Important MCQ’s in Hematology for NEET SS Pediatrics 

 Q1. Hereditary spherocytosis is the commonest congenital hemolytic disease worldwide. It is an autosomal dominant disorder. This disease is most commonly caused by a defect in which of the following proteins?

1. Duffy protein

2. Spectrin

3. Beatty’s protein

4. Glycophorin C 

Ans. 2) Spectrin 

Also read: NEET SS Pediatrics Most Important MCQS

Q2. A 6-year-old is brought to the medical outpatient department with complaints of a burning sensation in his mouth for two weeks. The peripheral blood smear of the patient was performed one year ago which revealed spherocytes. Examination reveals pallor mucosal membrane, scleral icterus and a swollen, red tongue. The investigation of the patient reveals Hb of 9.0 g/dL and MCV of 72 μm³. Which of the following would have prevented the patient’s oral symptoms? 

1. Cholecystectomy

2. Red blood cell transfusion

3. Gluten-free diet

4. Folic acid supplementation

Ans. 4) Folic acid supplementation 

Q3. An 8-year-old boy is brought to the medical outpatient department with complaints of mild fatigue for one month. An investigation of the patient was done which revealed microcytic, hypochromic anemia. The genetic analysis of the patient was done which revealed a mutation in intron 1 of a gene which is located on chromosome 11’s short arm. Which of the following is the most likely diagnosis? 

1. Acanthocytosis

2. Sickle cell anemia

3. β-thalassemia minor

4. Fanconi Anemia

Ans. 3) β-thalassemia minor

Q4. A 4-year-old child is brought to the clinic due to paleness, lethargy, palpitations, and irritability lasting for three months. Physical examination reveals pallor and low weight. The child was born prematurely and fed goat's milk since birth. Lab results show hypercellular bone marrow, low hemoglobin, thrombocytopenia, and neutropenia, along with abnormal neutrophils on the peripheral film. What is the likely diagnosis?

1. Iron deficiency anemia (IDA)

2. Anemia due to Folic Acid Deficiency

3. Anemia of Chronic Disease (ACD)

4. Aplastic Anemia 

Ans. 2) Anemia due to Folic Acid Deficiency

Also read: Graft Versus Host Disease Complete Overview

Q5. A 9-year-old boy, previously ill with flu-like symptoms, is now experiencing episodes of nosebleeds and a rash all over his body for the past three days. Examination shows petechiae on the trunk and limbs, with no other notable findings. Laboratory results indicate a hemoglobin level of 15 g/dL, platelets at 10,000/mm3, and normal white blood cell count. What is the most effective treatment for this condition?

1. Transfusion of platelets

2. Splenectomy

3. Prednisone

4. Rituximab 

Ans. 3) Prednisone 

Q6. An 11-year-old boy is brought to the pediatric outpatient department by his parents with a complaint of easy bruising for the last year. At the age of nine, his parents said that he experienced acute airway obstruction due to bleeding around the pharynx. Family history indicates that a few male family members also have bleeding problems. He is blending the patient's plasma 1:1 with healthy pooled plasma to fix the partial thromboplastin time. There is a display of laboratory test results below. Which signs and symptoms are most likely to worsen if left untreated?

Laboratory Report

Hemoglobin	13.1 g/Dl
Hematocrit	39.2%
Platelet count	228,000/mm3
WBC count	5950/mm3
Prothrombin Time	13 seconds
Partial Thromboplastin Time	52 seconds

1. Conjunctival petechiae

2. Hemarthrosis

3. Hemolysis

4. Hemochromatosis 

Ans. 2) Hemarthrosis 

Q7. A 14-year-old boy is brought by his mother to the pediatric outpatient department complaining of a cough and a high-grade fever for the last 4 days. The physical examination shows the temperature to be 39.2° C. The laboratory studies are listed below. A peripheral blood smear examination reveals RBCs with Howell-Jolly bodies and evident anisocytosis. Haemophilus influenzae grows on sputum culture. Which of the below describes the fundamental cause of the patient's condition?

Laboratory Report

Haemoglobin	14.8gdL
Hematocrit	44.4%
Platelet count	496,000/mm3
WBC count	15600/mm3

1. DiGeorge syndrome

2. Galactosemia

3. Gaucher disease

4. Prior splenectomy

Ans. 4) Prior splenectomy

Also read: What is Paroxysmal Nocturnal Hemoglobinuria?

Q8. A 6-year-old girl is brought by her mother to the pediatric outdoor department with a rash all over her body for the last day. There is a history of flu-like illness two weeks back with full recovery. The patient has had no bleeding, recent trauma or fever. There is no history of such illness in her family. Physical examination shows diffuse petechiae on the trunk and extremities. Oral mucosa appears normal. Spleen and lymph nodes are not palpable. Laboratory results are as follows:

• Hemoglobin 14 g/dl
• Platelets 35000/mm3
• Leucocytes 8000/mm3

Peripheral smear shows normal size and shape of platelets with a decreased count. Which of the following is the next best option for the management? 

