phenotypically, and
genotypically identical. If the peripheral blood lymphocytosis exceeds 4000
cells/mm3, it is diagnosed as chronic lymphocytic leukemia, and if not, it is
diagnosed as small lymphocytic lymphoma.
Q75. What is acute nonspecific lymphadenitis?
Ans: Acute nonspecific lymphadenitis is a form of lymphadenitis that may be

localized to a group of nodes draining a focal infection, or may be generalized in
systemic bacterial or viral infections.
Q76. What is Multiple Myeloma?
Ans: Multiple Myeloma is a neoplasm arising from germinal center B cells and is
characterized by a clone of B cells that differentiates into plasma cells and secretes a
single complete or partial immunoglobulin. It can be divided into six major variants
including multiple myeloma, localized plasmacytoma (solitary myeloma),
lymphoplasmacytic lymphoma, heavy chain disease, primary or immunocyte
associated amyloidosis, and monoclonal gammopathy of undetermined significance.
Q77. What is the prognosis for Acute Myelogenous Leukemia?
Ans: : The prognosis for Acute Myelogenous Leukemia (AML) depends on the
subtype. Subtypes with genetic aberrations such as t(8;21)(q22;q22); RUNX1/ETO
fusion gene and inv(16)(p13;q22); CBFB/MYH11 fusion gene have favorable
prognosis, whereas subtypes with t(15;17)(q22;11 12); RARA/PML fusion gene and
t(11q23;v); diverse MLL fusion genes have intermediate and poor prognosis,
respectively.
Q78. What is the etiology of Acute Myelogenous Leukemia?
Ans: The etiology of Acute Myelogenous Leukemia (AML) is unknown. However, it

has been associated with a number of factors including heredity (trisomy 21),
radiation exposure, and exposure to chemicals such as benzene and alkylating agents.
Q79. What is the difference between small lymphocytic lymphoma and
chronic lymphocytic leukemia?
Ans: The difference between small lymphocytic lymphoma (SLL) and chronic
lymphocytic leukemia (CLL) is that if the peripheral blood lymphocytosis exceeds
4000 cells/mm3, the patient is diagnosed with chronic lymphocytic leukemia (CLL); if
not, a diagnosis of small lymphocytic lymphoma (SLL) is made.
Q80. What are the causes of iron deficiency anemia?
Ans: Iron deficiency anemia is caused by low intake, malabsorption, increased

demands not met by normal dietary intake during pregnancy and infancy, and
chronic blood loss.
Q81. What are the types of classification of anemia?
Ans: The types of classification of anemia are based on the underlying cause, the
morphology of red cells, and the degree of hemoglobinization. Anemias are classified
based on the underlying cause as anemias of blood loss, hemolytic anemia, and
anemia of diminished erythropoiesis. Based on the morphology of red cells, anemias
are classified as normocytic, microcytic, or macrocytic. Based on the degree of
hemoglobinization, anemias are classified as normochromic or hypochromic.
Ans: Burkitt lymphoma is a type of non-Hodgkin's lymphoma that is endemic in some

parts of Africa and sporadic in other areas, including the United States. It is usually
seen in children and young adults and is associated with the Epstein-Barr virus (EBV).
Q83. What are the clinical features of Burkitt lymphoma?
Ans: : The clinical features of Burkitt lymphoma include an aggressive, high-grade

tumor that typically presents with a rapidly enlarging, often symptomatic mass at
one or several sites. Extranodal presentations are common, such as in the
gastrointestinal tract and brain.
Q84. What are the clinical features of Hodgkin Lymphoma?
Ans: Clinical features of Hodgkin Lymphoma include painless enlargement of the

lymph node, unexplained weight loss, pruritus, and anemia. It typically arises in a
single lymph node or chain of lymph nodes and spreads characteristically in a
stepwise fashion to the anatomically contiguous nodes. It is characterized
morphologically by the presence of distinctive neoplastic giant cells called Reed
Sternberg (RS) cells, which are admixed with reactive, nonmalignant inflammatory
cells. It is often associated with systemic manifestations such as fever.
Ans: Aplastic anemia is a type of marrow failure in which multipotent myeloid stem
cells are suppressed, leading to pancytopenia. It can be caused by idiopathic factors,
myelotoxic agents, viral infections, or autoreactive T cells. The red cells are
normocytic and normochromic and splenomegaly is characteristically absent.
Q86. What is EBV associated Children and young adults accounts for
approximately 30% of childhood NHLs in the United States?
Ans: EBV associated Children and young adults accounts for approximately 30% of
Non-Hodgkin Lymphomas (NHLs) in the United States. It is usually characterized by
involvement of extranodal sites such as maxilla or mandible in African patients and
abdominal tumors involving the bowel, retroperitoneum, and ovaries in North
America.
Q87. What is the cause of Anemia of Blood Loss?
Ans: The cause of Anemia of Blood Loss is excessive bleeding or hemorrhage. It can
be acute or chronic, and the anemia is usually normocytic and normochromic.

lymphadenitis?

Q89. What is Follicular Lymphoma?
Ans: Follicular Lymphoma is a relatively common tumor that constitutes 40% of the
adult NHLs in the United States. It is characterized by effacement of the lymph nodes
by proliferations that usually have a distinctly nodular appearance. The tumor cells
resemble normal follicular center B cells and can transform to Diffuse Large B-Cell
Lymphoma (DLBCL).
Q90. What are the clinical signs and symptoms of Acute Myelogenous
Leukemia?
Ans: Clinical signs and symptoms of Acute Myelogenous Leukemia (AML) closely
resemble those produced by Acute Lymphoblastic Leukemia (ALL). They usually
related to marrow failure caused by the replacement of normal marrow elements by
leukemic blasts and include fatigue and pallor, abnormal bleeding, and infections.
Q91. What are the red cell indices?
Ans: The red cell indices are mean cell volume (MCV), mean cell hemoglobin (MCH),
mean cell hemoglobin concentration (MCHC), and red cell distribution width (RDW).
Q92. What is the clinical course of aplastic anemia?
Ans: : The clinical course of aplastic anemia is characterized by normocytic and

normochromic red cells, splenomegaly is characteristically absent, and bone marrow
transplantation is an effective form of therapy.
Q93. What is leukopenia?
Ans: Leukopenia is a decrease in the number of white blood cells in the blood. It is
most commonly caused by a decrease in granulocytes, and can be caused by
inadequate or ineffective granulopoiesis or accelerated removal or destruction of
neutrophils.
Q94. What are the three broad categories of neoplastic
proliferations of white cells?
Ans: The three broad categories of neoplastic proliferations of white cells are tumors
of B cells, tumors of T cells and NK cells, and Hodgkin lymphoma.
Q95. What are the morphologic alterations in red cells in iron

deficiency anemia?
Ans: The red cells in iron deficiency anemia are microcytic and hypochromic and
there is often an increase in the platelet count. Extramedullary hematopoiesis is
uncommon.
Q96. How is Acute Myelogenous Leukemia diagnosed?
Ans: Acute Myelogenous Leukemia (AML) is diagnosed by determining the

percentage of myeloid blasts or promyelocytes in the bone marrow cellularity.
Myeloblasts (precursors of granulocytes) have delicate nuclear chromatin, three to
five nucleoli, and fine, azurophilic granules in the cytoplasm. Auer rods may also be
present.
Q97. What is the difference between intravascular and extravascular

hemolysis?
Ans: Intravascular hemolysis is the destruction of red cells within the vascular
compartment, and is caused by mechanical trauma or biochemical or physical agents
which damage the red cell membrane. Extravascular hemolysis is the more common
mode of red cell destruction, and takes place largely within the phagocytic cells of
the spleen and liver.
Q98. What is the median age of Acute Myelogenous Leukemia?
Ans: The median age of Acute Myelogenous Leukemia (AML) is 50 years.
Q99. What are the three major consequences of sickle cell anemia?
Ans: The three major consequences of sickle cell anemia are producing a chronic
extravascular hemolytic anemia, producing widespread microvascular obstructions,
and an increase in the breakdown of heme pigments which are processed into
bilirubin.
Ans: Hematopoietic Disorders is the process of formation of blood cells in the body.
It is a process in which hematopoietic stem cells in the bone marrow generate all
types of blood cells.
Ans: Auer rods are distinctive red staining rodlike structures that may be present in
myeloblasts or more differentiated cells in Acute Myelogenous Leukemia (AML).
They are particularly prevalent in the progranulocytes found in acute promyelocytic
leukemia and are a helpful diagnostic clue when present.
Ans: Acute lymphoblastic leukemia (ALLs) is a type of aggressive tumor composed of

immature lymphocytes (lymphoblasts) which occurs predominantly in children and
young adults. It usually takes on the clinical appearance of an acute lymphoblastic
leukemia (ALL) at some time during its course.
Ans: The symptoms of acute lymphoblastic leukemia include fatigue (due mainly to
leukocytes), and bleeding (petechiae, ecchymoses, epistaxis, gum bleeding)
secondary to thrombocytopenia, bone pain and tenderness, generalized
lymphadenopathy, splenomegaly, and hepatomegaly, and central nervous system
manifestations such as headache, vomiting, and nerve palsies resulting from
meningeal spread.

Ans: Reactive leukocytosis is an increase in white blood cells in response to a variety
of reactive inflammatory states caused by microbial and nonmicrobial stimuli.
Q105. What is the most common form of familial hemolytic anemia?
Ans: The most common form of familial hemolytic anemia is Sickle Cell Anemia.
Q106. What is lymphadenopathy?
Ans: Lymphadenopathy is an immune response against foreign antigens, often

associated with enlargement of the lymph nodes.
Ans: Pernicious anemia is used to describe vitamin B12 deficiency resulting from
inadequate gastric production or defective function of intrinsic factor. It is caused by
long standing malabsorption, and an autoimmune reaction against parietal cells and
intrinsic factor itself.

can be relative, caused by a decrease in plasma volume, or absolute, when there is
an increase in the total red cell mass.
Ans: Diffuse large B cell lymphoma is a type of non-Hodgkin's lymphoma that

accounts for approximately 50% of adult NHLs. It is characterized by a diffuse growth
pattern, B cell phenotype, and aggressive clinical history.
Q110. What is the normal life span of red cells?

Ans: The normal life span of red cells is approximately 120 days.
Q111. What is non-neoplastic disorder of white cells?
Ans: Non-neoplastic disorders of white cells include deficiencies and leukopenias,

which can be caused by inadequate or ineffective granulopoiesis or accelerated
removal or destruction of neutrophils.
Q112. What are the pathophysiological changes associated with small

lymphocytic lymphoma/chronic lymphocytic leukemia?
Ans: The pathophysiological changes associated with small lymphocytic

lymphoma/chronic lymphocytic leukemia include neoplastic B cells suppressing the
function of normal B cells, autoantibodies to B cells (in 15% of patients), breakdown
in immune regulation, and an absolute lymphocytosis of small, mature-looking
lymphocytes.
Ans: Megaloblastic anemia is a heterogeneous group of inherited disorders caused

by mutations that decrease the rate of synthesis of or globin chains. The
morphologic hallmark of megaloblastic anemias is an enlargement of erythroid
precursors (megaloblasts), which gives rise to abnormally large red cells
(macrocytes).granulocyte precursors are enlarged (giant metamyelocytes) and yield
highly characteristic hypersegmented neutrophils.
Q114. How is Sickle Cell Anemia caused?
Ans: : Sickle Cell Anemia is caused by a mutation in the globin chain gene that
creates sickle hemoglobin (HbS). It is caused by a single amino acid substitution in
the globin chain, with valine replacing glutamic acid at the sixth position of the chain.
Q115. What are the common features of hemolytic anemias?

Ans: The common features of hemolytic anemias are an increased rate of red cell
destruction, a compensatory increase in erythropoiesis resulting in reticulocytosis,
and the retention of the products of red cell destruction, including iron.
Q116. What is the pathogenesis of diffuse large B cell lymphoma?
Ans: : The pathogenesis of diffuse large B cell lymphoma is often associated with
Epstein-Barr virus (EBV) and is implicated in the pathogenesis of diffuse large B cell
lymphomas that arise in the setting of acquired immunodeficiency syndrome (AIDS)
and iatrogenic immunosuppression (e.g., in transplant patients).
Ans: The symptoms of acute lymphoblastic leukemia include fatigue (due to anemia),
fever (due to the absence of mature leukocytes), bone pain and tenderness,
generalized lymphadenopathy, splenomegaly, hepatomegaly, headache, vomiting,
nerve palsies, petechiae, ecchymoses, epistaxis, and gum bleeding.
Ans: Acute lymphoblastic leukemia (ALL) is a type of aggressive tumor which is

composed of immature lymphocytes (lymphoblasts) and is most common in children
and young adults.

lymphadenitis?

Q120. What are the common hemolytic anemias?
Ans: The common hemolytic anemias include Hereditary Spherocytosis and Sickle
Cell Anemia. Hereditary Spherocytosis is an inherited disorder of the red cell
membrane which renders the cells spheroidal, less deformable, and vulnerable to
splenic sequestration and destruction. Sickle Cell Anemia is caused by a mutation in
the globin chain gene that creates sickle hemoglobin (HbS).
Q121. What is the major subtype of AML in the WHO Classification?
Ans: The major subtype of AML in the WHO Classification is AML with genetic
aberrations, which includes AML with t(8;21)(q22;q22); RUNX1/ETO fusion gene,
AML with inv(16)(p13;q22); CBFB/MYH11 fusion gene, AML with t(15;17)(q22;11 12);
RARA/PML fusion gene, AML with t(11q23;v); diverse MLL fusion genes, and AML
with normal cytogenetics and mutated NPM.
Q122. What are the distinctive features of Acute Myelogenous

Leukemia?
Ans: The distinctive features of Acute Myelogenous Leukemia include the presence
of distinctive red staining rodlike structures (Auer rods) which may be present in
myeloblasts or more differentiated cells, and are particularly prevalent in the
progranulocytes found in acute promyelocytic leukemia. By definition, in AML
myeloid blasts or promyelocytes make up more than 20% of the bone marrow
cellularity.
Ans: Diffuse large B cell lymphoma is a type of aggressive NHL which is composed of
neoplastic B cells with large nuclei, dispersed chromatin, several distinct nucleoli,
and modest amounts of pale cytoplasm. It is the most common type of lymphoma in
adults and is often associated with Epstein-Barr virus (EBV).
Q125. What are the general features of hemolytic anemias?

