Hematology MCQs with Answer and Explanations | Chapter 4

Answer: Eosinophils

Eosinophils are a type of white blood cell primarily involved in allergic reactions and combating parasitic infections. They release substances that help fight against parasites and also play a role in allergic responses and asthma.

Incorrect options:

1. Monocytes: Monocytes are a type of white blood cell that can differentiate into macrophages, involved in phagocytosis and clearing cellular debris. They have a role in the immune response, but they are not primarily associated with allergic reactions or combating parasites.
2. Neutrophils: Neutrophils are the most abundant type of white blood cell and are essential for combating bacterial infections through phagocytosis. While they play a crucial role in the immune response against bacterial infections, they are not primarily involved in allergic reactions or parasite defense.
3. Basophils: Basophils are white blood cells involved in allergic reactions by releasing histamine and other chemicals. However, eosinophils are more directly associated with both allergic reactions and fighting parasitic infections compared to basophils.

Answer: Hemostasis

Hemostasis refers to the process of blood clot formation to prevent excessive bleeding when a blood vessel is injured. It involves a series of steps, including blood vessel constriction, platelet aggregation, and the coagulation cascade, leading to the formation of a blood clot.

Incorrect options:

1. Hematocrit: Hematocrit is the measure of the volume percentage of red blood cells in the blood. It doesn’t relate directly to blood clot formation but rather reflects the proportion of red blood cells in the total blood volume.
2. Hemolysis: Hemolysis refers to the rupture or destruction of red blood cells, leading to the release of hemoglobin into the surrounding fluid. It is not specifically related to blood clot formation.
3. Hemoglobinopathy: Hemoglobinopathy refers to genetic disorders that affect the structure or production of hemoglobin. It doesn’t involve the process of blood clot formation but rather pertains to abnormalities in hemoglobin.

Answer: Alanine Aminotransferase (ALT)

ALT is not a part of the Complete Blood Count (CBC) test. It is a liver enzyme used to assess liver function and is typically measured in a liver function test, not in a CBC.

Incorrect options:

1. Red Blood Cell Distribution Width (RDW): RDW is a component of a CBC test. It measures the variation in the size of red blood cells. Elevated RDW values can indicate various types of anemia.
2. Mean Platelet Volume (MPV): MPV is also included in a CBC test. It measures the average size of platelets in the blood and can help assess platelet function.
3. Hematocrit (Hct): Hematocrit is a fundamental component of a CBC test. It measures the proportion of red blood cells in the total blood volume and helps in diagnosing conditions related to red blood cells like anemia or polycythemia.

Answer: Neutrophils

Neutrophils are the first responders to infections and are highly phagocytic, meaning they can engulf and destroy pathogens like bacteria and fungi. They are a crucial part of the innate immune system, rapidly migrating to sites of infection to eliminate invading microbes.

Incorrect options:

1. Basophils: Basophils release histamine and other chemicals involved in allergic reactions and inflammation. They are not the first responders to infections and are not highly phagocytic like neutrophils.
2. Lymphocytes: Lymphocytes play a key role in the adaptive immune response, producing antibodies and coordinating the immune system’s response against specific pathogens. They are not the initial responders to infections and are not highly phagocytic.
3. Eosinophils: Eosinophils are primarily involved in allergic responses and defense against parasites. While they can perform phagocytosis to some extent, they are not as rapid or predominant in the initial response to infections as neutrophils.

Answer: Thrombocytopenia

A decrease in mean platelet volume (MPV) can be associated with thrombocytopenia, which is a condition characterized by a lower than normal platelet count in the blood. Thrombocytopenia can lead to an increased risk of bleeding or easy bruising.

Incorrect options:

1. Thrombocytosis: Thrombocytosis is the opposite of thrombocytopenia; it’s an abnormal increase in platelet count, not a decrease. Thrombocytosis would likely result in an elevated MPV, not a decrease.
2. Anemia: Anemia refers to a decrease in the number of red blood cells or hemoglobin levels in the blood, and it doesn’t directly relate to platelet volume. Anemia isn’t typically associated with changes in MPV.
3. Leukocytosis: Leukocytosis is an elevated white blood cell count and doesn’t specifically relate to changes in platelet volume. It involves an increase in white blood cells, not platelets.

Answer: Polycythemia

Polycythemia is a condition characterized by an excess of red blood cells in the blood. This can be primary (due to a problem in the bone marrow leading to overproduction of red blood cells) or secondary (due to factors like low oxygen levels or certain medical conditions).

Incorrect options:

1. Leukopenia: Leukopenia is a condition characterized by a decrease in the number of white blood cells in the blood, not an excess of red blood cells.
2. Anemia: Anemia refers to a deficiency in red blood cells or hemoglobin in the blood, resulting in reduced oxygen-carrying capacity. It’s the opposite of polycythemia.
3. Thrombocytopenia: Thrombocytopenia is a condition characterized by a decrease in the number of platelets in the blood. It’s not related to an excess of red blood cells but rather a decrease in platelet count, leading to an increased risk of bleeding.

Answer: Thrombosis

Thrombotic thrombocytopenic purpura (TTP) is a rare blood disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia (low platelet count), neurologic deficits, and renal failure due to the formation of small blood clots in blood vessels. However, thrombosis, or the formation of larger blood clots in larger vessels, is not typically associated with TTP.

