MIST-MEDICAL INSTITUTE FOR SCREENING TEST

MIST – MEDICAL INSTITUDE FOR SCREENING TEST

PATHOLOGY SUBJECT WISE TEST ON 14-NOVEMBER-2023

Q.1) Ultra-structural finding of irreversible injury

a. Karyolysis
b. Calcium deposits in mitochondria
c. Pyknosis
d. Karyorrhexis

Q.2) Stain for glycogen is

a. Sudan III stain
b. PAS stain
c. Von Kossa stain
d. Verghoff stain

Q.3) True about dystrophic calcification is

a. Calcium level is elevated
b. Occur in normal cells
c. Mitochondria involved earliest
d. None of the above

Q.4) Marker of apoptosis is

a. CD 55
b. Annexin V
c. CD 95
d. CD 59

Q.5) A surgeon was operating on a case of acute pain abdomen. On exploration of

abdomen, mesenteries shows the following. What is your diagnosis?

a. Nutmeg Liver
b. Necrosis in fat tissue leading to Ca accumulation in tisues
c. Putrefaction
d. Gall stones

Q.6) After binding to fas ligand (cd95l), fas (cd95) self-associates and activates fas-
associated death domain protein (fadd), which in turn induces apoptosis by
stimulating

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a. Bcl-2
b. Caspase 8
c. Cytochrome a3
d. Cytochrome p450

Q.7) All are true about apoptosis except?

a. Apoptotic cells appear as round mass of the intensely eosinophilic cytoplasm with
dense nuclear chromatin fragments
b. Apoptosis of cells induce inflammatory reaction
c. Condensation of chromatin
d. Considerable apoptosis may occur in a tissue before it becomes apparent in histology

Q.8) On autopsy of a 75 yrs old man who died during abdominal surgery; the heart was
found to be atrophied and brownish in colour. Deposition of the pigment is due to:
a. Abnormal calcium homeostasis
b. Lipid peroxidation
c. Elastic lamina breakdown
d. Abormal high rise of iron

Q.9) 18 year old girl presents with fever from 5 days and a cervical lymph node
swelling. A lymph node biopsy was done and granuloma with central neutrophilic
infiltrate was found. Whats the probable diagnosis?

a. Malaria
b. Tb
c. Lympho granulo venerum
d. Leprosy

Q.10) Granulation tissue in wound healing is seen at which stage of healing

a. 1st week
b. 2nd week
c. 3rd week
d. End of 2 months

Q.11) A 3-year-old boy presents with recurrent bacterial and fungal

infectionsprimarily involving his skin and respiratory tract. Physical
examinationreveals the presence of oculocutaneous albinism. Examination of
aperipheral blood smear reveals large granules within neutrophils, lymphocytes,and
monocytes. The total neutrophil count is found to be decreased.further workup reveals

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ineffective bactericidal capabilities of neutrophils due to defective fusion of
phagosomes with lysosomes. Pathogenesis regading the following condition is ?
a. Mutation in PHOX gene
b. Mutation in HBX gene
c. Mutation in LYST gene
d. Mutation in RAS gene

Q.12) A 47-year-old male presents with pain in the midportion of his chest.the pain
is associated with eating and swallowing food. Endoscopic examinationreveals an
ulcerated area in thelower portion of his esophagus. Histologicsections of tissue taken
from this area reveal an ulceration of theesophageal mucosa that is filled with blood,
fibrin, proliferating blood vessels,and proliferating fibroblasts. Mitoses are easily
found, and most of thecells have prominent nucleoli. Which one of the following
correctly describes this ulcerated area?
a. Caseating granulomatous inflammation
b. Dysplastic epithelium
c. Granulation tissue
d. Squamous cell carcinoma

Q.13) All of the following responses are seen in acute inflammation except:
a. Vasodilatation
b. Neutrophil migration
c. Granuloma formation
d. Increased vascular permeability

Q.14) Cytokine required for classical activation of macrophages is-

a. Il-2
b. Il-12
c. Tnf-alpha
d. Interferon gamma

Q.15) A 60 year old female is suffering from renal failure and is on hemodialysis since last
8 years. She developed carpel tunnel syndrome. Which of the following finding will be
associated
a. AL
b. AA
c. ATTR
d. Beta 2 microglobulin