Ans: The general features of hemolytic anemias include an increased rate of red cell
and the retention by the body of the products of red cell destruction (including iron).
Q126. What are the clinical features of Burkitt lymphoma?
Ans: The clinical features of Burkitt lymphoma include a rapidly enlarging, often
symptomatic mass at one or several sites, aggressive and fatal behavior, and
extranodal presentations. It is endemic in some parts of Africa and sporadic in other
areas, and is most commonly seen in children and young adults.
approximately 30% of childhood NHLs in the United States?
childhood NHLs in the United States. These are B cell lymphomas which involve the
maxilla or mandible in African patients, and abdominal tumors involving the bowel,
retroperitoneum, and ovaries in North American patients.
Q128. What is the clinical course of vitamin B12 deficiency anemia?
Ans: : The clinical course of vitamin B12 deficiency anemia is similar to other causes
of anemia. The spinal cord disease begins with symmetric numbness, tingling, and
burning in feet or hands, followed by unsteadiness of gait and loss of position sense,
particularly in the toes.
Q129. What are the causes of neutropenia/agranulocytosis?
Ans: The causes of neutropenia/agranulocytosis can be broadly divided into two

categories: inadequate or ineffective granulopoiesis and accelerated removal or
destruction of neutrophils.
Q130. What are the two principal causes of megaloblastic anemia?
Ans: The two principal causes of megaloblastic anemia are folate deficiency and
vitamin B12 deficiency.
Leukemia?
Ans: The clinical signs and symptoms of Acute Myelogenous Leukemia closely
the replacement of normal marrow elements by leukemic blasts. These can include
fatigue and pallor, abnormal bleeding, and infections.
Q132. What are the two major consequences of sickling of red cells?
Ans: The two major consequences of sickling of red cells are producing a chronic
obstructions.
Q133. What is Hodgkin Lymphoma?
Ans: Hodgkin Lymphoma encompasses a distinctive group of neoplasms that arise

almost invariably in a single lymph node or chain of lymph nodes and spread
characterized morphologically by the presence of distinctive neoplastic giant cells
inflammatory cells. It is often associated with systemic manifestations such as fever
and has a stereotypical pattern of spread.
Q134. What are the two types of polycythemia?
Ans: The two types of polycythemia are relative, caused by a decrease in plasma
volume, and absolute, caused by an increase in the total red cell mass.
Q135. What is the most common form of anemia in hospitalized

patients?
Ans: The most common form of anemia in hospitalized patients is anemia of chronic
disease. It is caused by an inflammation-induced sequestration of iron within the
cells of the mononuclear phagocyte system.
Q136. What is the clinical picture of Hodgkin Lymphoma?
Ans: : The clinical picture of Hodgkin Lymphoma typically includes painless

enlargement of the lymph node, unexplained weight loss, pruritus, and anemia.
Splenomegaly and lymphadenopathy are in general less prominent than in ALL.
Q137. What is Multiple Myeloma and Related Plasma Cell Disorders?
Ans: Multiple Myeloma and Related Plasma Cell Disorders is a clone of B cells that
differentiates into plasma cells and secretes a single complete or partial
immunoglobulin. Casts are made up of Bence Jones proteins, but they may also
contain complete immunoglobulins, Tamm Horsfall protein, and albumin.
MYELOMATOUS NEPHROSIS can be observed in the distal convoluted tubule and
collecting ducts.
Q138. What is the pathogenetic mechanism of aplastic anemia?
Ans: The pathogenetic mechanism of aplastic anemia is that autoreactive T cells

suppress multipotent myeloid stem cells, leading to marrow failure and
pancytopenia.
Q139. What is the incidence of Sickle Cell Anemia?
Ans: Approximately 8% of American blacks are heterozygous for HbS and in parts of
Africa where malaria is endemic the gene frequency approaches 30%. Sickle cell
anemia is the most common form of familial hemolytic anemia.
Q140. What is the mechanism of intravascular hemolysis?
Ans: Intravascular hemolysis can result from mechanical trauma or biochemical or

physical agents that damage the red cell membrane, such as fixation of complement,
exposure to clostridial toxins, or heat.
Q141. What is the primary cause of pernicious anemia?

Ans: The primary cause of pernicious anemia is a deficiency of vitamin B12, which
results from inadequate gastric production or defective function of intrinsic factor.
Q142. What are the morphologic alterations associated with

microangiopathic hemolytic anemia?
Ans: The morphologic alterations associated with microangiopathic hemolytic

anemia are schistocytes, burr cells, helmet cells, and triangle cells.
Q143. What is the clinical course of Hereditary Spherocytosis?

splenomegaly, and jaundice. Most commonly the anemia is moderate in severity and
the clinical course is often stable but may be punctuated by aplastic crises.
Q144. What is the clinical course of iron deficiency anemia?
Ans: In most cases, iron deficiency anemia is asymptomatic, but nonspecific

manifestations such as weakness and pallor may be present in severe cases. A
curious but characteristic neurobehavioral complication is pica, the compunction to
consume non foodstuffs such as dirt or clay.
Q145. What is the etiology and pathogenesis of Hodgkin Lymphoma?
Ans: The etiology and pathogenesis of Hodgkin Lymphoma is a neoplasm arising

from germinal center B cells. The EBV genome is present in the RS cells in as many as
70% of cases of the mixed cellularity type and a smaller fraction of the nodular
sclerosis type.
Q146. What is the most common form of nutritional deficiency?
Ans: The most common form of nutritional deficiency is iron deficiency anemia. It
affects about 10% of people in developed countries and 25% to 50% in developing
countries.
Ans: Hematopoietic Disorders refers to a group of disorders that affect the

production of blood cells in the body. These disorders can be genetic, environmental,
or acquired and can lead to anemia, polycythemia, and other conditions.
Q148. What are the morphologic alterations in Sickle Cell Anemia?
Ans: The morphologic alterations in Sickle Cell Anemia stem from the severe chronic
hemolytic anemia, increased breakdown of heme pigments, and microvascular
obstruction. In peripheral smears, bizarre elongated, spindled, or boat shaped
irreversibly sickled red cells are evident, as well as moderate splenomegaly caused
by congestion of the red pulp.
Ans: Follicular Lymphoma is a relatively common tumor that constitutes 40% of the
adult NHLs in the United States. It typically affects people of older age, with a male
to female ratio of 1:1. The tumor cells resemble normal follicular center B cells, and
the lymph nodes are effaced by proliferations that usually have a distinctly nodular
appearance. It can transform to DLBCL.
Ans: Lymphadenopathy is an immune response against foreign antigens which is

often associated with the enlargement of lymph nodes.
Q151. What are the etiological factors associated with Acute

Myelogenous Leukemia?
Ans: The etiological factors associated with Acute Myelogenous Leukemia include
heredity (trisomy 21), radiation exposure, and exposure to chemicals such as
benzene and alkylating agents.
Q152. What are the classifications of anemia based on the underlying
cause?
Ans: The classifications of anemia based on the underlying cause include Anemias of
Blood loss, Hemolytic anemia, and Anemia of diminished erythropoiesis.
Q153. What are the laboratory findings of acute lymphoblastic

leukemia?
Ans: The laboratory findings of acute lymphoblastic leukemia include a white cell
count that is variable but may be elevated to more than 100,000 cells/L, anemia, and
a platelet count that is usually below 100,000 platelets/L.
Ans: : The red cell indices include Mean cell volume (MCV), Mean cell hemoglobin
(MCH), Mean cell hemoglobin concentration (MCHC), and Red cell distribution width
(RDW).
Q155. What is small lymphocytic lymphoma/chronic lymphocytic

leukemia?
Ans: Small lymphocytic lymphoma/chronic lymphocytic leukemia (CLL) is a type of

morphologically, phenotypically, and genotypically identical disorder which is
characterized by an absolute lymphocytosis of small, mature looking lymphocytes
and an often asymptomatic presentation.
Q156. How is EBV associated with Diffuse Large B Cell Lymphoma?
Ans: EBV is implicated in the pathogenesis of diffuse large B cell lymphomas that
arise in the setting of the acquired immunodeficiency syndrome (AIDS) and
iatrogenic immunosuppression (e.g., in transplant patients).
Q157. What is Diffuse Large B Cell Lymphoma?

Ans: Diffuse Large B Cell Lymphoma is a diagnostic category that includes several
forms of non-Hodgkin lymphoma that share certain features, including a B cell
phenotype, a diffuse growth pattern, and an aggressive clinical history. It is the most
important type of lymphoma in adults, as it accounts for approximately 50% of adult
NHL.
Q158. What is the common mode of presentation of NHLs in African

patients?

mode of presentation of NHLs.
Q159. What are the components of the casts found in Myelomatous

Nephrosis?
Ans: The casts found in Myelomatous Nephrosis are made up of Bence Jones
proteins, complete immunoglobulins, Tamm Horsfall protein, and albumin.
Q160. What are the clinical features of Hereditary Spherocytosis?

splenomegaly, and jaundice. Most commonly, the anemia is moderate in severity.
The clinical course is often stable but may be punctuated by aplastic crises.
Q161. What is the incidence of Sickle Cell Anemia?
Ans: Approximately 8% of American blacks are heterozygous for HbS. In parts of

Africa where malaria is endemic, the gene frequency approaches 30%. Sickle cell
Q162. What is Hematopoiesis?
Ans: Hematopoiesis is the process of forming and maturing blood cells in the bone
marrow. It involves the production of all types of blood cells, including red cells,
white cells, and platelets.
Q163. How is Acute Myelogenous Leukemia clinically presented?
Ans: : Clinically, Acute Myelogenous Leukemia is presented with fatigue and pallor,
abnormal bleeding, infections, splenomegaly, and lymphadenopathy.
Q164. What is Acute Lymphoblastic Leukemia (ALL)?
Ans: Acute Lymphoblastic Leukemia (ALL) is a type of aggressive tumor composed of

immature lymphocytes (lymphoblasts). It is predominantly found in children and
young adults, with 80% of childhood leukemia cases being of pre B cell origin. The
pre T cell tumors are most common in adolescent males of between 15 and 20 years
of age.
Q165. What are the symptoms of pernicious anemia?
Ans: Symptoms of pernicious anemia are similar to other causes of anemia and may
include weakness and pallor. Unlike in vitamin B12 deficiency, neurologic
abnormalities such as symmetric numbness, tingling, and burning in feet or hands,
followed by unsteadiness of gait and loss of position sense, particularly in the toes,
do not occur.
Q166. What causes iron deficiency anemia?
Ans: Iron deficiency anemia is typically caused by low dietary intake, malabsorption,
increased demands not met by normal dietary intake during pregnancy and infancy,
and chronic blood loss.
Ans: Iron deficiency is the most common form of nutritional deficiency. It affects
about 10% of people in developed countries and 25% to 50% of people in developing
countries.
Q168. What are the causes of non-neoplastic disorders of white cells?

Ans: : Non-neoplastic disorders of white cells include leukopenias and lymphopenias,
which can be caused by congenital immunodeficiency diseases, advanced human
immunodeficiency virus (HIV) infection, or treatment with corticosteroids.
Neutropenia/agranulocytosis is characteristically caused by inadequate or ineffective
granulopoiesis or accelerated removal or destruction of neutrophils. Reactive
leukocytosis is commonly seen in a variety of reactive inflammatory states caused by
microbial and nonmicrobial stimuli.
Q169. What is the difference between Small Lymphocytic Lymphoma/

Chronic Lymphocytic Leukemia?
Ans: Small Lymphocytic Lymphoma/ Chronic Lymphocytic Leukemia are

morphologically, phenotypically, and genotypically identical, differing only in the
extent of peripheral blood involvement. If the peripheral blood lymphocytosis
exceeds 4000 cells/mm3, the patient is diagnosed with chronic lymphocytic leukemia
(CLL); if not, a diagnosis of small lymphocytic lymphoma (SLL) is made.

lymphadenitis?

Q171. What are the morphological changes in Sickle Cell Anemia?
Ans: In peripheral smears, bizarre elongated, spindled, or boat shaped irreversibly

sickled red cells are evident. In children, there is moderate splenomegaly caused by
congestion of the red pulp. In long-standing cases, there is prominent systemic
hemosiderosis.

Q173. What are the consequences of Sickle Cell Anemia?
Ans: : Two major consequences stem from the sickling of red cells in Sickle Cell
Anemia: it produces a chronic extravascular hemolytic anemia and produces
widespread microvascular obstructions. These lead to severe clinical symptoms.

patients?
Ans: Anemia of chronic disease is the most common form of anemia in hospitalized
patients. It is caused by inflammation-induced sequestration of iron within the cells
of the mononuclear phagocyte (reticuloendothelial) system.
Ans: Sickle cell anemia is a type of hemoglobinopathy caused by a mutation in the

globin chain gene that creates sickle hemoglobin (HbS). It is characterized by the
presence of structurally abnormal hemoglobins. In homozygotes, all HbA is replaced
by HbS, whereas in heterozygotes only about half is replaced. It produces a chronic
extravascular hemolytic anemia and widespread microvascular obstructions,
resulting in severe clinical symptoms.
Ans: Pernicious anemia is a form of vitamin B12 deficiency resulting from inadequate
gastric production or defective function of intrinsic factor.
Q177. What is Hemolytic Anemia?
Ans: Hemolytic anemia is anemia caused by accelerated destruction of red cells. It

can be caused by either inherent (intracorpuscular) red cell defects, which are
usually inherited, or external (extracorpuscular) factors, which are usually acquired.
It is usually associated with a marked erythroid hyperplasia within the marrow and
an increased reticulocyte count in peripheral blood.
MCV is the average volume per red cell, expressed in femtoliters (cubic microns).
MCH is the average content (mass) of hemoglobin per red cell, expressed in
picograms. MCHC is the average concentration of hemoglobin in a given volume of
packed red cells, expressed in grams per deciliter. RDW is the coefficient of variation
of red cell volume.
Q180. What is Burkitt Lymphoma?
Ans: Burkitt Lymphoma is a type of non-Hodgkin lymphoma that is endemic in some

parts of Africa and sporadic in other areas, including the United States. It is an EBV-
associated tumor that usually arises at extranodal sites and is more common in
children and young adults, accounting for approximately 30% of childhood NHLs in
the United States.
Q181. What is the etiology of Hodgkin's Lymphoma?
Ans: Hodgkin's Lymphoma is a neoplasm arising from germinal center B cells and the
Epstein-Barr virus genome is present in the Reed-Sternberg cells in as many as 70%
of cases of the mixed cellularity type.
Q182. What are the possible etiologies of Acute Myelogenous Leukemia?
Ans: The possible etiologies of Acute Myelogenous Leukemia include heredity

(trisomy 21), radiation exposure, and exposure to chemicals such as benzene and
alkylating agents.

Q184. What are the distinctive features of Acute Myelogenous

Leukemia?
Ans: The distinctive features of Acute Myelogenous Leukemia include a median age
of 50 years, heterogeneous disorder, clinical signs and symptoms related to marrow
failure, red staining rodlike structures called Auer rods, and myeloblasts making up
more than 20% of the bone marrow cellularity.
Q185. What are the six major variants of the Plasma Cell Dyscrasias?
Ans: The six major variants of the Plasma Cell Dyscrasias are multiple myeloma,
localized plasmacytoma, lymphoplasmacytic lymphoma, heavy chain disease,
primary or immunocyte associated amyloidosis, and monoclonal gammopathy of
undetermined significance.

splenic sequestration and destruction. It is an autosomal dominant trait, with
approximately 25% of patients having a more severe autosomal recessive form of
the disease. It is usually associated with compensatory hyperplasia of marrow red
cell progenitors and an increase in red cell production, which is marked by peripheral
blood reticulocytosis.
Q187. What are the symptoms of Acute Lymphoblastic Leukemia (ALL)?
Ans: The symptoms of Acute Lymphoblastic Leukemia (ALL) include fatigue (due to
anemia), fever (due to infections resulting from a lack of mature leukocytes),
bleeding (petechiae, ecchymoses, epistaxis, gum bleeding) secondary to
thrombocytopenia, bone pain and tenderness, generalized lymphadenopathy,
splenomegaly, and hepatomegaly, as well as central nervous system manifestations
such as headache, vomiting, and nerve palsies resulting from meningeal spread.
Q188. What are the distinctive features of Hodgkin Lymphoma?
Ans: The distinctive features of Hodgkin Lymphoma include the presence of

distinctive neoplastic giant cells called Reed-Sternberg cells, typically localized to a
single axial group of nodes, an orderly spread by contiguity, and systemic
manifestations such as fever.
Q189. What are the types of Anemia?
Ans: Anemia can be classified as anemia of blood loss, hemolytic anemia, anemia of
diminished erythropoiesis, and others. Anemia of blood loss is caused by excessive
blood loss, hemolytic anemia results from accelerated destruction of red cells, and
anemia of diminished erythropoiesis is caused by insufficient production of red cells.
Q190. What are the pathophysiology and clinical picture of Burkitt

Lymphoma?
Ans: : The pathophysiology of Burkitt Lymphoma involves the neoplastic B cells

suppressing the function of normal B cells, the production of autoantibodies to B
cells, and a breakdown in immune regulation. The clinical picture is characterized by
an abrupt stormy onset, symptoms related to depression of normal marrow function,
a total leukocyte count that may be increased only slightly or may exceed 200,000
cells/L, and hypogammaglobulinemia in 50% of patients. Autoimmune hemolytic
anemia and thrombocytopenia are also seen.
suppressed, leading to marrow failure and pancytopenia. It can be caused by
idiopathic factors, myelotoxic agents, viral infections, and autoimmune reactions.
Q192. What are the three general categories of Myeloid Neoplasia?
Ans: The three general categories of Myeloid Neoplasia are Acute Myelogenous
Leukemia, Chronic Myeloproliferative Disorders, and Myelodysplastic Syndromes.
Ans: Lymphadenopathy is an immune response against foreign antigens, which is

often characterized by the enlargement of lymph nodes.
Q194. What is the percentage of Childhood NHLs associated with EBV

in the United States?
EBV.
Q195. What are the symptoms of iron deficiency anemia?
Ans: Iron deficiency anemia is often asymptomatic, but nonspecific manifestations

such as weakness and pallor may be present in severe cases. A curious but
characteristic neurobehavioral complication is pica, the compunction to consume
non foodstuffs such as dirt or clay.
Ans: Megaloblastic anemia is a form of anemia caused by a deficiency of either folic

acid or vitamin B12. It is characterized by an enlargement of erythroid precursors
(megaloblasts), which gives rise to abnormally large red cells (macrocytes) and highly
characteristic hypersegmented neutrophils. Common symptoms include fatigue,
pallor, and difficulty concentrating.
Q197. What is immunohemolytic anemia?
Ans: Immunohemolytic anemia is an uncommon form of hemolytic anemia caused

by antibodies that recognize determinants on red cell membranes. The antibodies
may arise spontaneously or be induced by exogenous agents. It is classified based on
the nature of the antibody and the presence of certain predisposing conditions.