Incorrect options:

1. Thrombocytopenia: Thrombocytopenia, or a low platelet count, is a characteristic feature of TTP and contributes to the risk of bleeding and formation of small blood clots.
2. Microangiopathic hemolytic anemia: This condition involves the destruction of red blood cells as they pass through small blood vessels, leading to anemia, and is a hallmark feature of TTP.
3. Neurologic deficits: Neurologic symptoms like confusion, seizures, or focal neurologic deficits can occur due to the effects of small blood clots on the brain, which is a common manifestation of TTP.
4. Renal failure: Kidney dysfunction or acute renal failure is also associated with TTP due to the impact of blood clots on the kidneys’ small blood vessels.

Answer: Eosinophil

Eosinophilia is a central feature of the host response to helminth infection. Larval stages of parasitic worms are killed in vitro by eosinophils in the presence of specific antibodies or complement. These findings established host defense as the paradigm for eosinophil function.
In summary, eosinophils serve as recognition cells of certain unique PAMPs, playing a vital role in innate defense against viral, parasitic and bacterial infection.

Answer: Connective Tissue

Blood is classified as connective tissue. Connective tissues are characterized by cells dispersed in an extracellular matrix. In the case of blood, the cells (red and white blood cells) are suspended in a liquid matrix called plasma.

Incorrect Options:

• Epithelial Tissue: This tissue type covers surfaces and lines cavities, serving protective and absorptive functions. Examples include skin epithelium and lining of the digestive tract.
• Muscle Tissue: Muscle tissue is responsible for movement and is divided into three types: skeletal, smooth, and cardiac. It is not the correct classification for blood.
• Nervous Tissue: Nervous tissue forms the brain, spinal cord, and nerves. It’s specialized for communication through electrical impulses. It is distinct from blood tissue in structure and function.

Answer: Reticulocytes

New Methylene Blue (NMB) Reagent is used for staining reticulocytes. Reticulocytes are immature red blood cells that still contain remnants of ribosomal RNA. The stain helps in their visualization for various clinical purposes, including assessing bone marrow function and diagnosing certain anemias.

Incorrect Options:

• Platelets: Platelets are small cell fragments involved in blood clotting. They are not stained using New Methylene Blue.
• WBC’s (White Blood Cells): White blood cells, including various types like neutrophils, lymphocytes, and monocytes, are not specifically stained by New Methylene Blue. Specialized stains are used for differentiating and counting white blood cells.
• Heinz bodies: Heinz bodies are inclusions within red blood cells, typically containing denatured hemoglobin. They are not specifically stained by New Methylene Blue; other stains are more suitable for visualizing Heinz bodies.

Answer: 1:20

When white blood cells (WBCs) are counted manually using Tuk’s reagent, the blood is diluted in a 1:20 ratio. This dilution allows for better visualization and counting of the white blood cells in a specific volume of blood.

Incorrect Options:

• 1:50: This ratio is not the correct dilution when using Tuk’s reagent for manual WBC counting.
• 1:100: This ratio is not the correct dilution for manual WBC counting with Tuk’s reagent.
• 1:200: This ratio is not the correct dilution when employing Tuk’s reagent for manual WBC counting.

Answer: Nutrient absorption

Blood does not directly absorb nutrients. Nutrient absorption primarily occurs in the digestive system, specifically in the small intestine. Blood plays a crucial role in transporting absorbed nutrients to various cells and tissues.

Incorrect Options:

• Hormone Production: Blood transports hormones produced by endocrine glands to target organs and tissues, playing a key role in the endocrine system.
• Buffer System: Blood helps regulate the body’s pH by acting as a buffer, maintaining a stable and optimal pH level.
• Oxygen Transport: One of the primary functions of blood is to transport oxygen from the lungs to tissues and organs, ensuring cellular respiration and energy production.

Answer: EDTA

EDTA (Ethylenediaminetetraacetic acid) is the preferred anticoagulant tube for collecting blood samples for HbA1c (glycated hemoglobin) testing. It prevents blood clotting without interfering with the measurement of HbA1c.

Incorrect Options:

• Sodium Fluoride: While sodium fluoride tubes are used for blood glucose testing, they can inhibit the accurate measurement of HbA1c and are not recommended for this purpose.
• Heparin: Some studies suggest that heparin may also be acceptable for HbA1c testing, but EDTA remains the gold standard due to its minimal interference and wider compatibility with different testing methods.
• Sodium Citrate: Sodium citrate is commonly used for coagulation studies but, like heparin, may not be ideal for HbA1c testing as it can lead to slight variations in results compared to EDTA.

Answer: Factor VIII

Hemophilia A is caused by a deficiency or dysfunction of clotting factor VIII. Factor VIII is essential for the formation of blood clots, and its deficiency leads to impaired blood coagulation, resulting in prolonged bleeding.

Incorrect Options:

• Factor IX: Factor IX deficiency is associated with Hemophilia B, also known as Christmas disease. It is a different type of hemophilia.
• Factor X: Factor X is not associated with Hemophilia A. It plays a role in the common pathway of the coagulation cascade but is not deficient in Hemophilia A.
• Factor I (Fibrinogen): Factor I, or fibrinogen, is not deficient in Hemophilia A. Fibrinogen is involved in the final stages of blood clot formation, but its deficiency is not associated with Hemophilia A.