Q.16) True about hypertrophic scar are all except

a. No genetic predisposition
b. More common in blood group A
c. No HLA association
d. Predominantly collagen type 4

Q.17) Serum sickness is

a. Allergic reaction
b. Ab mediated reaction
c. Ag-Ab mediated reaction
d. Tcell mediated reaction

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Q.18) Bee sting will activate following cell in human body in cases of abnormal high
response
a. Th2 cells
b. Macrophage
c. Mast cells
d. Neutrophils

Q.19) All of the following are properly matched except

a. Medulloblastoma- Homer wright rossette
b. Small cell carcinoma lungs- L-MYC
c. Ovarian cancer- CA 125
d. Myxoma- Left ventricle

Q.20) Pancreatic cancer is having which of the following as an immunohistochemical

marker:
a. Cytokeratin
b. Calretin
c. Synaptophysin
d. Carcinoembryonic antigen

Q.21) Phosphorylation of the Rb gene will have which of the following effect on cell cycle
a. Inhibition of cell cycle at G1 phase
b. Inhibition of cell cycle at G2 phase
c. The cell cycle will progress as it is and the cell will divide
d. There will be no effect on cell cycle as for Rb gene phosphorylation is not needed

Q.22) A 48 yr old male died suddenly due to cardiac arrest. On biopsy taken from the heart,
pinkish hyaline material found to be amyloid seen deposited in cardiac myosites as shown in
image. Correct statement?

a. ATTR deposit
b. B2 amyloid deposit
c. Left ventricular hypertrophy seen
d. Rhematic carditis depicting aschoff bodies

Q.23) Hyperacute graft rejection is due to

a. Preformed antibodies
b. Cytotoxic t-lymphocyte mediated injury
c. Circulating macrophage mediated injury
d. Endothelitis caused by donor antibodies

Q.24) Th1 cells are involved in

a. Macrophage activation

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b. Allergic stimuli
c. Severe neutrophilic inflammation
d. Important in helminthic infection

Q.25) Xenograft is a graft between

a. A human and an animal
b. Two individuals of the same species
c. Two individuals of the same inbred strain
d. Identical twins

Q.26) Anti-double-stranded dna antibodies are most likely to be found inwhich one of the
listed individuals?
a. A 28-year-old female with arthritis and a bimalar photosensitive, erythematous rash
on her face
b. A 65-year-old female who develops congo red–positive extracellular deposits in her
liver
c. A 29-year-old female who presents with trouble swallowing and sclerodactyly
d. A 47-year-old female who presents with periorbital lilac discoloration and erythema
on the dorsal portions of her hands

Q.27) All are features of primary systemic amyloidosis except:

a. Associated with chronic inflammation
b. Formed of immunoglobulin light chain
c. Most common type of amyloidosis
d. Less in solid abdominal visceral organs

Q.28) Which of the following statements about graft versus host disease is least correct?
a. Occurs when host is immunocompromized
b. Occurs when donor cells are immunocompromized
c. Is also called runt disease
d. A common cause is stem cell transplantation

Q.29) Abnormal tissue at normal location is:

a. Metaplasia
b. Hamartoma
c. Choriostoma
d. Dysplasia

Q.30) Inactivation of E2F will have which of the following effect on cell cycle:
a. Inhibition of cell cycle at g1 phase
b. Inhibition of cell cycle at g2 phase
c. The cell cycle will progress as it is and the cell will divide
d. There will be no effect on cell cycle as for rb gene phosphorylation is not needed

Q.31) Least Radioresistent Phase of cell cycle:

a. S
b. G1
c. G2-M
d. G1-S

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Q.32) A 59-year-old male is found to have a 3.5-cm mass in the right upper lobe of his lung.
A biopsy of this mass is diagnosed as a moderately differentiated squamous cell
carcinoma.The paraneoplastic syndrome associated most commonly with this condition is:
a. Cushing syndrome
b. Hypercalcemia
c. SIADH
d. Medullary Ca thyroid

Q.33) Find the false matching:

a. Cytokeratin- epithelial cells
b. Ca125- ovarian tumor
c. Calcitonin- papillary carcinoma thyroid
d. Afp- yolk sac tumor