Ans: The most common form of familial hemolytic anemia is sickle cell anemia.
Q199. What causes leukocytosis?
Ans: : Leukocytosis is caused by reactive inflammatory states caused by microbial

and nonmicrobial stimuli. It is characterized by an increase in white blood cell count,
typically in response to an infection or injury.
Q200. What are the six major variants of plasma cell dyscrasias?
Ans: The six major variants of plasma cell dyscrasias are: (1) multiple myeloma, (2)
localized plasmacytoma (solitary myeloma), (3) lymphoplasmacytic lymphoma, (4)
Ans: Iron deficiency anemia is typically asymptomatic, but nonspecific manifestations

such as weakness and pallor can be present in severe cases. A curious but
characteristic neurobehavioral complication is pica, the compunction to consume
non foodstuffs such as dirt or clay.
Q202. What is the common mode of presentation in African patients

with NHL?

mode of presentation of NHL.

can be classified as either relative, which is caused by a decrease in plasma volume,
or absolute, which is when there is an increase in the total red cell mass.
Q204. What are the morphological features of Hereditary
Spherocytosis?
Ans: : The morphological features of Hereditary Spherocytosis include spherocytosis,

which is not diagnostic and is seen in other conditions such as immune hemolytic
anemias, compensatory hyperplasia of marrow red cell progenitors, an increase in
red cell production, and prominent systemic hemosiderosis in long-standing cases.
Ans: Auer rods are distinctive neoplastic giant cells that are present in the
myeloblasts or more differentiated cells of myeloid neoplasms.
Ans: Pernicious anemia is a form of vitamin B12 deficiency anemia caused by

inadequate gastric production or defective function of intrinsic factor. It is
characterized by the same symptoms as other causes of anemia, as well as
demyelinating disorders involving the peripheral nerves.
genotype (e.g., karyotype, presence of viral genomes) of each entity. It segregates
them on the basis of origin into three major categories: (1) tumors of B cells, (2)
tumors of T cells and NK cells, and (3) Hodgkin lymphoma.
Q208. What is the percentage of childhood non-Hodgkin lymphomas

(NHLs) associated with EBV in the United States?
EBV.
Q209. What causes neutropenia?

Ans: Neutropenia is caused by either inadequate or ineffective granulopoiesis or
accelerated removal or destruction of neutrophils. It is characterized by the total
white cell count being reduced to 1000 cells/L and in some instances to as few as
200 to 300 cells/L.
Q210. What is the normal lifespan of a red blood cell?
Ans: The normal lifespan of a red blood cell is approximately 120 days.
Q211. What is the mechanism of intravascular hemolysis?
Ans: Intravascular hemolysis can result from mechanical trauma, such as a defective
heart valve, or biochemical or physical agents that damage the red cell membrane,
such as fixation of complement, exposure to clostridial toxins, or heat.

lymphadenitis?

Q213. How is Hodgkin's lymphoma typically spread?
Ans: Hodgkin's lymphoma typically spreads in a stepwise fashion to the anatomically

contiguous nodes.
Q214. What are the common clinical signs and symptoms of acute
myelogenous leukemia?
Ans: The common clinical signs and symptoms of acute myelogenous leukemia are
fatigue and pallor, abnormal bleeding, and infections, which are usually related to
marrow failure caused by the replacement of normal marrow elements by leukemic
blasts.
Q215. What is the most common type of lymphoma in adults?
Ans: Diffuse large B cell lymphoma is the most common type of lymphoma in adults,
accounting for approximately 50% of adult NHLs.
Q216. What is the median age of patients with acute myelogenous

leukemia?
Ans: The median age of patients with acute myelogenous leukemia is 50 years.
Q217. What are the symptoms of acute lymphoblastic leukemia (ALLs)?
Ans: The symptoms of acute lymphoblastic leukemia (ALLs) include fatigue (due
mainly to anemia), fever (reflecting infections resulting from the absence of mature
lymphadenopathy, splenomegaly, and hepatomegaly, headache, vomiting, and nerve
palsies.
Q218. What are the lab findings of acute lymphoblastic leukemia?
Ans: : The lab findings of acute lymphoblastic leukemia include a white cell count
that is variable, often elevated to more than 100,000 cells/L, anemia, and a platelet
count that is usually below 100,000 platelets/L.
Ans: Lymphadenopathy is any immune response against foreign antigens which is

often associated with enlargement of the lymph nodes.
Q220. What is the difference between small lymphocytic

Ans: Small lymphocytic lymphoma/chronic lymphocytic leukemia are

Q221. Who was Lord Canning?
Ans: Lord Canning was the statesman and governor general of India during the
Indian Mutiny of 1857. He became the first viceroy of India in 1858. Important
events during his tenure included the suppression of the Mutiny of 1857, the passing
of the Indian Councils Act, 1861, the withdrawal of the Doctrine of Lapse, the
introduction of the Code of Criminal Procedure, the enactment of the Indian High
Courts Act, the Indian Penal Code (1858).
Q222. What are the major subtypes of acute myelogenous leukemia in

the WHO classification?
Ans: : The major subtypes of acute myelogenous leukemia in the WHO classification
are AML with t(8;21)(q22;q22); RUNX1/ETO fusion gene, AML with inv(16)(p13;q22);
CBFB/MYH11 fusion gene, AML with t(15;17)(q22;11 12); RARA/PML fusion gene,
AML with t(11q23;v); diverse MLL fusion genes, and AML with normal cytogenetics
and mutated NPM.
Q223. What is the general feature of hemolytic anemia?
Ans: The general features of hemolytic anemia include an increased rate of red cell
and the retention by the body of the products of red cell destruction, including iron.
obstructions.
Q225. What are the etiologies of acute myelogenous leukemia?

Ans: The etiologies of acute myelogenous leukemia include heredity (trisomy 21),
Ans: EBV (Epstein Barr Virus) is implicated in the pathogenesis of diffuse large B cell
lymphomas that arise in the setting of the acquired immunodeficiency syndrome
(AIDS) and iatrogenic immunosuppression (e.g., in transplant patients).
Q227. What is the pathophysiology of small lymphocytic

Ans: The pathophysiology of small lymphocytic lymphoma/chronic lymphocytic

leukemia includes neoplastic B cells suppressing the function of normal B cells,
autoantibodies to B cells (15% of patients), and breakdown in immune regulation.
Q228. What are the components of the casts found in myelomatous

nephrosis?
Ans: The components of the casts found in myelomatous nephrosis are Bence Jones
proteins, complete immunoglobulins, Tamm Horsfall protein, and albumin.
Q229. What is the cause of Hereditary Spherocytosis?
Ans: Hereditary Spherocytosis is caused by an inherited (intrinsic) defect in the red

cell membrane that renders the cells spheroidal, less deformable, and vulnerable to
splenic sequestration and destruction.
Ans: Aplastic anemia is a form of anemia caused by the suppression of multipotent

myeloid stem cells, leading to marrow failure and pancytopenia. Common causes
include idiopathic, myelotoxic agents, viral infections, and bone marrow failure.
Symptoms include fatigue, pallor, dizziness, and shortness of breath.
Q231. What are the classification of anemias?
Ans: The classification of anemias is based on the underlying the cause and can be
divided into anemias of blood loss, hemolytic anemia, and anemia of diminished
erythropoiesis.
Ans: Burkitt lymphoma is a high-grade tumor which is endemic in some parts of

Africa and sporadic in other areas, including the United States. It is most commonly
associated with EBV (Epstein Barr Virus) and usually arises at extranodal sites.
Q233. What are the common clinical features of Hereditary

Spherocytosis?
Ans: The common clinical features of Hereditary Spherocytosis are anemia,

splenomegaly, and jaundice.
Q235. What is the clinical course of aplastic anemia?
Ans: The clinical course of aplastic anemia is characterized by splenomegaly being

absent, normocytic and normochromic red cells, and extreme susceptibility to
bacterial and fungal infections. Bone marrow transplantation is an effective form of
therapy, especially in nontransfused patients younger than 40 years of age.
Q237. What are the major subtypes of AML in the WHO Classification?
Ans: The major subtypes of AML in the WHO Classification include AML with
t(8;21)(q22;q22); RUNX1/ETO fusion gene, AML with inv(16)(p13;q22); CBFB/MYH11
fusion gene, AML with t(15;17)(q22;11 12); RARA/PML fusion gene, AML with
t(11q23;v); diverse MLL fusion genes, AML with normal cytogenetics and mutated
NPM, and AML with t(8;21)(q22;q22); RUNX1/ETO fusion gene.
Ans: Reactive leukocytosis is an increase in the white blood cell count that is
common in a variety of reactive inflammatory states caused by microbial and non-
microbial stimuli.
These indices help to diagnose and classify anemias.
Q240. What are Myeloid Neoplasms?
Ans: Myeloid neoplasms arise from hematopoietic stem cells and typically give rise
to monoclonal proliferations that replace normal bone marrow cells. There are three
general categories of myeloid neoplasia, including acute myelogenous leukemia,
chronic myeloproliferative disorders, and myelodysplastic syndromes.
Q241. What are the laboratory findings associated with small

lymphocytic lymphoma/chronic lymphocytic leukemia?
Ans: Laboratory findings associated with small lymphocytic lymphoma/chronic

lymphocytic leukemia include an absolute lymphocytosis of small, mature looking
lymphocytes, anemia, hypogammaglobulinemia, and autoimmune hemolytic anemia
and thrombocytopenia.
Q242. What are the types of anemias?
Ans: Anemias are classified based on the underlying cause, morphology of red cells,
and degree of hemoglobinization. The types of anemias include anemias of blood
loss, hemolytic anemias, normocytic anemias, microcytic anemias, macrocytic
anemias, normochromic anemias, and hypochromic anemias.
Ans: Symptoms of acute lymphoblastic leukemia include fatigue (due to anemia),

fever (resulting from the absence of mature leukocytes), bone pain and tenderness,
generalized lymphadenopathy, splenomegaly, and hepatomegaly, headache,
vomiting, nerve palsies, and petechiae, ecchymoses, epistaxis, and gum bleeding
(due to thrombocytopenia).
Q244. What are the anatomic alterations in sickle cell anemia?
Ans: The anatomic alterations in sickle cell anemia stem from the three aspects of
the disease: the severe chronic hemolytic anemia, the increased breakdown of heme
pigments, and the microvascular obstruction, which can cause tissue ischemia and
infarction. In peripheral smears, irreversibly sickled red cells are evident, and in
children there is moderate splenomegaly.
Q245. What are the causes of leukopenia?
Ans: Leukopenia, or a decrease in the white blood cell count, is caused by a decrease
in granulocytes. Lymphopenias are much less common and are associated with
congenital immunodeficiency diseases or acquired illnesses, such as advanced HIV
infection or corticosteroid treatment.
Q246. What are the three patterns of Chronic Nonspecific

Lymphadenitis?
Ans: The three patterns of Chronic Nonspecific Lymphadenitis are follicular

Q247. What are Multiple Myeloma and Related Plasma Cell Disorders?
Ans: Multiple Myeloma and Related Plasma Cell Disorders are neoplasms arising
from germinal center B cells. They are characterized by a clone of B cells that
differentiates into plasma cells and secretes a single complete or partial
immunoglobulin. The plasma cell dyscrasias can be divided into six major variants,
including multiple myeloma, localized plasmacytoma, lymphoplasmacytic lymphoma,
heavy chain disease, primary or immunocyte associated amyloidosis, and


leukemia involves an expansion of immature cells (lymphoblasts) in the bone
marrow and inhibition of proliferation of other hematopoietic cells, as well as the
production of autoantibodies to B cells.
Q249. What is Acute Myelogenous Leukemia?
Ans: Acute Myelogenous Leukemia is an extremely heterogeneous disorder with a

median age of 50 years. The clinical signs and symptoms, which closely resemble
those produced by ALL, are usually related to marrow failure caused by the
replacement of normal marrow elements by leukemic blasts. By definition, in AML
cellularity. Distinctive red staining rodlike structures (Auer rods) may be present in
myeloblasts or more differentiated cells. The etiology is believed to be related to
heredity, radiation exposure, and exposure to chemicals such as benzene and
alkylating agents. Clinical picture often includes fatigue, pallor, abnormal bleeding,
and infections.
Q250. What are the causes of megaloblastic anemia?
Ans: Megaloblastic anemia is caused by a deficiency of either folic acid or vitamin

B12. The morphologic hallmark of megaloblastic anemias is an enlargement of
erythroid precursors (megaloblasts), which gives rise to abnormally large red cells
(macrocytes). Granulocyte precursors are also enlarged (giant metamyelocytes).
Q251. What are the clinical features of Burkitt Lymphoma?
Ans: Burkitt Lymphoma is a high grade tumor which is endemic in some parts of
Africa and sporadic in other areas, including the United States. It typically presents as
a rapidly enlarging, often symptomatic mass at one or several sites. It is typically
found in children and young adults and is often associated with Epstein-Barr virus.
Ans: Pernicious anemia is a term used to describe vitamin B12 deficiency resulting
from inadequate gastric production or defective function of intrinsic factor. It can
also cause a demyelinating disorder involving the peripheral nerves.
Q253. What is EBV associated childhood NHLs?
Ans: EBV associated childhood NHLs are a form of non-Hodgkin lymphoma that
accounts for approximately 30% of childhood cases in the United States. It is a high
grade tumor that usually arises at extranodal sites, with maxilla or mandible
involvement being more common in African patients and abdominal tumors
involving the bowel, retroperitoneum, and ovaries being more common in North
America.
Q254. What are the etiologies of aplastic anemia?
Ans: The etiologies of aplastic anemia include idiopathic causes (50%), myelotoxic
agents, viral infections, and a variety of other causes. It is thought that autoreactive
T cells may play an important role in the pathogenesis of this condition.
about 10% of people in developed countries and 25%-50% in developing countries.