Answer: RBC’s

Ammonium Oxalate reagent is commonly used for the counting of red blood cells (RBCs). It is used in the preparation of diluting solutions for the enumeration of RBCs in a hemocytometer or automated cell counter.

Incorrect Options:

• WBC’s (White Blood Cells): Ammonium Oxalate is not typically used for WBC counting. Different reagents and methods are employed for accurate white blood cell enumeration.
• Platelets: Platelets are not counted using Ammonium Oxalate reagent. Platelet counting requires specific techniques and reagents.
• Reticulocytes: Ammonium Oxalate is not the reagent of choice for counting reticulocytes. Special stains and methods are used to visualize and count these immature red blood cells.

Answer: None of the above

In Disseminated Intravascular Coagulation (DIC), multiple clotting factors are consumed, leading to both bleeding and thrombosis. Therefore, various coagulation tests, including PT (Prothrombin Time) and APTT (Activated Partial Thromboplastin Time), can show abnormal and high results due to the consumption of clotting factors.

Incorrect Options:

• PT (Prothrombin Time): PT can show high results in DIC due to the consumption of clotting factors.
• Platelets: Platelet count typically decreases in DIC, indicating consumption and activation of platelets, so this would not show high results.
• APTT (Activated Partial Thromboplastin Time): APTT can also show high results in DIC due to the depletion of clotting factors.

Answer:

Erythroblastosis fetalis, also known as hemolytic disease of the newborn (HDN), occurs when there is Rh (Rhesus) incompatibility between the blood types of a pregnant woman and her fetus. If an Rh-negative mother is carrying an Rh-positive baby, and if there is mixing of blood between the mother and the baby, the mother’s immune system may produce antibodies against the Rh-positive blood, leading to hemolysis (destruction of red blood cells) in the fetus.

Incorrect Options: Rh incompatibility

• ABO Incompatibility: ABO incompatibility can cause hemolytic reactions, but it usually leads to less severe consequences compared to Rh incompatibility. It occurs when there is a mismatch in the ABO blood group system between the mother and the fetus.
• Hemophilia: Hemophilia is a genetic disorder characterized by a deficiency of certain blood clotting factors. It is not related to Erythroblastosis fetalis.
• Leukemia: Leukemia is a cancer of the blood-forming tissues, leading to abnormal production of white blood cells. It is not a cause of Erythroblastosis fetalis, which is specifically associated with Rh incompatibility.

Answer: Polycythemia

Erythrocyte Sedimentation Rate (ESR) is a blood test that measures the rate at which red blood cells settle in a tube of blood. A low ESR value is typically associated with conditions that increase blood viscosity, such as polycythemia. Polycythemia is a disorder characterized by an increased number of red blood cells.

Incorrect Options:

• Anemia: Anemia is often associated with an increased ESR. In conditions of anemia, where there is a decrease in the number of red blood cells or changes in their shape, the ESR tends to be elevated.
• RA (Rheumatoid Arthritis): Rheumatoid arthritis is an inflammatory condition, and inflammatory states are generally associated with an elevated ESR. Therefore, RA is not a condition that would cause a low ESR.
• Tuberculosis: Tuberculosis is an infectious disease, and chronic infections are generally associated with an elevated ESR. A low ESR is not typically seen in tuberculosis.

Answer: Vitamin B12

Megaloblastic anemia is caused by a deficiency of two vitamins: folate (folic acid) and vitamin B12 (cobalamin). Both vitamins are essential for the synthesis of DNA, and their deficiency leads to impaired DNA replication and cell division, resulting in the characteristic large and immature red blood cells seen in megaloblastic anemia.

Incorrect Options:

• Vitamin A: Vitamin A deficiency is associated with various conditions, but it is not a cause of megaloblastic anemia. Vitamin A is important for vision, immune function, and skin health.
• Vitamin D: Vitamin D deficiency primarily affects bone health and calcium metabolism. It is not associated with megaloblastic anemia.
• Vitamin C: Vitamin C deficiency can lead to scurvy, but it is not a cause of megaloblastic anemia. Vitamin C is crucial for collagen synthesis, wound healing, and antioxidant functions.

Answer: TIBC

In iron deficiency anemia, the Total Iron Binding Capacity (TIBC) is expected to show an increased value. TIBC measures the maximum amount of iron that can be carried in the blood by transferrin (iron-transporting protein). In iron deficiency, the body tries to compensate by increasing the amount of transferrin available to bind and transport more iron.

Incorrect Options:

• Hemoglobin (Hb): Hemoglobin levels are decreased in iron deficiency anemia, not increased. Iron is a key component of hemoglobin, and a deficiency leads to a reduced ability of the blood to carry oxygen.
• Iron: Iron levels are decreased in iron deficiency anemia. This is a key parameter in diagnosing the condition.
• RBCs (Red Blood Cells): Red blood cell count is generally decreased in iron deficiency anemia due to insufficient iron for proper hemoglobin synthesis. Increased RBCs would not be a characteristic finding in this type of anemia.