Q.34) Which one of the following is an autosomal dominant disorder:

a. Duchenn’s muscular dystrophy
b. Frangile x syndrome
c. Fanconi’s anemia
d. Marfan syndrome

Q.35) The clinical features of turner syndrome in girls include the following except:
a. Normal iq
b. Webbing of the neck
c. Delayed puberty
d. Gynaecomastia

Q.36) Pattern of inheritance when disease gets transmitted from grandfather to father and
then to daughter and son both is:
a. AR
b. AD
c. XLR
d. XLD

Q.37) Comment on pedigree:

a. Autosomal recessive
b. X-linked recessive
c. X-linked dominant
d. Autosomal dominant

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Q.38) On genetic analysis of a child who is brought to the hospital by her parents with
complains of erratic behaviour, abnormal sleep pattern, improper gait, it is found that she is
having uniparental disomy of paternal chromosome. Gene deletion responsible for the
following is

a. P53
b. SNORP
c. UBE3A
d. FMR

Q.39) 53 yr old male is diagnosed with secondary hyperparathyroidism. Further workup

revealed high S. Calcium, high S. creatinine. On Xray osteolytic lesions were seen on skull.
BM examination revealed abnormally high levels of plasma cells with very high levels of
monoclonal protein in serum. Most common translocation associated is:

a. t(14:18)
b. t(11:18)
c. t(12:21)
d. t(11:14)

Q.40) Nitrous oxide is derived from:

a. Cysteine
b. Arginine
c. Phospholipid
d. Lipooxygenase

Q.41) Find the correct answer:

a. Normal, beta minor, beta major, sickle cell trait, sickle cell anemia
b. Normal, sickle cell anemia, beta minor, beta major, sickle cell trait,
c. Normal, beta minor, beta major, sickle cell anemia, sickle cell trait
d. Normal, alpha thal, beta major, sickle cell trait, sickle cell anemia

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Q.42) A 18 yr old boy came to the dermatology OPD with complains of skin
color change over the knuckles. He seems to be worried and also states that there is some
changes happening to his tongue as shown in the image. On CBC, Hb is 9.1 gm/dl, MCV is
111 fl. Diagnosis of the following condition is :

a. Strawberry tongue revealing kawasaki disease

b. Macroovalocytic anemia
c. Pelger huet anamoly
d. Scarlet Fever

Q.43) A 16 yr old female came to the medicine OPD with complains of

generalized weakness and irritability. She is pale and gives a history of heavy menstrual
bleed. On CBC, her Hb is 8.7gm/dl and MCV is 63fl. True regarding the above condition is:
a. Tear drop cells seen on peripheral blood smear
b. Hemolysis of RBC at 0.3% NaCl
c. High transferrin saturation
d. High Transferrin binding capacity

Q.44) A 5 yr old boy came to hospital with his parents having complains of
fever, weakness, fatigue, pallor and purpuric spots on skin. His CBC shows Hb-8.1gm/dl,
Tlc-2.2lakhs/cmm. BM evaluation reveals >36% blasts which are tdT positive. Clinical
examination shows mediastinal infiltration. True atatement regarding the same.
a. PML-RAR gene mutation
b. NOTCH gene mutation is positive in this patient leading to mediastinal infiltartion
c. EBF gene mutation is positive in this patient leading to mediastinal infiltartion
d. None of the above

Q.45) Cd-15 helps in assessment of which of the following:

a. Adult t-cell leukemia
b. Hodgkin’s disease
c. Mycosis fungoides
d. Larger granular lymphocytic leukemia

Q.46) Match the following:

1. t(8:21) A. CML

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2. t(12:21) B. AML

3. t(9:22) C. ALL

a. 1-A 2-B 3-C

b. 1-C 2-A 3-C
c. 1-B 2-A 3-C
d. 1-B 2-C 3-A

Q.47) Parents came with their 2 yr old child to the pediatric OPD with complains of fever,
lethargy, loss of appetite. Child is a known case of down’s syndrome. On CBC , Hb is very
low with very high TLC. On PBS, >30% immature cells are seen in blood which are MPO
positive. Clinical examination reveals hepatosplenomegaly. Most likely diagnosis of this child
would be:
a. T-ALL
b. B-ALL
c. Acute megakaryocytic leukemia
d. Acute promyelocytic leukemia