Ans: Hodgkin Lymphoma is a distinctive group of neoplasms that arise almost
invariably in a single lymph node or chain of lymph nodes and spread
called Reed Sternberg cells, which are admixed with reactive, nonmalignant
inflammatory cells. It is often associated with systemic manifestations such as fever
and has a stereotypical pattern of spread. It is more commonly localized to a single
axial group of nodes and rarely involves extranodal sites.
Q257. What are the clinical signs and symptoms of AML?
Ans: : The clinical signs and symptoms of Acute Myelogenous Leukemia closely
the replacement of normal marrow elements by leukemic blasts. Common
symptoms include fatigue and pallor, abnormal bleeding, and infections.
Splenomegaly and lymphadenopathy are generally less prominent than in ALL.
Q258. What is intravascular hemolysis?
Ans: Intravascular hemolysis is a type of red cell destruction caused by mechanical

trauma or biochemical or physical agents that damage the red cell membrane. It can
result in hemoglobinemia and hemoglobinuria, which can lead to jaundice.
Q259. What are the characteristics of neoplastic B cells in diffuse

large B cell lymphoma?
Ans: : Neoplastic B cells in diffuse large B cell lymphoma are characterized by large
nuclei (at least three to four times the size of resting lymphocytes), dispersed
chromatin, several distinct nucleoli, and modest amounts of pale cytoplasm.
Q260. What are the two broad categories of etiology and pathogenesis
of neutropenia/agranulocytosis?
Ans: : The etiology and pathogenesis of neutropenia/agranulocytosis can be broadly

divided into two categories: inadequate or ineffective granulopoiesis and
accelerated removal or destruction of neutrophils.
Q261. What is the most common form of childhood leukemia?
Ans: The most common form of childhood leukemia is acute lymphoblastic leukemia
(ALL), which accounts for approximately 80% of childhood leukemia cases.
Ans: Follicular Lymphoma is a relatively common tumor that constitutes 40% of adult
non-Hodgkin lymphomas in the United States. It is characterized by effaced lymph
nodes with a distinctly nodular appearance, and the tumor cells resemble normal
follicular center B cells. It can transform to diffuse large B-cell lymphoma.
Ans: The most common form of familial hemolytic anemia is sickle cell anemia, which
is caused by a mutation in the globin chain gene that creates sickle hemoglobin (HbS).
It is seen in 8% of American Blacks and 30% of people in parts of Africa where
malaria is endemic.
Q264. What is hematopoietic disorder?
Ans: Hematopoietic disorder is a disorder of the blood-forming organs, including the

bone marrow, thymus, spleen, and lymph nodes. It can lead to anemia, Polycythemia,
or neoplasms, and involve a variety of conditions including bleeding disorders, red
cell disorders, white cell disorders, and diseases of the spleen and thymus.
Ans: Lymphadenopathy is an immune response against foreign antigens which is

often associated with enlargement of lymph nodes.
Q266. What is the etiology of AML?

Ans: The etiology of Acute Myelogenous Leukemia is believed to be related to
heredity, radiation exposure, and exposure to chemicals such as benzene and
alkylating agents.
Q267. What are the general features of hemolytic anemias?
Ans: The general features of hemolytic anemias include an increased rate of red cell
and the retention by the body of the products of red cell destruction including iron.
It is also often associated with an erythroid hyperplasia within the marrow and an
increased reticulocyte count in peripheral blood.
Q268. What is hereditary spherocytosis?
Ans: Hereditary spherocytosis is an inherited (intrinsic) defect in the red cell

splenic sequestration and destruction. It is an autosomal dominant trait, and the
anemia is usually moderate in severity.
Q269. What are the major consequences of sickle cell anemia?
Ans: The major consequences of sickle cell anemia are producing a chronic
obstructions. It can also lead to splenomegaly, jaundice, and aplastic crises.
Q270. What is neutropenia/agranulocytosis?
Ans: Neutropenia/agranulocytosis is a disorder characterized by a reduction in the

total white blood cell count to 1000 cells/L or lower, with neutrophils being the most
affected cells. Affected persons are extremely susceptible to bacterial and fungal
infections.
Q271. What is the difference between relative and absolute

polycythemia?
Ans: Relative polycythemia, or hemoconcentration, is caused by a decrease in
plasma volume, while absolute polycythemia is caused by an increase in the total red
cell mass.
Q272. What is Myelomatous Nephrosis?
Ans: Myelomatous Nephrosis is a type of kidney disease caused by multiple myeloma

that presents as protein casts in the distal convoluted tubule and collecting ducts.
These casts are made up of Bence Jones proteins, but they may also contain
complete immunoglobulins, Tamm Horsfall protein, and albumin.
Q273. What are the morphological features of hereditary

spherocytosis?
Ans: : The morphological features of hereditary spherocytosis include spherocytosis,

compensatory hyperplasia of marrow red cell progenitors, and an increase in red cell
production, which is marked by peripheral blood reticulocytosis. Phagocytosed red
cells are often seen within macrophages lining the sinusoids, and in long standing
cases there is prominent systemic hemosiderosis.
Ans: The pathogenesis of diffuse large B cell lymphoma is thought to involve Epstein-
Barr virus (EBV), which is implicated in the pathogenesis of diffuse large B cell
(AIDS) and iatrogenic immunosuppression.
Q275. What are the morphologic alterations in red cells of iron

deficiency anemia?
Ans: The red cells in iron deficiency anemia are microcytic and hypochromic. For
unclear reasons, iron deficiency is often accompanied by an increase in the platelet
count. Extramedullary hematopoiesis is uncommon.
Q276. What is the etiology of Hodgkin's lymphoma?

Ans: Hodgkin's lymphoma is a neoplasm arising from germinal center B cells.
Q277. What is the median age of Acute Myelogenous Leukemia?
Ans: The median age of Acute Myelogenous Leukemia is 50 years.
Ans: Burkitt lymphoma is a high-grade tumor that is endemic in some parts of Africa
and sporadic in other areas, including the United States. It is associated with Epstein-
Barr virus and usually affects children and young adults, accounting for
approximately 30% of childhood NHLs in the United States. It is an aggressive and
fatal form of lymphoma, which typically arises at extranodal sites.
Ans: Symptoms of acute lymphoblastic leukemia include fatigue (due mainly to

leukocytes), bone pain and tenderness, generalized lymphadenopathy, splenomegaly,
and hepatomegaly, headache, vomiting, and nerve palsies resulting from meningeal
spread, petechiae, ecchymoses, epistaxis, and gum bleeding, secondary to
thrombocytopenia.
Q280. What is the gene frequency of sickle cell anemia in parts of

Africa where malaria is endemic?
Ans: : The gene frequency of sickle cell anemia in parts of Africa where malaria is
endemic is approximately 30%.
Leukemia?
Ans: The clinical signs and symptoms of Acute Myelogenous Leukemia are usually
related to marrow failure caused by the replacement of normal marrow elements by
leukemic blasts, and can include painless enlargement of the lymph node,
unexplained weight loss, pruritus, and anemia.
Q282. What are the three classification of anemia based on the

underlying the cause?
Ans: The three classification of anemia based on the underlying the cause are
anemias of blood loss, hemolytic anemia, and anemia of diminished erythropoiesis.
Q283. What are the distinctive red staining rodlike structures found
in myeloblasts?
Ans: The distinctive red staining rodlike structures found in myeloblasts are called
Auer rods.
Q284. What are the common clinical signs and symptoms of Hodgkin's
lymphoma?
Ans: The common clinical signs and symptoms of Hodgkin's lymphoma are painless
enlargement of the lymph node, unexplained weight loss, pruritus, and anemia.
Q285. What are the two major consequences of the sickling of red
cells?
Ans: The two major consequences of the sickling of red cells are producing a chronic
obstructions.
Q286. What is the typical pattern of spread in Hodgkin's lymphoma?
Ans: : The typical pattern of spread in Hodgkin's lymphoma is a stepwise fashion to

the anatomically contiguous nodes, with seldom involvement of mesenteric nodes
and the Waldeyer ring. Extranodal involvement is also uncommon.
Q287. What are the lab findings associated with acute lymphoblastic
leukemia?
Ans: : The lab findings associated with acute lymphoblastic leukemia include a white
cell count that is variable but sometimes elevated to more than 100,000 cells/L,
anemia, a platelet count usually below 100,000 platelets/L, and
hypogammaglobulinemia. Autoimmune hemolytic anemia and thrombocytopenia
are also seen.
inadequate gastric production or defective function of intrinsic factor.
Q289. What are the clinical features of vitamin B12 deficiency

anemia?
Ans: The clinical features of vitamin B12 deficiency anemia are the same as other
causes of anemia. The spinal cord disease begins with symmetric numbness, tingling,
and burning in feet or hands, followed by unsteadiness of gait and loss of position
sense, particularly in the toes.
Q290. What is the difference between small lymphocytic

Ans: Small lymphocytic lymphoma (SLL) and chronic lymphocytic leukemia (CLL) are
exceeds 4000 cells/mm3, the patient is diagnosed with CLL; if not, a diagnosis of SLL
is made.
Q291. What are the two modes of red cell destruction?
Ans: The two modes of red cell destruction are intravascular hemolysis and
extravascular hemolysis.

often associated with lymph node enlargement.
Ans: The major subtypes of AML in the WHO Classification are AML with
t(11q23;v); diverse MLL fusion genes, and AML with normal cytogenetics and
mutated NPM.
Q294. What are the three general features of hemolytic anemias?
Ans: The three general features of hemolytic anemias are an increased rate of red
cell destruction, a compensatory increase in erythropoiesis that results in
reticulocytosis, and the retention by the body of the products of red cell destruction
(including iron).
Ans: Diffuse large B cell lymphoma is a diagnostic category that includes several
forms of NHL that share certain features, including a B cell phenotype, a diffuse
growth pattern, and an aggressive clinical history. It is the most important type of
lymphoma in adults, accounting for approximately 50% of all adult NHL cases.
Ans: : Non-neoplastic disorders of white cells include leukopenias and proliferations,

which may be reactive or neoplastic. Leukopenia usually results from a decrease in
granulocytes, while lymphopenias are much less common and are associated with
congenital immunodeficiency diseases or are acquired such as advanced human
immunodeficiency virus (HIV) infection or treatment with corticosteroids.
Neutropenia/agranulocytosis is characterized by a total white cell count of 1000
cells/ L and in some instances as few as 200 to 300 cells/ L, and is associated with an
increased susceptibility to bacterial and fungal infections. Reactive leukocytosis is
common in a variety of reactive inflammatory states caused by microbial and
nonmicrobial stimuli.
Ans: In most instances, iron deficiency anemia is asymptomatic. Nonspecific

manifestations such as weakness and pallor may be present in severe cases. A
curious but characteristic neurobehavioral complication is pica, the compunction to
consume non foodstuffs such as dirt or clay.
suppressed, leading to marrow failure and pancytopenia. The etiology is often
idiopathic, but can also be caused by myelotoxic agents, viral infections, and other
factors. Symptoms include weakness, fatigue, and increased risk of infection.
Q299. What is acute lymphoblastic leukemia (ALL)?
Ans: Acute lymphoblastic leukemia (ALL) is an aggressive tumor composed of

immature lymphocytes (lymphoblasts) which occurs predominantly in children and
young adults. It is the most common type of childhood leukemia, accounting for 80%
of cases, and is characterized by an abrupt stormy onset with symptoms related to
the depression of normal marrow function.
Q300. What are the common causes of Acute Myelogenous Leukemia?
Ans: The common causes of Acute Myelogenous Leukemia are heredity (trisomy 21),
genotype (e.g., karyotype, presence of viral genomes) of each entity, and segregates
them on the basis of origin into three major categories: tumors of B cells (NHL),
tumors of T cells and NK cells (NHL) and Hodgkin lymphoma.
Q303. What are the six major variants of plasma cell dyscrasias?
Ans: The six major variants of plasma cell dyscrasias are (1) multiple myeloma, (2)
localized plasmacytoma (solitary myeloma), (3) lymphoplasmacytic lymphoma, (4)
approximately?
childhood NHLs in the United States.
Q306. What type of hemoglobin is present in normal adult red cells?
Ans: The type of hemoglobin present in normal adult red cells is HbA (2 2).
Q307. What is the primary defect in hereditary spherocytosis?

Ans: The primary defect in hereditary spherocytosis is an inherited (intrinsic) defect
in the red cell membrane that renders the cells spheroidal, less deformable, and
vulnerable to splenic sequestration and destruction.


lymphadenitis?

Ans: The pathogenesis of diffuse large B cell lymphoma is believed to involve the
neoplastic B cells suppressing the function of normal B cells, the breakdown of
immune regulation, and the presence of autoantibodies to B cells in 15% of patients.
It is also associated with Epstein-Barr virus in the setting of acquired
immunodeficiency syndrome (AIDS) and iatrogenic immunosuppression (e.g., in
transplant patients).
Q311. What is the normal lifespan of red cells?
Ans: The normal lifespan of red cells is approximately 120 days.
Q312. What is the common form of nutritional deficiency?
about 10% of people in developed countries and 25-50% in developing countries.
patients?
Ans: Anemia of chronic disease is the most common form of anemia in hospitalized
patients. It superficially resembles the anemia of iron deficiency, but it stems from
inflammation induced sequestration of iron within the cells of the mononuclear
phagocyte (reticuloendothelial) system.
Q314. What are the three anatomic alterations in sickle cell anemia?
Ans: The three anatomic alterations in sickle cell anemia are the severe chronic
hemolytic anemia, the increased breakdown of heme pigments, which are processed
into bilirubin, and the microvascular obstruction, which provokes tissue ischemia and
infarction.
Q315. What is the morphologic hallmark of megaloblastic anemias?
Ans: The morphologic hallmark of megaloblastic anemias is an enlargement of

erythroid precursors (megaloblasts), which gives rise to abnormally large red cells
(macrocytes). Granulocyte precursors are enlarged (giant metamyelocytes) and yield
highly characteristic hypersegmented neutrophils.
Ans: : Non-neoplastic disorders of white cells include leukopenia and lymphopenia,

neutropenia/agranulocytosis, and reactive leukocytosis. Leukopenia results most
commonly from a decrease in granulocytes, while lymphopenias are associated with
congenital immunodeficiency diseases or are acquired such as advanced human
immunodeficiency virus (HIV) infection or treatment with corticosteroids.
Neutropenia/agranulocytosis is characterized by a total white cell count of 1000
cells/L or lower, and reactive leukocytosis is common in a variety of reactive
inflammatory states caused by microbial and nonmicrobial stimuli.
Q317. What are the clinical features of acute lymphoblastic leukemia?
Ans: The clinical features of acute lymphoblastic leukemia include fatigue (due
mainly to anemia), fever (reflecting infections resulting from the absence of mature
lymphadenopathy, splenomegaly, and hepatomegaly, central nervous system
manifestations (headache, vomiting, and nerve palsies), white cell count variability,
and anemia and low platelet count.