Answer: All of above

Erythropoietin (EPO) is a hormone that is produced mainly by the kidneys, specifically in the renal cortex. It plays a crucial role in the regulation of red blood cell (RBC) production. The three statements are correct:

1. Secreted by Kidney: Erythropoietin is primarily secreted by the kidneys, although a small amount may also be produced by the liver.
2. Stimulates the Bone Marrow to Produce RBCs: EPO acts on the bone marrow to stimulate the production of red blood cells. This is especially important in response to conditions like hypoxemia (low oxygen levels) or anemia.
3. Released in Response to Hypoxemia: EPO release is triggered by low oxygen levels in the blood. When tissues are not getting enough oxygen, EPO production increases to stimulate the production of more red blood cells, which carry oxygen to the tissues.

Answer: Red Blood Cells

Jaundice occurs when there is an excessive breakdown of red blood cells (hemolysis), leading to an increased production of bilirubin. Bilirubin is a yellow pigment produced from the breakdown of hemoglobin in red blood cells. If the rate of hemolysis is rapid, the liver may have difficulty processing and excreting the increased bilirubin, resulting in the characteristic yellowing of the skin and eyes seen in jaundice.

Incorrect Options:

1. WBCs (White Blood Cells): White blood cells are not typically associated with jaundice. Jaundice is primarily related to the breakdown of red blood cells.
2. Platelets: Platelets are involved in blood clotting and are not directly associated with the development of jaundice.
3. Plasma Cells: Plasma cells are a type of white blood cell involved in the immune response. They are not directly linked to the process of hemolysis and the development of jaundice.

Answer: Pelger-huet anomaly (PHA)

Pelger-Huet anomaly (PHA) is a rare inherited disorder characterized by the failure of granulocytes (specifically neutrophils) to develop beyond the band or two-lobed stage. Neutrophils in individuals with PHA have nuclei that appear bilobed or have a band-like shape instead of the usual segmented appearance.

Incorrect Options:

• Bernard-Soulier Syndrome (BSS): BSS is a rare bleeding disorder characterized by giant platelets and low platelet counts. It is not associated with abnormalities in neutrophil development.
• Chédiak–Higashi Syndrome (CHS): CHS is a rare genetic disorder that affects various cells, including neutrophils. It is characterized by recurrent infections, but the specific neutrophil abnormality involves large granules and impaired chemotaxis, not the failure to develop beyond a certain stage.
• May-Hegglin Anomaly (MHA): MHA is a rare inherited disorder characterized by large platelets and the presence of Döhle-like bodies in neutrophils. It is not associated with a failure of neutrophils to develop beyond a specific stage.

Answer: Rouleaux

In multiple myeloma, a condition characterized by the proliferation of plasma cells in the bone marrow, rouleaux formation is often observed on a peripheral blood smear. Rouleaux refers to the stacking or clustering of red blood cells, resembling a stack of coins. This phenomenon is caused by the increased presence of abnormal proteins, particularly immunoglobulins, in the blood, which reduces the repulsive forces between red blood cells.

Incorrect Options:

• Basophilic Stippling: Basophilic stippling is more commonly associated with conditions such as lead poisoning or certain hemoglobinopathies, not multiple myeloma.
• Blast Cells: Blast cells are immature cells often associated with leukemia or other hematological malignancies. They are not typically seen in the peripheral smear of multiple myeloma.
• Hypersegmented Neutrophils: Hypersegmented neutrophils are characteristic of megaloblastic anemias, usually caused by vitamin B12 or folate deficiencies, and are not a feature of multiple myeloma.

Answer: Eosinophils

Eosinophils are a type of white blood cell that plays a crucial role in the immune response against parasitic infections and allergic reactions. An increase in eosinophil count, known as eosinophilia, is commonly observed in response to parasitic infections, allergic diseases, and certain inflammatory conditions.

Incorrect Options:

• Neutrophils: Neutrophils are the most abundant type of white blood cells and are primarily involved in bacterial infections. They are not typically the main cells increased in response to parasitic or allergic reactions.
• Lymphocytes: Lymphocytes are involved in the adaptive immune response, including the production of antibodies. While they play a role in various immune reactions, an increase in lymphocyte count is not the typical response to parasitic or allergic reactions.
• Basophils: Basophils release histamine and other substances involved in allergic reactions, but their overall count doesn’t typically increase significantly in response to parasitic infections. Eosinophils are more commonly associated with these conditions.

Answer: Lymphocytic

Plasma cells, also known as effector B cells, evolve from the B-cell line in the lymphocytic cell line. B lymphocytes, or B cells, are a type of white blood cell that originates from stem cells in the bone marrow and matures in the lymphoid organs. When B cells are activated, they can differentiate into plasma cells, which are specialized for the production and secretion of antibodies.

Incorrect Options:

• Monocytic: Monocytes give rise to macrophages and dendritic cells, but they are not directly involved in the evolution of plasma cells.
• Myelocytic: Myelocytic cells include various types of cells that differentiate into granulocytes (neutrophils, eosinophils, basophils) and monocytes. They are not directly involved in the evolution of plasma cells.
• Megamyelocytic: There is no specific cell line known as megamyelocytic. The term “megakaryocytic” is associated with the development of megakaryocytes, which are involved in platelet production and are distinct from the evolution of plasma cells.