Q.48) A middle aged man came to medicine dept with repeated episodes of fever and throat
infection. Routine blood investigations revealed a case of pancytopenia but the absolute
lymphocyte count was raised. Coomb’s test was positive. PBS image is given below
demonstrating Smudge cells. True statement regarding the same is:

a. Most common genetic abnormality with the associated dieases is 13p-

b. Myeloid to lymphoid ratio is deranged leading to mutiple fold rise in lymphoid origin cells in
the blood and bone marrow
c. NOTCH gene mutation signifies B cell mutation
d. All of the above

Q.49) 58 yr old female came to the hospital with complains of heaviness in the abdominal
area & constipation. She also complains of bleeding from the gums sometimes. CBC reveals
marked eosinophilia and basophilia with TLC 63000/cmm. Metamyelocytes (33%),
myelocytes (19%) and band form (23%) are seen. PBS finding is attached below. All are true
regarding the same except:

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a. No maturation arrest
b. Low LAP score
c. Hepatospenomegaly seen
d. No risk of acute lymphoid leukemia

Q.50) On performing biopsy of a patient with cervical lymphadenopathy with a history of

weekly on-off fever, inflammatory infiltrate is seen with presence of giant cells which are CD
15 and 30 positive. image is attached below. Spot the diagnosis:

a. Smudge cells on the Lymph node biopsy

b. Glycogen filled mesangial cells
c. RS cells with clearing of cytoplasm
d. Target cells on muscle biopsy

Q.51) 46 yr old HIV positive male presented to the OPD with complains of fever, fatigue
and cervical lymphadenopathy. On CBC, TLC and DLC came out to be normal with no
immature cells seen in the blood. However on performing lymph node biopsy, effacement of
lymph node is seen with tumor cells to be positive for CD 10 and BCL 6. Comment on the
diagnosis.
a. Follicular lymphoma
b. Diffuse large B cell lymphoma
c. Hodgkin’s lymphoma
d. Mantle zone lymphoma

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Q.52) A 10-yr. Old boy with mass in the abdomen. On imaging the paraaortic ln is enlarged.
On biopsy starry sky appearance is seen confirming the diagnosis of burkitts lymphoma.
False regarding the same?

a. MC translocation is 8:14
b. Highly metastatic tumor
c. C-MYC tumor supressor gene mutation is seen
d. C-myc gene is located on chromosome 8

Q.53) Inheritance pattern of abo blood group system and hla system?
a. Pseudodominace
b. Autosomal dominant
c. Autosomal recessive
d. Codominant

Q.54) Which of the following statements pertaining to leukemia is correct?

a. Blasts of acute myeloid leukemia doesn’t have nucleoli
b. Blasts of acute lymphoblastic leukemia are typically myloperoxidase positive
c. High leucocyte alkaline phosphatase score is characteristically seen in blastic phase of chronic
myeloid leukemia
d. Tartarate resistant acid phosphatase positivity is typically seen in hairy cell leukemia

Q.55) Increased BT and aPTT with normal platelet count and PT are most suggestive of ?
a. VWD
b. Bernanrd soullier syndrome
c. DIC
d. Hemolytic Uremic Syndrome

Q.56) The integrity of rbc maintained by g6pd is:

a. Controlling oxidative stress on rbc
b. Controlling reduction stress on rbc
c. Maintaining flexibility of cell membrane
d. Component of electron transport chain

Q.57) 25/f came to opd with anemia, jaundice and joint pain.peripheral smear shows the
following. What is the pathogenesis associated with the following smear finding

a. Autosomal dominant mutation

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b. Abnormality of RBC memebrane
c. Missense point muttion
d. Severe iron absoprtion deficiency leading to pancytopenia

Q.58) A 63-year old man presented with massive splenomegaly, lymphadenopathy and a
total leucocyte count of 17000 per mm3. The flowcytometry showed CD19 positive, CD5
positive, CD23 negative, monoclonal B-cells with bright kappa positivity comprising 80% of
the peripheral blood lymphoid cells. The genetic analysis showed translocation between 11
and 14 chromosome confirming the diagnosis to be mantle zone lymphoma. True regarding
the same is
a. Cyclin D1 mutation is associated with prolifeartion of cells
b. Antiapoptotic molecule BCL-2 has a strong association
c. CD3 positivity will confirm the diagnosis even further for typifying
d. All of the above