Ans: Iron deficiency anemia is the most common form of nutritional deficiency.
Ans: Acute lymphoblastic leukemia (ALLs) is a type of aggressive tumor composed of

immature lymphocytes (lymphoblasts), which occurs predominantly in children and
young adults. It is the most common type of leukemia in children, peaking in
incidence at age 4, with most of the cases being of pre B cell origin.
inadequate gastric production or defective function of intrinsic factor.
Q322. What is Multiple Myeloma and what is its origin?
Ans: Multiple Myeloma is a neoplasm arising from germinal center B cells and
involves a clone of B cells that differentiates into plasma cells and secretes a single
complete or partial immunoglobulin.
Q323. What are the clinical features of vitamin B12 deficiency?
Ans: The clinical features of vitamin B12 deficiency are similar to other causes of
anemia. The spinal cord disease begins with symmetric numbness, tingling, and
burning in feet or hands, followed by unsteadiness of gait and loss of position sense,
particularly in the toes.
Q324. What is the percentage of adult NHLs in the United States that
are Follicular Lymphoma?
Ans: Follicular Lymphoma accounts for 40% of the adult NHLs in the United States.
Q325. How does Epstein-Barr virus contribute to the pathogenesis of

diffuse large B cell lymphomas?
Ans: Epstein-Barr virus is implicated in the pathogenesis of diffuse large B cell

(AIDS) and iatrogenic immunosuppression (e.g., in transplant patients).

patients?
Ans: Anemia of Chronic Disease is the most common form of anemia in hospitalized
patients. It superficially resembles the anemia of iron deficiency, but it stems from
inflammation induced sequestration of iron within the cells of the mononuclear
phagocyte (reticuloendothelial) system.
Q327. What are the general features of Hemolytic Anemias?
Ans: Hemolytic Anemias are characterized by an increased rate of red cell

destruction, a compensatory increase in erythropoiesis, and the retention by the
body of the products of red cell destruction (including iron). There is usually a
marked erythroid hyperplasia within the marrow and an increased reticulocyte count
in peripheral blood. In long-standing cases, there is prominent systemic
hemosiderosis.
Ans: : Auer rods are distinctive red staining rodlike structures that may be present in
myeloblasts or more differentiated cells in Acute Myelogenous Leukemia and are
particularly prevalent in the progranulocytes found in acute promyelocytic leukemia.
Q330. What is Phagocytosed red cells?
Ans: : Phagocytosed red cells are red cells that have been engulfed by macrophages
in the spleen and liver. These macrophages remove damaged or immunologically
targeted red cells from the circulation. Phagocytosed red cells are frequently seen
within macrophages lining the sinusoids and, in particular, within the cords.
Ans: The three major categories of lymphoid neoplasms are tumors of B cells (non-
Hodgkin's lymphoma), tumors of T cells and NK cells (non-Hodgkin's lymphoma), and
Hodgkin's lymphoma.
Q332. What is Intravascular Hemolysis?
Ans: Intravascular Hemolysis is a type of red cell destruction that occurs in the
vascular compartment. It can be caused by mechanical trauma, such as a defective
heart valve, or biochemical or physical agents that damage the red cell membrane,
such as fixation of complement, exposure to clostridial toxins, or heat.
Ans: Lymphadenopathy is an immune response against foreign antigens that is often

associated with the enlargement of lymph nodes.
Q334. What are the Red Cell Indices?
Ans: Red Cell Indices are parameters that measure various characteristics of red
blood cells. These include Mean Cell Volume (MCV), Mean Cell Hemoglobin (MCH),
Mean Cell Hemoglobin Concentration (MCHC), and Red Cell Distribution Width
(RDW). These indices help to diagnose anemias and other blood disorders.
Q335. What are the lab findings associated with small lymphocytic
Ans: : The lab findings associated with small lymphocytic lymphoma/chronic

lymphocytic leukemia include an absolute lymphocytosis of small, mature looking
lymphocytes, a total leukocyte count of slightly elevated (in SLL) or more than
200,000 cells/L, hypogammaglobulinemia, and autoimmune hemolytic anemia and
thrombocytopenia.
Ans: Aplastic anemia is a condition in which multipotent myeloid stem cells are
suppressed, leading to marrow failure and pancytopenia. The causes of aplastic
anemia include idiopathic, myelotoxic agents, and viral infections.
Q337. What is Extravascular Hemolysis?
Ans: Extravascular Hemolysis is a more common mode of red cell destruction, which
occurs largely within the phagocytic cells of the spleen and liver. The mononuclear
phagocyte system removes damaged or immunologically targeted red cells from the
circulation. Extravascular hemolysis is not associated with hemoglobinemia and
hemoglobinuria, but it often produces jaundice and bilirubin-rich gallstones.
Ans: Sickle Cell Anemia is a protoypical hemoglobinopathy caused by a mutation in

the globin chain gene that creates sickle hemoglobin (HbS). In homozygotes, all HbA
is replaced by HbS, whereas in heterozygotes, only about half is replaced. Two major
consequences stem from the sickling of red cells: it produces a chronic extravascular
hemolytic anemia and widespread microvascular obstructions. Morphological
features include bizarre elongated, spindled, or boat shaped irreversibly sickled red
cells in peripheral smears, moderate splenomegaly, and congested red pulp.
Ans: Burkitt lymphoma is a type of non-Hodgkin's lymphoma that is endemic in some

parts of Africa and sporadic in other areas, including the United States. It usually
presents as a rapidly enlarging, often symptomatic mass at one or several sites, and
is associated with Epstein-Barr virus. It typically affects children and young adults
and is a high grade tumor.
Q340. What are the common mode of presentation for African patients
with NHLs?
Ans: Involvement of the maxilla or mandible is the common mode of presentation

for African patients with NHLs.

leukemia?
Ans: Small lymphocytic lymphoma/chronic lymphocytic leukemia is a disorder that is

Q342. What is the typical pattern of spread of Hodgkin Lymphoma?
Ans: Hodgkin Lymphoma typically spreads in a stepwise fashion to the anatomically

contiguous nodes, with more frequent involvement of multiple peripheral nodes and
rare involvement of mesenteric nodes and Waldeyer ring.
Q343. What is the etiology of Acute Myelogenous Leukemia?

Ans: The etiology of Acute Myelogenous Leukemia is heterogeneous and can include
heredity, radiation exposure, chemicals, benzene, drugs, alkylating agents.
Q344. What is Anemia of Blood Loss?
Ans: Anemia of Blood Loss is caused by the loss of red blood cells due to acute or
chronic bleeding. With acute blood loss, the immediate threat to the patient is
hypovolemia, and hemodilution begins at once. With chronic blood loss, iron stores
are gradually depleted, leading to a chronic anemia of underproduction. The anemia
is normocytic and normochromic, and recovery is enhanced by a rise in
erythropoietin level.
Q345. What are the three general categories of myeloid neoplasia?
Ans: The three general categories of myeloid neoplasia are Acute Myelogenous
Leukemia, Chronic Myeloproliferative Disorders, and Myelodysplastic Syndromes.
Ans: Hematopoietic Disorders are a group of diseases that affect the production and
function of blood cells. These include red cell disorders, white cell disorders,
bleeding disorders, neoplasms, and diseases of the spleen and thymus.
Q347. What are Reed Sternberg (RS) cells?
Ans: Reed Sternberg (RS) cells are neoplastic giant cells present in Hodgkin
Lymphoma which are admixed with reactive, nonmalignant inflammatory cells.

splenic sequestration and destruction. It is an autosomal dominant trait, and
approximately 25% of patients have a more severe autosomal recessive form. The
red cells lack the central zone of pallor because of their spheroidal shape. Clinical
features include anemia, splenomegaly, and jaundice.
Ans: Diffuse large B cell lymphoma is a diagnostic category that includes several
forms of non-Hodgkin's lymphoma that share certain features, including a B cell
phenotype, a diffuse growth pattern, and an aggressive clinical history. It is the most
important type of lymphoma in adults, as it accounts for approximately 50% of adult
non-Hodgkin's lymphoma.
Q350. What is the most common type of lymphoid neoplasms?
Ans: Hodgkin Lymphoma is the most common type of lymphoid neoplasms.
Q351. What are the different classification of Anemia?
Ans: Anemia is classified based on the underlying cause, the morphology of the red
cells, and the degree of hemoglobinization. The underlying causes include anemias
of blood loss, hemolytic anemia, and anemia of diminished erythropoiesis. The
morphology of red cells is classified as normocytic, microcytic, or macrocytic. The
degree of hemoglobinization is classified as normochromic or hypochromic.

lymphadenitis?

Q353. What are the causes of iron deficiency anemia?
Ans: The causes of iron deficiency anemia include low intake, malabsorption,
increased demands not met by normal dietary intake during pregnancy and infancy,
and chronic blood loss.
Q354. What are the morphological characteristics of iron deficiency

anemia?
Ans: The red cells in iron deficiency anemia are microcytic and hypochromic. For
unclear reasons, iron deficiency is often accompanied by an increase in the platelet
count. Extramedullary hematopoiesis is uncommon.
Q355. What is the percentage of childhood NHLs caused by EBV

associated Children and young adults in the United States?
Ans: Approximately 30% of childhood NHLs in the United States are caused by EBV
associated Children and young adults.

often associated with enlargement of lymph nodes.
Q357. What type of cells do the tumor cells of follicular lymphoma

resemble?
Ans: The tumor cells of follicular lymphoma resemble normal follicular center B cells.
Q358. What is the immediate threat to the patient with acute blood
loss?
Ans: : The immediate threat to the patient with acute blood loss is hypovolemia
(shock) rather than anemia.
Q359. What is the cause of hereditary spherocytosis?
Ans: Hereditary spherocytosis is caused by an inherited defect in the red cell

splenic sequestration and destruction.
Q360. What are the causes of Iron Deficiency Anemia?

Ans: The causes of iron deficiency anemia include low intake, malabsorption which
can occur with sprue and celiac disease or after gastrectomy, increased demands not
met by normal dietary intake during pregnancy and infancy, and chronic blood loss.
Q361. What are the morphological alterations observed in the injured

red cells in Microangiopathic Hemolytic Anemia?
Ans: The morphological alterations observed in the injured red cells in

Microangiopathic Hemolytic Anemia are striking and quite characteristic and include
schistocytes, burr cells, helmet cells, and triangle cells.
Q362. What is the etiology of Hodgkin lymphoma?
Ans: Hodgkin lymphoma is a neoplasm arising from germinal center B cells.
Q363. What are the three major categories of white cell disorders?
Ans: The three major categories of white cell disorders are lymphoid neoplasms,
myeloid neoplasms, and histiocytic neoplasms.
Q364. What are the clinical features of Vitamin B12 (Cobalamin)

Deficiency Anemia?
Ans: The clinical features of Vitamin B12 (Cobalamin) Deficiency Anemia are similar
to other causes of anemia and include nonspecific manifestations such as weakness
and pallor. A curious but characteristic neurobehavioral complication is pica, the
compunction to consume non foodstuffs such as dirt or clay. The spinal cord disease
begins with symmetric numbness, tingling, and burning in feet or hands, followed by
unsteadiness of gait and loss of position sense, particularly in the toes.
Q365. What are the three aspects of sickle cell anemia?
Ans: The three aspects of sickle cell anemia are the severe chronic hemolytic anemia,
the increased breakdown of heme pigments, and the microvascular obstruction
which provokes tissue ischemia and infarction.
Q366. What are the four types of lymphoid neoplasms?
Ans: The four types of lymphoid neoplasms are precursor B and T cell lymphoblastic
leukemia/lymphoma, acute lymphoblastic leukemia, small lymphocytic
lymphoma/chronic lymphocytic leukemia, and diffuse large B cell lymphoma.
Q367. What are the clinical signs and symptoms of Burkitt lymphoma?
Ans: : The clinical signs and symptoms of Burkitt lymphoma include easy fatigability,
weight loss, anorexia, generalized lymphadenopathy and hepatosplenomegaly,
hypogammaglobulinemia, autoimmune hemolytic anemia and thrombocytopenia,
and a rapidly enlarging, often symptomatic mass at one or several sites with
extranodal presentations being common.

patients?
Ans: The most common form of anemia in hospitalized patients is Anemia of Chronic
Disease which is caused by inflammation induced sequestration of iron within the
cells of the mononuclear phagocyte (reticuloendothelial) system.
Q369. What is Pernicious Anemia?
Ans: Pernicious Anemia is a term used to describe vitamin B12 deficiency resulting
from inadequate gastric production or defective function of intrinsic factor.
Q371. What is the pathophysiology of acute lymphoblastic leukemia?
Ans: The pathophysiology of acute lymphoblastic leukemia is expansion of immature

cells (blasts) in the bone marrow and inhibition of proliferation of other
hematopoietic cells.
Q372. How do the clinical features of Hodgkin lymphoma differ from
other lymphoid neoplasms?
Ans: Hodgkin lymphoma is often associated with somewhat distinctive clinical

features, including systemic manifestations such as fever. It also has stereotypical
pattern of spread which allows it to be treated differently than most other lymphoid
neoplasms.
Q373. What are the four red cell indices?
Ans: The four red cell indices are mean cell volume (MCV), mean cell hemoglobin
(MCH), mean cell hemoglobin concentration (MCHC), and red cell distribution width
(RDW).
Q374. What is the hallmark of megaloblastic anemias?
Ans: The hallmark of megaloblastic anemias is an enlargement of erythroid

precursors (megaloblasts) which gives rise to abnormally large red cells (macrocytes).
Granulocyte precursors are also enlarged (giant metamyelocytes) and yield highly
characteristic hypersegmented neutrophils.
Q375. What is the difference between intravascular and extravascular

hemolysis?
Ans: Intravascular hemolysis occurs when mechanical trauma or biochemical or

physical agents damage the red cell membrane, leading to the destruction of the red
cells in the vascular compartment. Extravascular hemolysis occurs when damaged or
immunologically targeted red cells are removed from the circulation by the
mononuclear phagocyte system, primarily in the spleen and liver.


leukemia includes neoplastic B cells suppressing the function of normal B cells,
autoantibodies to B cells in 15% of patients, and breakdown of immune regulation.
Q377. What are the common clinical signs and symptoms of acute
myelogenous leukemia (AML)?
Ans: The common clinical signs and symptoms of acute myelogenous leukemia (AML)
include fatigue and pallor, abnormal bleeding, and infections, which are usually
related to marrow failure caused by replacement of normal marrow elements by
leukemic blasts.
Ans: Polycythemia, or erythrocytosis, is a condition which denotes an increase in the

blood concentration of red cells, which usually correlates with an increase in the
hemoglobin concentration. It can be classified as relative, caused by a decrease in
plasma volume, or absolute, when there is an increase in the total red cell mass. The
absolute type can be further divided into primary and secondary causes.
Q379. What are the two forms of nonspecific lymphadenitis?
Ans: The two forms of nonspecific lymphadenitis are acute nonspecific lymphadenitis
and chronic nonspecific lymphadenitis.
Q380. What are the common sites of involvement of the disease in

African patients?

mode of presentation of the disease.
Q381. What is the normal lifespan of red blood cells?
Ans: The normal lifespan of red blood cells is about 120 days.
Q382. What are the three types of anemia based on the underlying
cause?
Ans: The three types of anemia based on the underlying cause are anemias of blood
loss, hemolytic anemia, and anemia of diminished erythropoiesis.
Q383. What are the etiologies of AML?
Ans: : The etiologies of AML include heredity (trisomy 21), radiation exposure,
chemicals (benzene and alkylating agents), and drugs.
Q384. What is the approximate percentage of childhood NHLs caused by

EBV associated Children and young adults in the US?
Ans: Approximately 30% of childhood NHLs in the United States are caused by EBV
associated Children and young adults.
Q385. What is Aplastic Anemia?
Ans: Aplastic Anemia is a condition in which multipotent myeloid stem cells are
suppressed, leading to marrow failure and pancytopenia. The most common causes
are idiopathic, myelotoxic agents, and viral infections. The pathogenetic events
leading to marrow failure remain vague, but it seems that autoreactive T cells may
play an important role. The clinical course typically includes splenomegaly which is
absent in aplastic anemia. The red cells are normocytic and normochromic. Bone
marrow transplantation is an extremely effective form of therapy, especially if
performed in nontransfused patients younger than 40 years of age.
Q386. What are the major subtypes of AML according to WHO

classification?
Ans: The major subtypes of AML according to WHO classification are AML with
mutated NPM.
Q387. What is the clinical course of homozygous sickle cell disease?