Answer: Bernard Soulier Syndrome (BSS)

Bernard-Soulier Syndrome (BSS) is a rare inherited bleeding disorder characterized by a prolonged bleeding time and the presence of giant platelets. BSS is caused by a deficiency or dysfunction of the glycoprotein Ib-IX-V complex on the surface of platelets, which is essential for platelet adhesion to damaged blood vessels.

Incorrect Options:

• Glanzmann’s Thrombasthenia: Glanzmann’s thrombasthenia is a different inherited bleeding disorder characterized by a lack or dysfunction of the platelet glycoprotein IIb/IIIa complex, leading to impaired platelet aggregation.
• Von Willebrand Disease (VWD): VWD is the most common inherited bleeding disorder, but it is characterized by a deficiency or dysfunction of von Willebrand factor, a protein involved in platelet adhesion and the clotting process. It does not typically involve giant platelets.
• Wiskott-Aldrich Syndrome (WAS): WAS is an X-linked immunodeficiency disorder that can present with thrombocytopenia (low platelet count) and small platelets, but it is not specifically characterized by giant platelets.

Answer: Four deleted α-Genes (- -/- -)

Hydrops Fetalis is a severe form of thalassemia that results from the deletion of all four α-globin genes (- -/- -). The α-globin genes are located on chromosome 16, and their deletion leads to a severe deficiency of α-globin chains, causing imbalance with the β-globin chains and resulting in ineffective erythropoiesis and severe anemia. This condition is incompatible with life in the absence of intrauterine interventions.

Incorrect Options:

1. One deleted α-Genes (-α/αα): This genotype represents alpha-thalassemia trait, where one alpha-globin gene is deleted. It does not lead to Hydrops Fetalis.
2. Two deleted α-Genes (- -/αα): This represents alpha-thalassemia trait or silent carrier, where two alpha-globin genes are deleted. It does not lead to Hydrops Fetalis.
3. Three deleted α-Genes (- -/- α): This genotype is associated with HbH disease, a milder form of alpha-thalassemia, and does not result in Hydrops Fetalis.

Answer: Sickle Cell Disease

Sickle cell disease is a genetic blood disorder that affects the hemoglobin protein in red blood cells. The abnormal hemoglobin molecules change the shape of red blood cells, making them sickle-shaped. These sickle-shaped cells are stiff and sticky, causing them to get stuck in blood vessels. This can lead to a variety of serious health problems, including:

• Painful episodes (called crises)
• Fatigue
• Shortness of breath
• Infections
• Stroke
• Organ damage

Here’s why the other options are incorrect:

• Beta Thalassemia: This is another genetic blood disorder that affects the production of hemoglobin. However, it doesn’t result in the abnormal shape of red blood cells seen in sickle cell disease.
• Haemoglobin CC Disease: This is a mild form of thalassemia that typically doesn’t cause any symptoms.
• Haemoglobin Lepore Syndrome: This is a rare blood disorder that can cause mild anemia but doesn’t cause the sickle-shaped cells seen in sickle cell disease.

Answer: Idiopathic thrombocytopenic purpura

Idiopathic Thrombocytopenic Purpura (ITP) is an immune-mediated condition characterized by a low platelet count. It often occurs in children and is characterized by the destruction of platelets by the immune system. The term “idiopathic” indicates that the cause is unknown, and “purpura” refers to the purple discolorations on the skin caused by bleeding into the skin.

Incorrect Options:

• Thrombotic Thrombocytopenic Purpura (TTP): TTP is a disorder characterized by the formation of small blood clots throughout the body, leading to a low platelet count. It is different from ITP.
• May-Hegglin Anomaly: May-Hegglin anomaly is a rare inherited disorder characterized by giant platelets and the presence of Döhle-like bodies in neutrophils. It is not primarily associated with a low platelet count.
• Wiskott-Aldrich Syndrome: Wiskott-Aldrich Syndrome is an X-linked immunodeficiency disorder associated with low platelet counts, eczema, and recurrent infections. It is not specifically characterized by immune-mediated destruction of platelets as in ITP.

Answer: RBC

Blood group antigens, such as ABO and Rh factors, are present on the surface of red blood cells (RBCs). These antigens determine an individual’s blood type and play a crucial role in blood transfusions. The ABO system includes antigens A and B, and the Rh system includes the Rh factor (positive or negative).

Incorrect Options:

• WBC (White Blood Cell): Blood group antigens are not typically present on the surface of white blood cells. WBCs have other markers and antigens that are important for immune functions.
• Platelet: Platelets do not carry ABO or Rh blood group antigens. These antigens are specific to red blood cells.
• Neutrophil: Neutrophils, a type of white blood cell, do not carry the ABO or Rh blood group antigens. Blood group antigens are primarily associated with red blood cells.

Answer: RBC

The malarial parasite, Plasmodium, resides and replicates inside red blood cells (RBCs) during its life cycle. The parasite is responsible for causing malaria, a mosquito-borne infectious disease. Different species of Plasmodium, such as Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, and Plasmodium ovale, can infect human red blood cells.