1. Platelet transfusion

2. Intravenous immunoglobulin

3. Splenectomy

4. Observation

Ans. 4) Observation

Q9. A 3-year-old girl is brought by her mother to the pediatric outdoor department with purple dots over her trunk and extremities for the last two days. There is a history of upper respiratory tract infection 4 weeks back. There is no history of fever or body aches. Physical examination shows diffuse purpura on the trunk and extremities. Spleen and lymph nodes are not palpable. Laboratory results are as follows:

Hemoglobin 13 g/dl

Platelets 25000/mm3

Leucocytes 9000/mm3

Where would be the antibodies most commonly directed in the case discussed above?

1. ADP receptor

2. Antithrombin III

3. Glycoprotein IIb/IIIa

4. Platelet-activating factor

 Ans. 3) Glycoprotein IIb/IIIa 

Also read: Hematopoiesis: The Journey Of Blood Cell Production

Q10. A 13-year-old boy presents with his mother to the pediatric hematology department with complaints of sore throat associated with high-grade fever for the last 2 days. His mother reports that his son has frequent sore throats. Examination reveals hypertrophied tonsils and a tonsillectomy is done. Post-operatively, the patient has excessive mucosal bleeding. His laboratory results show defective platelet aggregation and prolonged bleeding time. What is the most likely cause of excessive bleeding in this patient? 

1. Von Willebrand disease

2. Hemophilia A

3. Hemophilia B

4. Hemophilia C 

Ans. 1) Von Willebrand disease

Q11. A 2-day-old neonate girl is brought by her father to the pediatric outpatient department complaining of bleeding from her mouth 1 hour ago. Examination of the neonate reveals no significant findings. NG tube is inserted which shows blood suggestive of gastrointestinal bleeding. Her laboratory investigations reveal marked prolongation of PT and PTT. There is no evidence of consumptive coagulopathy. Which of the following is deficient in this disorder?

1. Factor 1 deficiency

2. Factor VIII deficiency

3. Factor IX deficiency

4. Factor X deficiency 

Ans. 1) Factor 1 deficiency

Q12. A 14-year-old boy is brought by his father to the pediatric outpatient department complaining of sudden onset of the appearance of purple dots and bruises over his body for the last few hours. His examination reveals generalised petechiae and purpura. Rest his general physical and systemic examination is unremarkable. His laboratory findings indicate thrombocytopenia, increased reticulocyte count and decreased haptoglobin whereas white blood cell count and differential counts are normal. What is the most likely diagnosis in this case?

1. Evans Syndrome

2. Wiskott-Aldrich syndrome

3. Glanzmann thrombasthenia

4. Bernard soulier syndrome

 Ans. 1) Evans Syndrome

Also read: Polycythemia And Ploycythemia Vera  In Children

Q13. A 13-year-old girl diagnosed with thalassemia requires a whole blood transfusion due to acquired aplastic anemia caused by chloramphenicol intake for recent infection. Which red blood cell preparations will significantly lower the risk of CMV infection associated with transfusions? 

1. Leukoreduction 

2. Warming

3. Washing

4. Irradiation 

Ans. 1) Leukoreduction

Q14. A 13-year-old thalassemic female is transfused with whole blood before surgery. After an hour, the patient starts to experience flank discomfort and shows signs of severe distress. Her blood pressure is 99/50 mm Hg, her temperature is 38.5°C (101.3°F), her pulse is 111/min, and she breathes 22 times per minute. The oxygen saturation in room air, measured by pulse oximetry, is 97%. The urine on the Foley catheter is dark brown. Which of the following is most likely to be revealed by further testing on this patient?

1. Positive direct coombs test

2. Serum antibodies against Class I HLA antigens

3. Low levels of serum IgA immunoglobulins

4. Bilateral pulmonary infiltrates on CXR 

Ans. 1) Positive direct Coombs test

Also read: Platelet Transfusion In Children

Q15. A 12-year-old girl had acute difficulties breathing quickly after a surgical transfusion of 1 unit of packed red blood cells due to substantial blood loss. She is breathing 35 times per minute, her temperature is 38.3 C (100.8 F), and her blood pressure is 88/57 mmHg. Oxygen saturation in room air is 72%. A physical examination reveals cyanosis and excessive perspiration. Both peripheral oedema and jugular venous distension are absent. A normal cardiac silhouette and bilateral interstitial and alveolar infiltrates are shown on a chest x-ray. Which of the following describes the transfusion response in this patient the most likely? 

1. Activation of primed neutrophils

2. ABO incompatibility

3. Type I hypersensitivity reaction

4. Cytokine accumulation during blood storage  

Ans. 1) Activation of primed neutrophils

Hope you found this blog helpful for your NEET SS Pediatrics Hematology Preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.

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