Q.59) The most likely diagnosis in the case of a patient with multiple pulmonary cavities,
hematuria and crescents in kidney is
a. Anti gbm disease
b. Churg-strauss allergic granulomatosis
c. Systemic lupus erythematosus
d. Wegner's granulomatosis

Q.60) Cytokine responsible for proliferation of smooth muscle in the pateint suffering from
atherosclerosis is -
a. IFN- Gamma
b. IL-6
c. TGF-beta
d. FGF

Q.61) All the following are true regarding PAN except:

a. Affects large size blood vessels
b. May affect renal vessels
c. Necrotizing granuloma may be seen on microscopy
d. HBsAg positivity is seen with severe patients

Q.62) Gene mutation seen with most common tumor of heart in child is
a. Beta catenin
b. TSC 1
c. PRKAR
d. HBX

Q.63) In a patient with periorbital edema, oligouria, high serum creatinine and respiratory
distress, a biopsy was taken from renal artery. There appears presence of granuloma and biopsy
is consistent with presence of Perinuclear-ANCA. These findings are most suggestive of which
disease?
a. Giant cell arteritis
b. Classic polyarteritis nodosa
c. Wegener’s granulomatosis
d. Microscopic polyangiitis

Q.64) Heart muscle biopsy of the patient shows following histological finding consistent
with Aschoff bodies as shown in figure. All are true about the finding except

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a. Mitral valve is the most common valve involved in the following disease
b. Contaminated growth on one side of the mitral valve is seen
c. Catterpillar like chromatin cells are found well immeresed in myocardium
d. Mitral valve stenosis is the valvular damage seen in long standing disease

Q.65) Acute rheumatic fever classically develops in children 1 to 4 weeks after a group a β-
hemolytic streptococcal (streptococcus pyogenes) infection of the
a. Aorta
b. Heart
c. Lungs
d. Pharynx

Q.66) 43 yr old male patient came to the hospital with complaints of dizziness, headache,
decreased vision and sensorium. Ct scan was done and a 3*3 cm foci was seen. Biopsy is
performed and it revealed following findings described as rossettes. Most appropriate
statement amongst the following is:

a. Increase in S. calcium of the patient leads to folowing finding on biopsy

b. Dura matter biospy is the characteristic location for biopsy
c. Cerebellum is the area commonly involved
d. Metastasis occurs late so management is easier in comparison tp other tumors of brain

Q.67) True statement amongst the following is-

a. Lepidic pattern is characteristic finding of small cell carcinoma lungs
b. Coal macule is characteristic of Richter syndrome
c. Ground glass opacities are seen in lungs with quartz dust prolonged exposure
d. None of the above

Q.68) One is not true about chronic bronchitis?

a. Ratio of total respiratory epithelial thickness to glandular layer thickness is increased.
b. Smoking leads to increase risk of chronic bronchitis
c. Increased risk of adenocarcinoma lungs
d. Not associated with Amyloidosis

Q.69) Autopsy of a person who died of severe respiratory distress following blood
transfusion shows the following. He has been diagnosed with ARDS. All are true except

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a. Surfactant production is compromised in ARDS

b. IL-8 is the cause of inflammatory damage in ARDS
c. Mast cells are responsible for severe respiratory distress
d. Can lead to Pulmonary edema

Q.70) Comment on Pedigree:

a. Autosomal recessive
b. X-linked recessive
c. X-linked dominant
d. Autosomal dominant

Q.71) Choose the TRUE statement regarding Colliquative necrosis:

a. Ishemia to heart causes liquifactive necrosis
b. Commonest form of necrosis
c. Characterized by white, soft or liquid 'cheesy' appearance
d. Occurs in brain because of lack of tissue architecture provided by substantial
surrounding stroma

Q.72) In the given image of cellular event of inflammation what receptor does A
indicate:

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a. ICAM/VCAM
b. Integrins
c. Selectinbs
d. PECAM

Q.73) The photomicrograph of the bronchial washing specimen shown below

depicts:

a. Schaumann bodies
b. Ferruginous bodies
c. Cholesterol crystals
d. Silica particles