Incorrect Options:

• WEB: There is no specific structure or location known as “WEB” in the context of malarial parasites.
• Monocyte: Malarial parasites primarily infect red blood cells, not monocytes. Monocytes are a type of white blood cell involved in the immune response.
• Megakaryocyte: Megakaryocytes are large bone marrow cells that produce platelets. They are not the target for malarial parasites, which specifically invade and replicate within red blood cells.

Answer: RBC

Erythropoietin (not “Erythroprotein”) is a hormone related to the production of red blood cells (RBCs). Erythropoietin is primarily produced by the kidneys in response to low oxygen levels in the blood. It stimulates the bone marrow to increase the production of red blood cells, which are essential for carrying oxygen to tissues and organs.

Incorrect Options:

• WBC (White Blood Cell): Erythropoietin is not directly related to the production of white blood cells (WBCs). It specifically targets and stimulates the production of red blood cells.
• Platelet: Erythropoietin is not involved in the production or regulation of platelets. Platelets are formed from megakaryocytes in the bone marrow.
• Blood: While erythropoietin is related to the regulation of blood composition, its specific role is in the regulation of red blood cell production, not the entire blood.

Answer: Fibrinolysis

Fibrinolysis is the process of breaking down and dissolving blood clots. It involves the enzymatic degradation of fibrin, the protein that forms the mesh-like structure of a blood clot. Plasmin, an enzyme, plays a key role in fibrinolysis by breaking down fibrin into smaller fragments.

Incorrect Options:

• Hemostasis: Hemostasis refers to the process of preventing and stopping bleeding, which includes vasoconstriction, platelet plug formation, and clotting cascade activation. It is not the process of breaking down a clot.
• Hemolysis: Hemolysis is the rupture or destruction of red blood cells, leading to the release of hemoglobin into the surrounding fluid. It is not directly related to the lysis of a blood clot.
• Glycolysis: Glycolysis is the metabolic pathway that involves the breakdown of glucose into pyruvate, producing energy. It is a cellular process and is not related to the dissolution of blood clots.

Answer: Platelets

Platelets, also known as thrombocytes, play a crucial role in blood clotting or hemostasis. When there is a breach in blood vessels, platelets adhere to the exposed collagen, become activated, and release chemical signals. This initiates a cascade of events that leads to the formation of a blood clot, sealing the breach and preventing excessive bleeding.

Incorrect Options:

• RBC (Red Blood Cell): Red blood cells do not play a direct role in blood clotting. Their main function is to transport oxygen from the lungs to the rest of the body and to carry carbon dioxide back to the lungs.
• WBC (White Blood Cell): White blood cells are primarily involved in the immune response, defending the body against infections. While some types of white blood cells may play a role in inflammation, they are not directly involved in the initial stages of blood clotting.
• All of Above: This is incorrect. While red blood cells, white blood cells, and platelets are all components of blood, only platelets are directly involved in blood clotting.

Answer: 9:1

The correct ratio of blood to Tri-Sodium (sodium citrate) for prothrombin time (PT) testing is typically 9 parts blood to 1 part anticoagulant (9:1 ratio). Sodium citrate is commonly used as an anticoagulant in blood collection tubes for coagulation studies, including PT. This ratio helps prevent clotting by binding calcium, an essential component of the coagulation cascade.

Incorrect Options:

• 1:9: This ratio would result in an excess of anticoagulant, potentially leading to under-filled blood collection tubes and affecting the accuracy of the test.
• 4:1: This ratio would also lead to an excess of anticoagulant and may affect the clotting properties of the blood sample.
• 1:4: This ratio would result in insufficient anticoagulant, potentially leading to clotting within the blood collection tube and affecting the accuracy of the PT test.

Answer: Diabetic

The HbA1c test, or glycated hemoglobin test, is primarily done for patients with diabetes. It measures the average blood glucose levels over the past 2-3 months. This test is valuable in assessing long-term blood sugar control and helps in the management of diabetes. It provides a percentage that reflects the amount of glucose bound to hemoglobin in red blood cells.

Incorrect Options:

• Tuberculosis: The HbA1c test is not specific to tuberculosis. It is not used as a diagnostic or monitoring tool for this infectious disease.
• Arthritis: The HbA1c test is not directly related to arthritis. Arthritis is a condition affecting the joints, and HbA1c is focused on assessing diabetes control.
• Anaemia: While diabetes can coexist with other conditions, the HbA1c test is not primarily done to diagnose or manage anemia. It is specifically used in the context of diabetes care.

Answer: Anisocytosis

Anisocytosis refers to an abnormal variation in the size of red blood cells (RBCs). In a normal blood sample, RBCs are relatively uniform in size. Anisocytosis is commonly observed in various conditions, including nutritional deficiencies (such as iron deficiency anemia), certain medical treatments, and certain types of anemias.

Incorrect Options:

• Microcytosis: Microcytosis specifically refers to the presence of smaller-than-normal red blood cells. It is a specific type of anisocytosis.
• Poikilocytosis: Poikilocytosis is the presence of irregularly shaped red blood cells. It includes various abnormal shapes, such as spherocytes or elliptocytes, but it does not specifically refer to size variation.
• Spherocytosis: Spherocytosis is a condition characterized by the presence of spherical-shaped red blood cells. It is not synonymous with anisocytosis, as it focuses on the specific shape rather than size variation.