Ans: The clinical course of homozygous sickle cell disease usually becomes apparent
after the sixth month of life. The anemia is severe and a feared complication is the
acute chest syndrome, which can be triggered by pulmonary infections or fat emboli
from necrotic marrow that secondarily involve the lung. Another major complication
is central nervous system stroke. Sickle cell disease patients are prone to infections
by encapsulated bacteria, such as pneumococci.
Q388. What is the most common leukemia of adults in the western

world?
Ans: Small lymphocytic lymphoma/chronic lymphocytic leukemia is the most

common leukemia of adults in the western world.

lymphadenitis?

Q390. What are the Non Neoplastic Disorders of White Cells?
Ans: : The Non Neoplastic Disorders of White Cells include leukopenia resulting most
commonly from a decrease in granulocytes, and lymphopenia which is associated
with congenital immunodeficiency diseases or acquired conditions such as advanced
human immunodeficiency virus (HIV) infection or treatment with corticosteroids.
Neutropenia/Agranulocytosis is characterized by a total white cell count which is
reduced to 1000 cells/ L and in some instances to as few as 200 to 300 cells/ L,
making the affected individuals extremely susceptible to bacterial and fungal
infections. Reactive Leukocytosis is common in a variety of reactive inflammatory
states caused by microbial and nonmicrobial stimuli.
Q391. What are the two types of anemia based on the morphology of
red cells?
Ans: The two types of anemia based on the morphology of red cells are normocytic
and microcytic or macrocytic, and normochromic or hypochromic.
Q392. How is acute myelogenous leukemia (AML) typically diagnosed?
Ans: AML is typically diagnosed by the presence of monoclonal proliferations that

replace normal bone marrow cells. It is also diagnosed by the presence of distinctive
red staining rodlike structures (Auer rods) which are typically found in myeloblasts or
more differentiated cells.
reticulocytosis, and the retention of products of red cell destruction.
Q394. What are the clinical signs and symptoms of acute

lymphoblastic leukemia?
Ans: The clinical signs and symptoms of acute lymphoblastic leukemia include fatigue
(due mainly to anemia), fever (reflecting infections resulting from the absence of
mature leukocytes), and bleeding (petechiae, ecchymoses, epistaxis, gum bleeding)
lymphadenopathy, splenomegaly, and hepatomegaly, and central nervous system
manifestations such as headache, vomiting, and nerve palsies resulting from
meningeal spread.
Q395. What type of tumor is follicular lymphoma?
Ans: Follicular lymphoma is a relatively common tumor that constitutes 40% of the
adult NHLs in the United States. It is a low grade tumor.
Ans: Hodgkin Lymphoma is a distinctive group of neoplasms that arise almost

invariably in a single lymph node or chain of lymph nodes and spread
inflammatory cells. It is often associated with somewhat distinctive clinical features,
including systemic manifestations such as fever, and has a stereotypical pattern of
spread.
Ans: The pathogenesis of diffuse large B cell lymphoma is thought to involve an

expansion of neoplastic B cells, suppression of the function of normal B cells,
production of autoantibodies to B cells, and a breakdown in immune regulation.
Q398. What are the morphological features of hereditary

spherocytosis?
Ans: The morphological features of hereditary spherocytosis include the red cells
lacking a central zone of pallor due to their spheroidal shape, compensatory
hyperplasia of marrow red cell progenitors, and an increase in red cell production
marked by peripheral blood reticulocytosis.
Ans: Lymphadenopathy is an immune response against foreign antigens, typically

resulting in enlargement of the lymph nodes.
Q400. What is the clinical picture of small lymphocytic

Ans: Small lymphocytic lymphoma/chronic lymphocytic leukemia is often

asymptomatic at presentation. The most common symptoms are easy fatigability,
weight loss, and anorexia. Generalized lymphadenopathy and hepatosplenomegaly
are present in 50% to 60% of cases. The total leukocyte count may be increased only
slightly (in SLL) or may exceed 200,000 cells/L. Hypogammaglobulinemia,
autoimmune hemolytic anemia and thrombocytopenia are also seen in some
patients.

Ans: Pernicious anemia is a type of vitamin B12 deficiency resulting from inadequate
gastric production or defective function of intrinsic factor.
Q402. What are the morphological alterations in sickle cell anemia?
Ans: The morphological alterations in sickle cell anemia stem from the severe
chronic hemolytic anemia, increased breakdown of heme pigments which are
processed into bilirubin, and microvascular obstruction which provokes tissue
ischemia and infarction. In peripheral smears, bizarre elongated, spindled, or boat
shaped irreversibly sickled red cells are evident.
Q403. What is Acute Myelogenous Leukemia?
Ans: Acute Myelogenous Leukemia is an extremely heterogeneous disorder with a

median age of 50 years. The clinical signs and symptoms, which closely resemble
those produced by ALL, are usually related to marrow failure caused by the
replacement of normal marrow elements by leukemic blasts. By definition, in AML
cellularity. Distinctive red staining rodlike structures (Auer rods) may be present in
myeloblasts or more differentiated cells.
Ans: The most common form of nutritional deficiency is iron deficiency anemia.
obstructions.

patients?
Ans: The most common form of anemia in hospitalized patients is anemia of chronic
disease.
Ans: Symptoms of acute lymphoblastic leukemia include fatigue (due mainly to

secondary to thrombocytopenia. Bone pain and tenderness, generalized
lymphadenopathy, splenomegaly, and hepatomegaly can also be present. Central
nervous system manifestations such as headache, vomiting, and nerve palsies can
also occur.
Ans: Follicular Lymphoma is a relatively common type of NHL which constitutes 40%
of adult NHLs in the United States. It is characterized by effacement of the lymph
nodes by proliferations that usually have a distinctly nodular appearance, and the
tumor cells resemble normal follicular center B cells. It is a low grade tumor and has
the potential to transform to Diffuse Large B-Cell Lymphoma (DLBCL).
Q409. What is the normal life span of a red cell?
Ans: The normal life span of a red cell is approximately 120 days.
Q410. What is the main symptom of neutropenia/agranulocytosis?
Ans: The main symptom of neutropenia/agranulocytosis is an extreme susceptibility

to bacterial and fungal infections, which can be severe enough to cause death.
Q411. What is the prototypical hemoglobinopathy?
Ans: The prototypical hemoglobinopathy is caused by a mutation in the globin chain

gene that creates sickle hemoglobin (HbS).
Q412. What is Multiple Myeloma and Related Plasma Cell Disorders?

Ans: Multiple Myeloma and Related Plasma Cell Disorders is a neoplasm that arises
from a clone of B cells which differentiate into plasma cells and secrete a single
complete or partial immunoglobulin. The plasma cell dyscrasias can be divided into
six major variants: multiple myeloma, localized plasmacytoma, lymphoplasmacytic
lymphoma, heavy chain disease, primary or immunocyte associated amyloidosis, and
monoclonal gammopathy of undetermined significance. Myelomatous nephrosis is
characterized by the presence of protein casts in distal convoluted tubules and
collecting ducts.
Q413. What is the primary cause of lymphopenia?
Ans: The primary causes of lymphopenia are congenital immunodeficiency diseases

and advanced human immunodeficiency virus (HIV) infection or treatment with
corticosteroids.
Q414. What is the etiology of Hodgkin Lymphoma?
Ans: : The etiology of Hodgkin Lymphoma is believed to stem from a neoplasm

arising from germinal center B cells. The EBV genome is present in the RS cells in as
many as 70% of cases of the mixed cellularity type and a smaller fraction of the
nodular sclerosis type.
Ans: Acute lymphoblastic leukemia (ALL) is a type of lymphoblastic tumor composed

of immature lymphocytes, which occurs predominantly in children and young adults.
It is the most common type of childhood leukemia, and can take on the clinical
appearance of an acute lymphoblastic leukemia at some time during its course.
Q416. What are the common etiologies of Acute Myelogenous Leukemia?
Ans: The common etiologies of Acute Myelogenous Leukemia include heredity

(trisomy 21), radiation exposure, and exposure to chemicals such as benzene and
alkylating agents.
Q417. What is the most common type of lymphoma in adults?

Ans: Diffuse large B cell lymphoma is the most common type of lymphoma in adults,
accounting for approximately 50% of adult NHL. It is characterized by a B cell
phenotype, a diffuse growth pattern, and an aggressive clinical history.
Q418. What is the normal adult red cell composition?
Ans: : The normal adult red cell composition is 96% HbA (2 2), 3% HbA2 (2 2), and 1%
fetal Hb (HbF, 2 2).
Ans: : Burkitt lymphoma is a type of high-grade tumor that is endemic in some parts
of Africa and sporadic in other areas, including the United States. It is usually
associated with Epstein-Barr virus (EBV) and most commonly affects children and
young adults. It typically arises at extranodal sites and is aggressive and fatal.
Q420. What is EBV associated NHL?
Ans: EBV associated NHL is a type of childhood Non-Hodgkin's Lymphoma (NHL) that
accounts for approximately 30% of childhood NHLs in the United States. It usually
arises from extranodal sites and involves the maxilla or mandible in African patients,
while abdominal tumors involving the bowel, retroperitoneum, and ovaries are more
common in North America.
Q421. What are the two types of polycythemia?
Ans: The two types of polycythemia are relative, which is caused by a decrease in
plasma volume, and absolute, which is caused by an increase in the total red cell
mass.
Q423. What is Myeloid Neoplasms?
Ans: Myeloid neoplasms arise from hematopoietic stem cells and typically give rise
to monoclonal proliferations that replace normal bone marrow cells. There are three
general categories of myeloid neoplasia: acute myelogenous leukemia, chronic
myeloproliferative disorders, and myelodysplastic syndromes.
Ans: The major subtypes of AML in the WHO Classification are AML with
mutated NPM.
Q425. What is the incidence of sickle cell anemia?
Ans: Approximately 8% of American blacks are heterozygous for HbS, and in parts of
Africa where malaria is endemic the gene frequency approaches 30%. Sickle cell
Q426. What is a reactive leukocytosis?
Ans: : A reactive leukocytosis is an increase in white blood cell count that is common
in a variety of reactive inflammatory states caused by microbial and nonmicrobial
stimuli.
Q427. What are the clinical features of Acute Myelogenous Leukemia?
Ans: The clinical features of Acute Myelogenous Leukemia include fatigue and pallor,
abnormal bleeding, and infections that usually present within a few weeks of the
onset of symptoms. Splenomegaly and lymphadenopathy are in general less
prominent than in ALL.
lymphadenitis?

Q429. What is the main cause of iron deficiency anemia?
Ans: The main cause of iron deficiency anemia is an inadequate dietary supply of iron,
malabsorption, increased demands not met by normal dietary intake, or chronic
blood loss.
Q430. What is the pathogenesis of aplastic anemia?
Ans: The pathogenesis of aplastic anemia is thought to involve autoreactive T cells

suppressing the multipotent myeloid stem cells, leading to marrow failure and
pancytopenia.
reticulocytosis, and the retention by the body of the products of red cell destruction
(including iron).
Q432. What are the characteristic clinical features of hereditary

spherocytosis?
Ans: The characteristic clinical features of hereditary spherocytosis are anemia,

splenomegaly, and jaundice. Most commonly the anemia is moderate in severity,
and the clinical course is often stable but may be punctuated by aplastic crises.
Q433. What is the primary cause of megaloblastic anemias?

Ans: The primary cause of megaloblastic anemias is a deficiency in either folate or
vitamin B12.

leukemia?
Ans: Small lymphocytic lymphoma/chronic lymphocytic leukemia is a type of

lymphoid neoplasm, consisting of morphologically, phenotypically, and genotypically
identical diseases, which differ only in the extent of peripheral blood involvement. If
the peripheral blood lymphocytosis exceeds 4000 cells/mm3, the patient is
diagnosed with chronic lymphocytic leukemia (CLL); if not, a diagnosis of small
lymphocytic lymphoma (SLL) is made.
Q435. What is the primary cause of hereditary spherocytosis?
Ans: The primary cause of hereditary spherocytosis is an inherited (intrinsic) defect

in the red cell membrane that renders the cells spheroidal, less deformable, and
vulnerable to splenic sequestration and destruction.
Fillups (185 Questions)
Q436. The pathogenetic events leading to marrow failure in Aplastic

Anemia remain ___________.
1. Clear
2. Vague
3. Ambiguous
4. Neat
Q437. Megaloblastic Anemias are caused by _______________.

1. Folate deficiency
2. Vitamin B12 deficiency
3. Iron Deficiency Anemia
4. Malaria
Q438. The anemia resulting from Vitamin B12 Deficiency is known as

___________.
1. Folate Deficiency Anemia
2. Megaloblastic Anemia
4. Pernicious Anemia
Q439. Neutropenia/Agranulocytosis is characterized by a total white

cell count of ____________.
1. 500 cells/L
2. 1000 cells/L
3. 200 to 300 cells/L
4. 5000 cells/L
Q440. In Iron Deficiency Anemia ____________ is often accompanied by

an increase in the platelet count.
1. Iron balance
2. Extramedullary hematopoiesis
3. Microangiopathic hemolytic anemia
4. Normocytic and normochromic red cells
Q441. Iron balance is maintained largely by ____________.
1. Malabsorption
2. Decrease in plasma volume
3. Regulating the absorption of dietary iron
4. Increase in platelet count
Q442. Reactive Leukocytosis is usually caused by ___________.
1. Inadequate or ineffective granulopoiesis
2. Accelerated removal or destruction of neutrophils
3. Microbial and nonmicrobial stimuli
4. Malabsorption
Q443. Polycythemia, or erythrocytosis, is an increase in the

_________ concentration of red cells.
1. Blood
2. Plasma
3. Hemoglobin
4. All of the above
Q444. The morphologic hallmark of Megaloblastic Anemias is

____________.
1. Enlargement of red cells
2. Hypersegmented neutrophils
3. Enlargement of erythroid precursors
4. Burr cells, helmet cells, and triangle cells
Q445. The phenomenon documented which proved the accuracy of General

Relativity to better than a trillionth of a percent was ___________.
1. The solar eclipse of 1919
2. The Cosmic Microwave Background Radiation
3. The bending of light around the sun
4. The orbiting of two neutron stars
Q446. In Sickle Cell Anemia, the abnormal hemoglobin is called _____.
1. HbS
2. HbF
3. HbA
4. HbA2
Q447. Polycythemia can be relative or absolute. Relative
polycythemia is caused by ________________.
1. An increase in the total red cell mass
2. A decrease in plasma volume
3. High altitude living
4. Surreptitious erythropoietin use
Q448. _____ is the average content (mass) of hemoglobin per red cell,
expressed in picograms.
1. Mean cell volume (MCV)
2. Mean cell hemoglobin (MCH)
3. Mean cell hemoglobin concentration (MCHC)
4. Red cell distribution width (RDW)
Q449. Aplastic anemia is observed in a variety of pathologic states

in which small vessels become partially obstructed. Such anemias are
referred to as ___________.
1. Megaloblastic Anemias
2. Immunohemolytic Anemias
3. Anemias of Diminished Erythropoiesis
4. Microangiopathic Hemolytic Anemia

Q450. Reactive Leukocytosis is common in a variety of reactive
inflammatory states caused by ______________.
1. Viral infections
3. Corticosteroids
4. Surreptitious erythropoietin use
Q451. Neutropenia is associated with _______________.
1. Congenital Immunodeficiency Diseases
2. Advanced Human Immunodeficiency Virus (HIV) Infection
3. Appropriate Lung Disease
4. All of the above
Q452. The most common form of nutritional deficiency is

_______________.
1. Anemia of Chronic Disease
2. Vitamin B12 Deficiency Anemia
Q453. In most cases of Hemolytic Anemias, the anemia is _____.