Q.74) A routine chest x-ray performed on an asymptomatic adult male patient who
works at sandblasting reveals a fine nodularity in the upper zones of the lungs and
“eggshell” calcification of the hilar lymph nodes.The patient’s serum calcium level is
9.8 mg/dL, while his total protein is 7.2 g/dL. He denies any history of drug use or
cigarette smoking. A biopsy from his lung reveals birefringent particles within
macrophages. True statement regarding the following is:
a. Very commonly associated with adenocarcinoma lungs
b. MC lobe involved is upper lobe
c. Very commonly associated with plumbing artifact prolonged administration
d. Chest X Ray shows snowstorm appearance

Q.75) Clumping of nuclear chromatin in reversible cell injury is due to:

a. Decreased Na+-K+ ATPase activity
b. Decreased pH
c. Decreased protein synthesis
d. Influx of Ca+2

Q.76) Why are males more likely to exhibit an X linked recessive trait than females?
a. Most genes on the X chromosome are not shared with the Y
b. Male sex hormones affect expression of genes from the X chromosome
c. X linked traits tend to control male secondary sexual development
d. None of these

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Q.77) Digeorge syndrome is involvement of chromosome no 22 leading to its
deletion. all are seen except:
a. Child with cleft lip and palate
b. MC cardiac anamoly is patent ductus arteriosus
c. Thymic hypoplasia which with time can lead to absent thymic gland
d. Hypocalcemia

Q.78) Find the pedigree analysis:

a. XLR
b. AR
c. AD
d. XLD

Q.79) A 22-year-old woman in the second month of her first pregnancy presents with
lower abdominal pain and vaginal bleeding. Histologic examination of blood clots
taken from the vaginal vault reveals decidualized tissue and occasional chorionic villi.
Chromosomal analysis of these products of conception from her spontaneous abortion
reveals a triploid karyotype. What is the total number of chromosomes present in this
abnormal karyotype?
a. 23
b. 46
c. 47
d. 69

Q.80) Karyotype of a male patient shows the following chart, find the correct
statement regarding the same?

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a. Most common genotype is 45XO

b. Presents with simian crease
c. Most common cause of male hypogonadism
d. Breast cancer is the most common cancer associated with the disease

Q.81) Evaluation of a pedigree for a certain abnormality reveals the following

information: there are skipped generations with male-to-male transmission; females
are affected at the same rate as are males; and the disease is produced in the
homozygous state, while heterozygous individuals are carriers.What is the true
reagrding this inheritance pattern?
a. MC inheritence pattern for genetic disease
b. Disease transmission rate is 25%
c. Carriers are only males
d. Only mother transmits the disease in this pattern

Q.82) Patient came in complaining of pallor, fatigue, malaise. His lab findings shows
decreased Hb, decreased MCH, decreased MCV. PBS finding shows pencil cells and
microcytic hypochromic RBC with severe anisopoiklocytosis. What is the treatment
for the patient’s condition ?
a. Iron supplement
b. Vit B12
c. Vit B 6
d. Folic acid

Q.83) A 42 years male after ileal resection complains of peripheral neuropathy

with dizziness and fatigue on rest, his peripheral smear is given in the image
below, what is the most likely diagnosis.

a. Autoimmune hemolytic anemia

b. Megaloblastic anemia
c. Immune thrombocytopenic purpura
d. P.N.H

Q.84) Which of the following in the image shown are basophil?

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a. A
b. B
c. C
d. D

Q.85) In acute myeloid leukemia, auer rods are numerous in:

a. M2
b. M3
c. M4
d. M5

Q.86) Following are seen in polycythemia vera except:

a. Most common cause of polycythemia
b. Increased erythropoietin
c. Erythropoietin independent growth of red cell progenitors
d. Intrinsic abnormality of hematopoietic precursors

Q.87) All of the following are true regarding CLL except:

a. Most common type of leukemia in adults
b. Males are commonly affected
c. ZAP-70 has prognostic importance
d. Affects T-cells more commonly

Q.88) Low iron & low TIBC is found in:

a. Anaemia of chronic disease
b. Sideroblastic anaemia
c. Iron deficienc anaemia
d. Aplastic anemia

Q.89) Identify the inheritance in the following pedigree?

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a. AD
b. AR
c. XR
d. Mitochondrial

Q.90) Surest sign of malignancy is

a. Mitoses
b. Anaplasia
c. Nuclear pleomorphism
d. None

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