Answer: RBC

Formal citrate solution is an anticoagulant, which means it prevents blood from clotting. This is important for accurate cell counting, as clotting can clump cells together and make it difficult to get an accurate count. RBCs are the most common type of blood cell, and so they are the cell type most often counted using formal citrate solution.

Incorrect Options :

• WBC (White Blood Cells): While formal citrate solution can also be used to prevent clotting in samples for WBC counting, EDTA (ethylenediaminetetraacetic acid) is the preferred anticoagulant for this purpose. EDTA binds to calcium ions, which are necessary for blood clotting, while citrate does not. EDTA also preserves the morphology of WBCs better than citrate.
• Platelets: Platelets are very small blood cells that are easily clumped together by anticoagulants. Therefore, neither formal citrate nor EDTA is ideal for platelet counting. Automated platelet counters use a different method that does not require an anticoagulant.

Answer: EDTA

A lavender color top tube is commonly used for collecting blood samples with EDTA (Ethylenediaminetetraacetic acid) as the anticoagulant. EDTA prevents blood clotting by chelating calcium ions, making it suitable for various hematological tests, including complete blood count (CBC) and blood cell morphology examinations.

Incorrect Options:

• Heparin: Heparin tubes typically have a green or light green top. Heparin is an anticoagulant that prevents clotting by inhibiting thrombin and other clotting factors.
• Sodium Fluoride: Tubes with sodium fluoride are usually gray or light gray. They are used for tests that require the preservation of glucose levels, as sodium fluoride inhibits glycolysis.
• ESR (Erythrocyte Sedimentation Rate): The ESR test is often performed using a tube with a black top. The ESR measurement is influenced by the aggregation of red blood cells and does not necessarily require an anticoagulant like EDTA.

Answer: Reticulocyte

New Methylene Blue stain is used for the staining and counting of reticulocytes in a blood smear. Reticulocytes are immature red blood cells that still contain remnants of ribosomal RNA, giving them a reticulated appearance when stained with certain dyes like New Methylene Blue. Counting reticulocytes is important in assessing bone marrow function and monitoring erythropoiesis (red blood cell production).

Incorrect Options:

• Erythrocyte: Erythrocytes are mature red blood cells, and New Methylene Blue stain is not specifically used for their counting. It is more suitable for visualizing reticulocytes.
• Platelet: New Methylene Blue is not used for counting platelets. Platelets are typically counted using different staining methods and automated hematology analyzers.
• Malaria: New Methylene Blue is not a specific stain for the identification of malaria parasites. Specialized stains such as Giemsa stain or Wright’s stain are commonly used for the microscopic examination of blood smears to detect malaria parasites.

Answer: Thick Smear

Dehaemoglobinization is the process of removing the hemoglobin pigment from red blood cells (RBCs), making them transparent. This allows other blood cells, like parasites in the case of malaria diagnosis, to be more easily seen under a microscope. Thick smears are specifically designed to concentrate blood cells by spreading a larger drop of blood, and dehaemoglobinization is crucial for visualizing them effectively in this dense layer.

Incorrect Options:

• Thin smear: Thin smears use a smaller drop of blood spread out thinly, making dehaemoglobinization unnecessary. The cells are already well-spaced and visible for examination.
• Wet smear: Wet smears are simply unfixed blood preparations, and dehaemoglobinization is not typically done in this context. They are usually used for immediate examination of moving cells, like sperm.

Answer: Sialic Acid

Red blood cells (RBCs) are negatively charged due to the presence of sialic acid on their surface. Sialic acid is a type of sugar that contributes to the negative charge of the RBC membrane. This negative charge helps prevent the cells from sticking together (agglutination) and facilitates their smooth flow through blood vessels.

Incorrect Options:

• Antigen A & B: The ABO blood group antigens are proteins present on the surface of red blood cells, but they do not contribute to the negative charge. They are involved in blood typing and compatibility.
• Erythropoietin: Erythropoietin is a hormone that stimulates the production of red blood cells in the bone marrow. It does not contribute to the negative charge of RBCs.
• Iron: Iron is a crucial component of hemoglobin, the protein responsible for oxygen transport in RBCs. However, it does not play a role in the negative charge of RBCs.

Answer: B Lymphocyte

B lymphocytes, also known as B cells, are responsible for the production of antibodies. When the immune system encounters a foreign antigen, B cells are activated to differentiate into plasma cells. Plasma cells, in turn, produce and release antibodies (immunoglobulins) that specifically target and bind to the antigen, marking it for destruction or removal by other immune cells.

Incorrect Options:

• T Lymphocyte: T lymphocytes (T cells) are involved in cell-mediated immunity and do not directly produce antibodies. They play a role in coordinating immune responses and killing infected or abnormal cells.
• Macrophage: Macrophages are phagocytic cells that engulf and digest pathogens, but they do not produce antibodies. They present antigens to T cells, initiating an immune response.
• Reticulocyte: Reticulocytes are immature red blood cells and are not involved in antibody production. They are part of the process of erythropoiesis, the formation of red blood cells in the bone marrow.