1. Severe
2. Mild
3. Moderate
4. Acute
Q454. In Sickle Cell Anemia, the normal adult red cell contains
_____.
1. 3% HbA2 (2 2)
2. 96% HbS (2 2)
3. 96% HbA (2 2)
4. 1% Fetal Hb (HbF, 2 2)
Q455. Extravascular hemolysis is not associated with _____.
1. Bilirubin
2. Hemoglobinemia
3. Gallstones
4. Hemoglobinuria
Q456. With chronic blood loss, _____ are gradually depleted.
1. Reticulocytes
2. Iron stores
3. Hemoglobin
4. Red cells
Q457. Neutropenia is characterized by a total white cell count of

___________.
1. 1000 cells/L
2. 2000 cells/L
3. 3000 cells/L
4. 4000 cells/L
Q458. _____ is the coefficient of variation of red cell volume.
1. Red cell distribution width (RDW)
2. Mean cell volume (MCV)
3. Mean cell hemoglobin concentration (MCHC)
4. Mean cell hemoglobin (MCH)
Q459. Megaloblastic anemia is characterized by the enlargement of

____________.
1. Granulocyte precursors
2. Red cells
3. White cells
4. Platelets
Q460. The thalassemias are a heterogeneous group of inherited

disorders caused by mutations that decrease the rate of synthesis of
___________.
1. Vitamin B12
2. Folic acid
3. Iron
4. Hemoglobin
Q461. Aplastic anemia is caused by ______________.
1. Inadequate or ineffective granulopoiesis
2. Autoreactive T Cells
4. All of the above
Q462. The characteristic clinical features of Hereditary

Spherocytosis are anemia, _____ and jaundice.
1. Splenomegaly
2. Extramedullary hematopoiesis
3. Phagocytosed red cells
4. Hypoxic tissue damage

Q463. Pernicious anemia is caused by a deficiency of _____________.
1. Vitamin B12
2. Folate
3. Iron
4. Hemoglobin
Q464. Anemias of Blood loss, Hemolytic anemia and Anemia of

diminished erythropoiesis are the classification of anemia based on
the _____.
1. Degree of hemoglobinization
2. Morphology of red cells
3. Underlying the cause
4. Reticulocyte count
Q465. In normal development of blood cells, red cells are produced

in _____.
1. Bone marrow
2. Spleen
3. Liver
4. Lymph nodes

___________.
1. An enlargement of erythroid precursors
2. An enlargement of granulocyte precursors
3. An increase in the platelet count
4. Burr cells, helmet cells, and triangle cells
Q467. Reactive Leukocytosis is caused by __________.
1. Inadequate granulopoiesis
4. An increase in the hemoglobin concentration
Q468. Megaloblastic Anemias are caused by a deficiency of __________.
1. Iron
2. Vitamin B12
3. Folic acid
4. Vitamin C
Q469. Polycythemia is an increase in the blood concentration of

___________.
1. Neutrophils
2. Lymphocytes
3. Red cells
4. Platelets
Q470. _____ is characterized by distention and prominence of the

lymphatic sinusoids.
1. Precursor B and T Cell Lymphoblastic Leukemia/Lymphoma
2. Acute lymphoblastic leukemia
3. Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia
4. Sinus Histiocytosis
Q471. Iron Deficiency Anemia is caused by __________.
1. Low intake
2. Malabsorption
3. Increased demands
4. All of the above
Q472. _____ is the most common symptoms in small lymphocytic

lymphoma/chronic lymphocytic leukemia.
1. Easy fatigability
2. Bone pain and tenderness
3. Generalized lymphadenopathy
4. Fever
Q473. Vitamin B12 Deficiency Anemia is also known as ___________.
2. Aplastic Anemia
Q474. _____ is the most important type of lymphoma in adults.
2. Chronic lymphocytic leukemia
3. Small lymphocytic lymphoma
4. Diffuse large B cell lymphoma

Relativity to better than a trillionth of a percent was _________.
Q476. Immunohemolytic Anemias are classified based on ___________.

1. The nature of the antibody and the presence of certain predisposing
condition
2. The morphologic alterations in the injured red cells
3. The cause of the anemia
4. The onset of the anemia
Q477. _____ is the most common type of peripheral blood involvement

in small lymphocytic lymphoma/chronic lymphocytic leukemia.
1. Leukocytosis
2. Anemia
3. Thrombocytopenia
4. Lymphocytosis
Q478. _____ is the most common childhood leukemia.
Q479. The pathogenesis of _____ is associated with EBV.

Q480. Neutropenia/Agranulocytosis is characteristically associated

with a total white cell count of _________.
1. 1000 cells/L
2. 200 to 300 cells/L
3. 5000 cells/L
4. 10000 cells/L
Q481. The three major categories of white cell disorders based on

the origin of the tumor cells are _____, _____ and _____.
1. Lymphoid neoplasms, Myeloid neoplasms, Histiocytic neoplasms
2. Acute lymphoblastic leukemia, Pre B cell origin, Pre T cell tumors
3. Acute myeloid leukemia, Hodgkin lymphoma, Chronic myeloid leukemia
4. Non Hodgkin’s lymphoma, Small lymphocytic lymphoma, Burkitt lymphoma
Q482. _____ is the most common leukemia of adults in the western

world.

4. Acute myeloid leukemia
Q483. _____ are seen in most patients with small lymphocytic

lymphoma/chronic lymphocytic leukemia.
1. Autoantibodeis to B cells
2. Break down in immune regulation
3. An absolute lymphocytosis of small, mature looking lymphocytes
4. Hypogammaglobulinemia
Q484. Aplastic Anemia results from the suppression of ___________.
1. Neutrophils
2. Lymphocytes
3. Megaloblasts
4. Multipotent myeloid stem cells
Q485. _____ is the diagnostic category which includes several forms

of NHL that share certain features.

Q486. Vitamin B12 deficiency can cause a __________ disorder

involving the peripheral nerves.
1. Neural
2. Nervous
3. Demyelinating
4. Electrical
Q487. A deficiency of vitamin B12 is caused by __________.
1. Iron deficiency
2. Megaloblastic anemia
3. Pernicious anemia
4. Aplastic anemia
Q488. Burkitt Lymphoma is associated with ___________.
1. HIV
2. EBV
3. Rheumatoid Arthritis
4. Toxoplasmosis
Q489. Leukopenia results most commonly from a decrease in __________.

1. White cells
2. Red cells
3. Hemoglobin
4. Granulocytes
Q490. Bone marrow failure (aplastic anemia) is caused by __________.
1. Intrinsic factor
2. Malabsorption
3. Tumor or inflammatory cells
4. Low intake
Q491. Follicular hyperplasia is usually seen in ___________.
1. HIV infection
2. Vaccinations
3. Rheumatoid arthritis
4. Toxoplasmosis
Q492. __________ anemia is observed in a variety of pathologic

states in which small vessels become partially obstructed.
1. Iron deficiency
2. Megaloblastic
3. Microangiopathic
4. Aplastic
Q493. The WHO classification of lymphoid neoplasms considers

___________.
1. Cell of origin
2. Genotype
3. Morphology
4. All of the above
Q494. Reactive leukocytosis is common in a variety of __________

states.
1. Microbial
2. Non-microbial
3. Reactive inflammatory
4. Neoplastic
Q495. Polycythemia, or erythrocytosis, is denoted by an increase in

the __________ concentration.
1. Blood
2. Hemoglobin
3. Red cells
4. Plasma
Q496. Pathogenesis of neutropenia can be broadly divided into

__________ categories.
1. Two
2. Three
3. Four
4. Five
Q497. Iron balance is maintained largely by regulating __________.
1. The red cell count
2. The hemoglobin concentration
3. The absorption of dietary iron
4. The platelet count
Q498. Precursor B and T Cell Lymphoblastic Leukemia/Lymphoma is most

common in ___________.
1. Adolescent males
2. Elderly
3. Children
4. Young adults
Q499. Diffuse Large B Cell Lymphoma is the most important type of
lymphoma in_________.
1. Children
2. Young adults
3. Adults
4. Elderly
Q500. Paracortical hyperplasia is usually seen in ___________.
1. HIV infection
2. Rheumatoid arthritis
3. Vaccinations
4. Toxoplasmosis
Q501. The nuclei of the neoplastic B cells in diffuse large B cell

lymphoma are ___________.
1. small
2. Fragile
3. Large
4. Round
Q502. The most common symptoms of small lymphocytic lymphoma/chronic

lymphocytic leukemia are ___________.
1. Easy fatigability, weight gain, and anorexia
2. Joint pain and tenderness
3. Platelet count below 100,000
4. Generalized lymphadenopathy and splenomegaly
Q503. Any immune response against foreign antigens is often

associated with ___________.
1. Splenomegaly
2. Lymphadenopathy
3. Hepatomegaly
4. Bone pain
Q504. The morphologic alterations in the injured red cells

(schistocytes) are __________ and quite characteristic.
1. Subtle
2. Distinguishable
3. Striking
4. Normal
Q505. Sinus Histiocytosis is often encountered in lymph nodes

___________.
1. draining cancers
2. draining infections
3. draining vaccinations
4. draining drugs
Q506. The hemoglobinopathies are a group of hereditary disorders

that are defined by the presence of _____.
1. Structurally normal hemoglobins
2. Structurally abnormal hemoglobins
3. Non-hereditary hemoglobins
4. Both A and C
Q507. The anemia of Chronic Disease is caused by ___________.
1. Idiopathic
2. Viral Infections
3. Myelotoxic Agents
4. Inflammation induced sequestration of iron
Q508. The pathogenetic events leading to marrow failure in Aplastic

Anemia remain ___________.
1. Clear
2. Obscure
3. Understandable
4. Unknown
Q509. In children, the chronic splenic erythrostasis results in

_____.
1. Congestion of the red pulp
2. Tissue ischemia
3. Infarction
4. Progressive hypoxic tissue damage
Q510. Anemias that are associated with accelerated destruction of

red cells are termed _____.
1. Microcytic anemias
2. Normocytic anemias
3. Normochromic anemias
4. Hemolytic anemias
Q511. The morphologic hallmark of megaloblastic anemias is an

enlargement of ___________.
1. Granulocyte precursors
2. Erythrocytes
3. Erythroid precursors
4. Neutrophils
Q512. The prototypical hemoglobinopathy is caused by a mutation in

the globin chain gene that creates _____.
1. HbA
2. HbA2
3. HbF
4. HbS
Q513. Neutropenia/Agranulocytosis is characterized by a total white

cell count of ___________.
1. 1000 cells/L
2. 500 cells/L
3. 200 cells/L
4. 300 cells/L
Q514. Iron balance is maintained largely by regulating the

absorption of ___________.
1. Vitamin B12
2. Folic Acid
3. Intrinsic Factor
4. Dietary Iron
Q515. Polycythemia, or erythrocytosis, is an increase in the blood
concentration of ___________.
1. White Cells
2. Hemoglobin
3. Red Cells
4. Neutrophils
Q516. In homozygotes, _____ is replaced by HbS.
1. HbA2
2. Fetal Hb
3. HbA
4. HbF
Q517. The anatomic alterations in sickle cell anemia stem from _____.
1. The microvascular obstruction
2. The severe chronic hemolytic anemia
3. The increased breakdown of heme pigments
4. All of the above
Q518. In peripheral smears, irreversibly sickled red cells appear

_____.
1. Boat shaped
2. Spindled
3. Elongated
4. All of the above
Q519. The normal adult red cell contains _____.
1. 2% HbA
2. 96% HbA
3. 1% HbF
4. 3% HbA2
Q520. Inappropriate erythropoietin secreting tumors include

___________.
1. Renal Cell Carcinoma
2. Hepatoma
3. Cerebellar Hemangioblastoma
4. All of the above
Q521. The thalassemias are a heterogeneous group of inherited

disorders caused by mutations that decrease the rate of synthesis of
___________.
1. DNA
2. Intrinsic Factor
3. Folic Acid
4. Vitamin B12
Q522. The abnormal hemoglobin present in the sickle cell anemia is

_____.
1. HbA
2. HbF
3. HbA2
4. HbS
Q523. In parts of Africa where malaria is endemic, the gene

frequency of HbS is _____.
1. 1%
2. 8%
3. 25%
4. 30%
Q524. Vitamin B12 deficiency anemia is also referred to as

___________.
2. Folate Deficiency Anemia

3. Aplastic Anemia
Q525. Non-neoplastic disorders of white cells include ___________.
1. Deficiencies and Neoplasms
2. Reactive and Neoplastic
3. Proliferations and Deficiencies
4. Reactive and Proliferations
Q526. In children there is moderate _________ caused by congestion

of the red pulp.
1. Infarction
2. Splenomegaly
3. Hemolysis
4. Icterus
Q527. Extravascular hemolysis is not associated with ___________.
1. Hemoglobinuria
2. Hemoglobinemia
3. Jaundice
4. Gallstones
Q528. . Burkitt lymphoma is commonly seen in _____.
1. Children and young adults
2. Adults over 40 years of age
3. Only endemic regions
4. Patients with autoimmune diseases
Q529. . Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia is

characterized by _____.
1. High grade tumor
2. Aggressive clinical history
3. Peripheral blood lymphocytosis
4. Diffuse growth pattern
Q530. Neutropenia/Agranulocytosis is characteristically observed

when the total white cell count is reduced to ___________.
1. 1000 cells/L
2. 200 cells/L
3. 500 cells/L
4. 1100 cells/L
Q531. The hemoglobinopathies are a group of hereditary disorders

that are defined by the presence of structurally abnormal _________.
1. Hemoglobin
2. Globins
3. Red Cells
4. Anemia
Q532. Approximately 8% of American blacks are _________ for HbS.
1. Heterozygous
2. Homozygous
3. Recessive
4. Dominant
Q533. Neutropenia/Agranulocytosis can be broadly divided into two

categories ___________ and ___________.
1. Inadequate or ineffective granulopoiesis, Accelerated removal
2. Effective granulopoiesis, Accelerated destruction
3. Inadequate or ineffective granulopoiesis, Accelerated destruction
4. Effective granulopoiesis, Accelerated removal
Q534. . The WHO classification of lymphoid neoplasms considers _____

in determining the origin of the tumor cells.
1. Morphology
2. Cell type
3. Genotype
4. All of the above
Q535. ___________ is the term used to describe an increase in the

blood concentration of red cells.
1. Leukopenia
2. Lymphopenia
3. Neutropenia
4. Polycythemia
Q536. The normal adult red cell contains 96% __________.
1. HbA
2. HbA2
3. Fetal Hb
4. HbS
Q537. . Sinus histiocytosis is often seen in lymph nodes associated

with _____.
1. Systemic bacterial infections
2. Systemic viral infections

3. Cancers
4. Vaccinations
Q538. The morphologic alterations in the injured red cells seen in

hemolytic anemias resulting from mechanical trauma are ___________.
1. Schistocytes
2. Burr cells
3. Helmet cells
4. Triangle cells
Q539. Iron is essential for hemoglobin synthesis and effective

___________.
1. Reticulocytosis
2. Extravascular hemolysis
3. Intravascular hemolysis
4. Erythropoiesis
Q540. Non-neoplastic disorders of white cells include ___________.
1. Leukopenias
2. Lymphopenias
3. Neutropenias
4. Polycythemias
Q541. Etiology of pernicious anemia seems to stem from an autoimmune

reaction against ___________ and intrinsic factor itself.
1. Reticuloendothelial cells
2. Parietal cells
3. Myeloid stem cells
4. Erythroid precursors
Q542. Pernicious Anemia is used to describe Vitamin B12 deficiency

resulting from inadequate gastric production or defective function
of __________.
1. Folate
2. Iron
3. Vitamin B12
4. Intrinsic factor
Q543. In peripheral smears, bizarre elongated, spindled, or boat

shaped irreversibly _________ red cells are evident.
1. Round
2. Oval
3. Sickled
4. Normal
Q544. . Myeloid neoplasms are a type of _____.
1. B-cell tumors
2. T-cell tumors
3. Histiocytic tumors
4. White cell disorders
Q545. ___________ is the most common form of anemia in hospitalized

patients.
2. ernicious Anemia
Q546. HbS results from a single amino acid substitution in the