Answer: Cyan meth method

The Cyanmethemoglobin method is considered one of the best and most accurate methods for the estimation of hemoglobin (Hb) levels in a blood sample. In this method, hemoglobin is converted to cyanmethemoglobin, a stable compound, and the absorbance of light at a specific wavelength is measured to determine the concentration of hemoglobin in the sample.

Incorrect Options:

• Sahli’s Method: Sahli’s method is an older and less precise method for hemoglobin estimation. It involves comparing the color of a diluted blood sample with a standardized color scale.
• Alkali Hematin Method: Alkali hematin method involves the conversion of hemoglobin to alkali hematin, and the color intensity is then measured. While it is a method for hemoglobin estimation, the Cyanmethemoglobin method is generally considered more accurate.
• Specific Gravity Method: The specific gravity method is not commonly used for direct hemoglobin estimation. It is used for estimating hemoglobin concentration indirectly in some situations, but it is not considered as accurate as the Cyanmethemoglobin method.

Answer: Hemoglobin

The majority of iron in the human body is present in hemoglobin, the protein responsible for oxygen transport in red blood cells. Hemoglobin contains iron in the form of heme groups, which bind to oxygen and give red blood cells their color.

Incorrect Options:

• Transferrin: Transferrin is a plasma protein that transports iron through the bloodstream and delivers it to cells. While it plays a role in iron transport, it does not contain the majority of the body’s iron.
• Hemosiderin: Hemosiderin is an iron storage complex found in cells, particularly in macrophages. It is formed when excess iron is stored in ferritin and later converted into hemosiderin. While it is an iron storage form, it does not contain the majority of the body’s iron.

Answer: HbF

Fetal hemoglobin (HbF) is a type of hemoglobin that is present in high amounts in the blood of newborns and fetuses. It is composed of two alpha and two gamma globin chains. HbF has a higher affinity for oxygen than adult hemoglobin (HbA), which facilitates the transfer of oxygen from the maternal bloodstream to the developing fetus during pregnancy.

Incorrect Options:

• HbA1: HbA1 is a subtype of adult hemoglobin (HbA) and is not specifically associated with fetal development. It is formed by the non-enzymatic glycation of hemoglobin A.
• HbA2: HbA2 is another subtype of adult hemoglobin and is composed of two alpha and two delta globin chains. It is not the hemoglobin primarily present in fetuses.
• HbS: Hemoglobin S (HbS) is associated with sickle cell anemia and is not specifically referred to as fetal hemoglobin. It is a mutated form of adult hemoglobin.

Answer: AIHA

Extrinsic hemolysis refers to the premature destruction of red blood cells occurring outside the cells themselves. AIHA (Autoimmune Hemolytic Anemia) is a condition where the immune system produces antibodies that mistakenly target and attack red blood cells, leading to their destruction. This process occurs outside the red blood cells, causing extrinsic hemolysis.

Incorrect Options:

• Sickle Cell Anemia: Sickle cell anemia primarily involves intrinsic hemolysis, where the abnormal shape of red blood cells (sickle-shaped) leads to their premature destruction within blood vessels.
• G6PD Deficiency: Glucose-6-phosphate dehydrogenase (G6PD) deficiency can lead to hemolysis, but it is typically triggered by oxidative stress, and the destruction of red blood cells occurs intrinsically.
• Spherocytosis: Hereditary spherocytosis involves intrinsic hemolysis, as the red blood cells have a spherical shape that makes them more prone to premature destruction within the bloodstream.

Answer: Blood is Liquid connective tissue

Blood is considered a liquid connective tissue because it consists of cells (red blood cells, white blood cells, and platelets) suspended in a liquid matrix called plasma. It plays a crucial role in transporting substances such as oxygen, nutrients, hormones, and waste products throughout the body.

Incorrect Options:

• Blood Contains Only Platelets: This is incorrect. Blood contains various components, including red blood cells (erythrocytes), white blood cells (leukocytes), platelets (thrombocytes), and plasma.
• In Veins, Blood is Pinkish-Red in Color: This is incorrect. In veins, blood appears dark red or maroon due to a lower oxygen content. Arterial blood is bright red, while venous blood appears darker.
• Normally Blood Contains Bacteria: This is incorrect. Under normal circumstances, blood is considered a sterile environment in the body, and the presence of bacteria in the bloodstream is abnormal and indicative of an infection.

Answer: Plastic Anemia

Aplastic anemia is a condition characterized by a decrease in the number of all types of blood cells—red blood cells (RBCs), white blood cells (WBCs), and platelets. This occurs because the bone marrow fails to produce an adequate number of these blood cells. Aplastic anemia can result from various causes, including genetic factors, exposure to certain toxins, or autoimmune disorders affecting the bone marrow.

Incorrect Options:

• Hemolytic Anemia: Hemolytic anemia involves the premature destruction of red blood cells, leading to a decrease in red cell count. It does not necessarily affect white blood cells and platelets in the same way as aplastic anemia.
• ITP (Immune Thrombocytopenic Purpura): ITP is a disorder characterized by a low platelet count (thrombocytopenia), but it does not necessarily lead to a decrease in red and white blood cell counts.
• Iron Deficiency Anemia: Iron deficiency anemia primarily results in a decrease in red blood cells due to insufficient iron for hemoglobin synthesis. It does not affect white blood cells and platelets in the same manner as aplastic anemia.