__________ gene.
1. Globin
2. Hemoglobin
3. Red cell
4. Anemia
Q547. In homozygotes all HbA is replaced by __________.

1. HbS
2. HbA2
3. Fetal Hb
4. HbF
Q548. The anatomic alterations in sickle cell anemia stem from the
__________ aspects of the disease.
1. Three
2. Two
3. Four
4. Five
Q549. Reactive leukocytosis is common in a variety of reactive

inflammatory states caused by ___________.
1. Bacterial infections
2. Fungal infections
4. Viral infections
Q550. The anemia caused due to inadequate dietary supply of

__________ is Iron Deficiency Anemia.
1. Folate
2. Vitamin B12
3. Iron
4. Calcium
Q551. The WHO classification of lymphoid neoplasms considers

__________, cell of origin, clinical features, and genotype of each
entity.
1. Morphology
2. Tumor size
3. Cell composition
4. Chromosomal structure
Q552. The white cell count in patients with acute lymphoblastic

leukemia (ALL) is usually ____________.
1. Elevated
2. Normal
3. Variable
4. Low
Q553. The nuclei of the neoplastic B cells in Diffuse Large B Cell

Lymphoma are ___________.
1. Small
2. Medium
3. Large
4. Giant
Q554. The ___________ form of Burkitt Lymphoma is associated with

Epstein Barr Virus (EBV).
1. African
2. Endemic
3. Non-endemic
4. Sporadic
Q555. The most common symptoms of Small Lymphocytic Lymphoma/Chronic

Lymphocytic Leukemia (CLL) are ___________.
1. Fever, headache, vomiting
2. Bone pain, tenderness
3. Easy fatigability, weight loss, and anorexia
4. Petechiae, ecchymoses, epistaxis, gum bleeding
Q556. ___________ is the most common form of anemia in hospitalized

patients.
2. Vitamin B12 Deficiency
3. Aplastic Anemia
Q557. Reactive Leukocytosis is commonly observed in ___________.
3. Reactive Inflammatory States
Q558. The anemia caused by Vitamin B12 Deficiency is ___________.
3. Aplastic Anemia
Q559. ___________ is an increase in the blood concentration of red

cells, which usually correlates with an increase in the hemoglobin
concentration.
1. Anemia
2. Leukopenia
3. Polycythemia
Q560. The non-Hodgkin's Lymphoma (NHL) is segregated on the basis of
origin into ___________ categories.
1. Three
2. Four
3. Five
4. Six
Q561. Most patients with Small Lymphocytic Lymphoma/Chronic

Lymphocytic Leukemia (CLL) have a ___________ peripheral blood
lymphocytosis.
1. High
2. Normal
3. Moderate
4. Low
Q562. ___________ is the most common form of nutritional deficiency.
Q563. The Burkitt Lymphoma is _________ in some parts of Africa and

___________ in other areas.
1. Endemic; Sporadic
2. Endemic; Endemic
3. Sporadic; Endemic
4. Sporadic; Sporadic
Q564. Patients with Burkitt Lymphoma typically present with a

___________ mass at one or several sites.
1. Rapidly enlarging
2. Slow enlarging
3. Painless
4. Painful
Q565. ___________ is an autoimmune reaction against parietal cells

and intrinsic factor itself.
3. Aplastic Anemia

___________.
1. An enlargement of erythroid precursors

2. A decrease in the rate of synthesis of globin chains
3. An increase in the platelet count
4. Highly characteristic hypersegmented neutrophils
Q567. ___________ is the phenomenon documented which proved the

accuracy of General Relativity to better than a trillionth of a
percent.
Q568. ___________ is the primary cause of Vitamin B12 Deficiency

Anemia.
1. Inadequate Gastric Production
2. Defective Function of Intrinsic Factor
3. Increased Erythropoietin Levels
4. Malabsorption
Q569. Neutropenia/Agranulocytosis is characterized by a reduction of

total white cell count to ___________ cells/L.
1. 1000
2. 2000
3. 500
4. 300
Q570. The Epstein Barr Virus (EBV) is implicated in the pathogenesis

of ____________.
1. Small Lymphocytic Lymphoma
2. Chronic Lymphocytic Leukemia
3. Diffuse Large B Cell Lymphoma
4. Precursor B and T Cell Lymphoblastic Leukemia/Lymphoma
Q571. __________ are uncommon forms of hemolytic anemia.
3. Immunohemolytic Anemias
4. Aplastic Anemia
Q572. Anemia of blood loss is usually________.
1. Normocytic
2. Microcytic
3. Macrocytic
4. Normochromic
Q573. In homozygotes for sickle cell anemia, the normal adult red
cell contains ______.
1. 0% HbA
2. 1% HbA
3. 3% HbA
4. 96% HbA
Q574. __________ are a heterogeneous group of inherited disorders

caused by mutations that decrease the rate of synthesis of or globin
chains.
1. Aplastic Anemia
2. Reactive Leukocytosis
4. Thalassemias
Q575. __________ is an autoimmune reaction against parietal cells

and intrinsic factor itself which causes Vitamin B12 deficiency.
2. Aplastic Anemia
Q576. __________ is the most common form of nutritional deficiency.

3. Vitamin B12 Deficiency Anemia
4. Aplastic Anemia
Q577. __________ is a decrease in plasma volume which causes

relative Polycythemia.
1. Increased erythropoietin levels
2. Decreased erythropoietin levels
3. High altitude living
4. Plasma volume decrease
Q578. The anatomic alterations in sickle cell anemia stem from______.
1. Increased breakdown of heme pigments
2. Microvascular obstruction
3. Chronic splenic erythrostasis
4. Chronic extravascular hemolytic anemia
Q579. Reactive Leukocytosis is commonly observed in __________

states.
1. Neoplastic
2. Megaloblastic
3. Reactive inflammatory
4. Immunodeficiency
Q580. In homozygotes all HbA is replaced by ______.
1. HbA2
2. HbF
3. HbS
4. HbO
Q581. Neutropenia is characteristically diagnosed when the total

white cell count is reduced to __________ cells/ L.
1. 1000
2. 200
3. 300
4. 500
Q582. Approximately ______ of American blacks are heterozygous for

HbS.
1. 6%
2. 8%
3. 10%
4. 12%
Q583. Red cell indices include _______, MCH, MCHC and RDW.
1. MCV
2. MCH
3. MCHC
4. MCV, MCH, MCHC and RDW
Q584. Extramedullary hematopoiesis often develops in the _______.
1. Spleen
2. Liver
3. Lymph nodes
4. Spleen, liver, and lymph nodes
Q585. With chronic blood loss, iron stores are gradually depleted
leading to ______.
1. Normocytic anemia
2. Hemolytic anemia
3. Anemia of underproduction
4. Anemia of blood loss

Q586. __________ is an effective form of therapy for Aplastic Anemia.
1. Immunohemolytic Anemia
3. Bone marrow transplantation
Q587. __________ is a disease which causes Vitamin B12 deficiency

resulting from inadequate gastric production or defective function
of intrinsic factor.
3. Aplastic Anemia
Q588. The onset of the marrow response is marked by ________.
1. Hypovolemia
2. Jaundice
3. Reticulocytosis
4. Aplastic crises
Q589. __________ is an increase in the blood concentration of red

cells, which usually correlates with an increase in the hemoglobin
concentration.
1. Aplastic Anemia
4. Polycythemia
Q590. Hemoglobinopathies are a group of hereditary disorders

identified by the presence of _______.
1. Structurally abnormal hemoglobins
2. Inherent red cell defects
3. Reduced red cell mass
4. Iron deficiency
Q591. Inappropriate erythropoietin secreting tumors are an example

of ________.
1. Relative polycythemia
2. Primary polycythemia
3. Secondary polycythemia
4. Absolute polycythemia
Q592. The anemia of chronic disease superficially resembles ________.
1. Megaloblastic anemia
3. Iron deficiency anemia
4. Aplastic anemia
Q593. Vitamin B12 deficiency is also called as ________.
1. Iron deficiency anemia
3. Folate deficiency
4. Aplastic anemia
Q594. The pathogenetic events leading to marrow failure in aplastic

anemia remain ________.
1. Well understood
2. Unclear
3. Obvious
4. Known
Q595. Polycythemia is caused by an increase in ________.
1. Plasma volume
2. Hemoglobin concentration
3. Red cell mass

4. White cells
Q596. Iron deficiency is often accompanied by ________.
1. Increase in red cells
3. Decrease in white cells
4. Increase in haemoglobin
Q597. Reactive leukocytosis is caused by ________.
1. Inadequate granulopoiesis
2. Accelerated removal of neutrophils
3. Microbial and non-microbial stimuli
4. Vitamin deficiencies
Q598. Symptoms of megaloblastic anemia include ________.
1. Weakness and pallor
2. Pica
3. Splenomegaly
Q599. Neutropenia is characterized by a total white cell count of

________.
1. 1000 cells/L
2. 200 to 300 cells/L
3. 500 cells/L
4. 1500 cells/L
Q600. Megaloblastic anemia is characterized by ________.
1. Enlargement of erythroid precursors
2. Enlargement of granulocyte precursors
Q601. In children, there is moderate splenomegaly in sickle cell

anemia caused by ___________.
1. Congestion of the red pulp
Q602. Polycythemia is also referred to as _____.
1. Erythrocytosis
4. Aplastic Anemia
Q603. Hemoglobinopathies are defined by the presence of ___________.
1. Structurally normal hemoglobin
2. Structurally abnormal hemoglobin
3. HbA2
4. HbS
Q604. Sickle cell anemia is the most common form of ___________.
1. Familial anemia
4. Familial hemolytic anemia
Q605. Neutropenia/Agranulocytosis is a disorder of white cells which

is characterized by a total white cell count of _____ cells/L.
1. 1000
2. 200
3. 300
4. 800
Q606. The morphologic hallmark of megaloblastic anemias is an
enlargement of _____.
1. Red Cells
2. Granulocytes
3. Erythroid Precursors
4. Neutrophils
Q607. In the hemoglobinopathies, Valine is substituted for

___________ in the globin chain gene.
1. Glutamic acid
2. Histidine
3. Lysine
4. Proline
Q608. Vitamin B12 deficiency anemia is known as _____.
1. Aplastic Anemia
4. Hemolytic Anemia
Q609. The chronic splenic erythrostasis in sickle cell anemia

results in ___________.
1. Infarction
3. Progressive hypoxic tissue damage
4. Hemoglobinemia

Relativity to better than a trillionth of a percent was _____.
1. The Bending of Light Around the Sun
2. The Solar Eclipse of 1919
4. The Orbiting of Two Neutron Stars
Q611. The primary cause of Iron Deficiency Anemia is _____.
1. Low Intake
2. Malabsorption
3. Chronic Blood Loss
Q612. The anemia caused by an inadequate dietary supply of

substances iron, folic acid, and vitamin B12 is _____.

Q613. Two major consequences of sickle cell anemia stem from

___________.
2. Hemolytic anemia
3. Both A and B
4. None of the above
Q614. Reactive Leukocytosis is caused by _____ stimuli.
1. Non-microbial
2. Non-inflammatory
3. Microbial
4. Immunogenic
Q615. Megaloblastic Anemias is caused by _____.
1. Folate Deficiency
3. Iron Deficiency
4. Mechanical Trauma
Q616. In homozygotes, all HbA is replaced by ___________.
1. HbA2
2. HbS
3. HbF
4. HbA
Q617. Neutropenia is caused by _____.
1. Accelerated Removal or Destruction of Neutrophils
2. Inadequate Granulopoiesis
3. Non-Microbial Stimuli
4. Immunogenic Stimuli
Q618. In peripheral smears, the characteristic red cells in sickle

cell anemia are ___________.
1. Spherical
2. Boat shaped
3. Elongated
4. Spindled
Q619. In the normal adult red cell, ___________ is present.

1. HbS
2. HbA2
3. HbF
4. HbA
Q620. The prototype hemoglobinopathy is caused by a mutation which

creates ___________.
1. HbF
2. HbA2
3. HbS
4. HbA

Patho of Hema Q&a

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Descriptive (435 Questions)

Q1. What is Polycythemia?

Ans: Polycythemia, or erythrocytosis, is an increase in the blood concentration of red

Q2. What is Hereditary Spherocytosis?

Ans: Hereditary Spherocytosis is an inherited (intrinsic) defect in the red cell

Q3. What is small lymphocytic lymphoma/chronic lymphocytic leukemia?

Ans: Small lymphocytic lymphoma/chronic lymphocytic leukemia is a type of

Q4. What are the common hemolytic anemia?

Q6. What is acute nonspecific lymphadenitis?

Ans: Acute nonspecific lymphadenitis is a form of lymphadenitis that may be

Q7. What is the result of iron deficiency anemia?

Q8. What is pernicious anemia?

Q9. What is Anemia of Blood Loss?

Ans: Anemia of Blood Loss is an anemia caused by excessive bleeding or hemorrhage.

Q10. What is diffuse large B cell lymphoma?

Ans: Diffuse large B cell lymphoma is a type of non-Hodgkin's lymphoma which is

Q11. What is Burkitt lymphoma?

Ans: Burkitt lymphoma is a type of non-Hodgkin's lymphoma which is endemic in

Q12. What is the percentage of childhood NHLs in the United States

Q13. What is aplastic anemia?

Q14. What is the WHO classification of lymphoid neoplasms?

Q15. What are the possible etiologies of AML?

Ans: The three patterns of chronic nonspecific lymphadenitis are follicular

Q19. What are the three general categories of myeloid neoplasia?

Q20. What is Non-Hodgkin's Lymphoma?

Ans: Non-Hodgkin's Lymphoma (NHL) is a group of malignant tumors of the lymphoid

Q22. How is recovery from blood loss anemia enhanced?

Q23. What are the characteristics of Hodgkin lymphoma?

Ans: Hodgkin lymphoma is characterized by a distinctive group of neoplasms that

Q25. What is the etiology of Hodgkin lymphoma?

Ans: In African patients, involvement of the maxilla or mandible is the common

Q27. What are the non-neoplastic disorders of white cells?

Ans: Non-neoplastic disorders of white cells include leukopenias and proliferations,

Q28. What is Sickle Cell Anemia?

Q29. What are the pathogenesis and clinical picture of Burkitt

Ans: : The pathogenesis of Burkitt lymphoma is thought to be associated with

Q30. How is red cell indices measured?

Q31. What is acute lymphoblastic leukemia (ALL)?

Ans: Acute lymphoblastic leukemia (ALL) is a type of lymphoblastic tumor that is

Q32. What are the three broad categories of neoplastic

Q34. What is the classification of anemia based on the underlying

Ans: Classification of anemia based on the underlying cause includes Anemias of

Q35. What are some general features of hemolytic anemias?

Ans: Involvement of the maxilla or mandible is the common mode of presentation

Q37. What are Auer rods?

Q38. What is vitamin B12 deficiency anemia?

Q39. What is the clinical course of Hereditary Spherocytosis?

Ans: The characteristic clinical features of Hereditary Spherocytosis are anemia,

Q40. What are the three patterns of chronic nonspecific

Ans: The three patterns of chronic nonspecific lymphadenitis are follicular

Q41. What are the two categories of neutropenia?

Ans: Neutropenia is divided into two categories: inadequate or ineffective

Q43. What are the different types of hemolytic anemias?

Q44. What type of cells are found in Myeloid Neoplasms?

Ans: : Myeloid Neoplasms are characterized by monoclonal proliferations of

Q45. What is acute lymphoblastic leukemia?

Q46. What is hemosiderosis?

Q49. What are the three major categories of lymphoid neoplasms?

Q50. What is Hemoglobinopathy?