Q.1 Which of the following is a common cause of microcytic anemia?
Vitamin B12 deficiency
Iron deficiency
Folate deficiency
Aplastic anemia
Explanation - Microcytic anemia is characterized by smaller than normal red blood cells, commonly caused by iron deficiency due to chronic blood loss or inadequate dietary intake.
Correct answer is: Iron deficiency
Q.2 Which laboratory test is most useful for monitoring long-term glucose control in diabetic patients?
Fasting blood glucose
Random blood glucose
HbA1c
Oral glucose tolerance test
Explanation - HbA1c reflects average blood glucose over the previous 2-3 months and is used to monitor long-term glucose control in diabetic patients.
Correct answer is: HbA1c
Q.3 A peripheral blood smear showing 'target cells' is most commonly associated with:
Iron deficiency anemia
Thalassemia
Vitamin B12 deficiency
Aplastic anemia
Explanation - Target cells are RBCs with a central area of hemoglobin, commonly seen in thalassemia, liver disease, and post-splenectomy.
Correct answer is: Thalassemia
Q.4 Which of the following is a marker of hemolysis in laboratory tests?
Increased haptoglobin
Decreased LDH
Elevated indirect bilirubin
Decreased reticulocyte count
Explanation - Hemolysis leads to the breakdown of RBCs, releasing hemoglobin, which is metabolized to indirect bilirubin, elevating its levels in the blood.
Correct answer is: Elevated indirect bilirubin
Q.5 In which condition would you most likely find Howell-Jolly bodies in red blood cells?
Iron deficiency anemia
Post-splenectomy
Vitamin B12 deficiency
Sickle cell anemia
Explanation - Howell-Jolly bodies are nuclear remnants in RBCs, usually removed by the spleen. They appear in peripheral blood after splenectomy or in functional hyposplenism.
Correct answer is: Post-splenectomy
Q.6 Which of the following is the primary laboratory feature of nephrotic syndrome?
Hematuria
Proteinuria
Leukocytosis
Hyperbilirubinemia
Explanation - Nephrotic syndrome is characterized by excessive protein loss in urine (>3.5 g/day), along with hypoalbuminemia, edema, and hyperlipidemia.
Correct answer is: Proteinuria
Q.7 Which of these cells is primarily elevated in allergic reactions?
Neutrophils
Eosinophils
Basophils
Monocytes
Explanation - Eosinophils play a key role in allergic reactions and parasitic infections, leading to their elevated count in peripheral blood.
Correct answer is: Eosinophils
Q.8 Prothrombin time (PT) is used to assess the function of which pathway of coagulation?
Intrinsic pathway
Extrinsic pathway
Common pathway
Fibrinolytic pathway
Explanation - PT measures the function of the extrinsic and common coagulation pathways, primarily dependent on factor VII and tissue factor interaction.
Correct answer is: Extrinsic pathway
Q.9 Which stain is commonly used to detect iron in bone marrow or liver biopsy specimens?
Hematoxylin and Eosin
Prussian blue
Wright-Giemsa
PAS stain
Explanation - Prussian blue stain reacts with ferric iron to form a blue pigment, allowing visualization of iron deposits in tissue samples.
Correct answer is: Prussian blue
Q.10 An elevated reticulocyte count indicates:
Bone marrow suppression
Increased RBC destruction or loss
Iron deficiency
Vitamin B12 deficiency
Explanation - Reticulocytes are immature RBCs. Their elevation indicates a compensatory response of the bone marrow to anemia caused by blood loss or hemolysis.
Correct answer is: Increased RBC destruction or loss
Q.11 Which of the following is considered a pre-renal cause of acute kidney injury?
Glomerulonephritis
Hypovolemia
Acute tubular necrosis
Pyelonephritis
Explanation - Pre-renal AKI occurs due to decreased renal perfusion, commonly from hypovolemia, dehydration, or heart failure, without intrinsic kidney damage initially.
Correct answer is: Hypovolemia
Q.12 Which of the following is a feature of nephritic syndrome?
Massive proteinuria
Edema
Hematuria
Hyperlipidemia
Explanation - Nephritic syndrome is characterized by hematuria, hypertension, mild proteinuria, and variable edema, typically due to glomerular inflammation.
Correct answer is: Hematuria
Q.13 Which laboratory test is used to diagnose disseminated intravascular coagulation (DIC)?
PT, aPTT, D-dimer, platelet count
ESR and CRP
Serum creatinine and urea
Liver function tests
Explanation - DIC is characterized by widespread coagulation and fibrinolysis, which prolongs PT and aPTT, consumes platelets, and elevates D-dimer.
Correct answer is: PT, aPTT, D-dimer, platelet count
Q.14 Which of the following is the hallmark of iron deficiency anemia on a peripheral smear?
Macrocytosis
Hypochromia and microcytosis
Spherocytes
Schistocytes
Explanation - Iron deficiency anemia presents with small (microcytic) and pale (hypochromic) red blood cells due to impaired hemoglobin synthesis.
Correct answer is: Hypochromia and microcytosis
Q.15 Which serum marker is elevated in hemolytic anemia?
Direct bilirubin
Indirect bilirubin
Albumin
Creatinine
Explanation - In hemolytic anemia, RBC destruction releases hemoglobin, which is metabolized to unconjugated (indirect) bilirubin, elevating its serum level.
Correct answer is: Indirect bilirubin
Q.16 Which blood cell type is primarily involved in bacterial infections?
Lymphocytes
Neutrophils
Eosinophils
Basophils
Explanation - Neutrophils are the first line of defense against bacterial infections and are elevated (neutrophilia) in acute bacterial infections.
Correct answer is: Neutrophils
Q.17 Which of the following is the most specific marker for myocardial infarction?
CK-MB
Troponin I
LDH
AST
Explanation - Troponin I is highly specific for myocardial injury and is the preferred biomarker for diagnosing acute myocardial infarction.
Correct answer is: Troponin I
Q.18 Which laboratory finding is characteristic of chronic kidney disease?
Hyperkalemia
Hypokalemia
Hypernatremia
Hypocalcemia
Explanation - CKD leads to reduced renal excretion of potassium, resulting in hyperkalemia, along with other electrolyte disturbances like hypocalcemia.
Correct answer is: Hyperkalemia
Q.19 Which of the following is considered a hallmark of multiple myeloma in laboratory tests?
Bence-Jones proteins in urine
Hypercalcemia
Anemia
All of the above
Explanation - Multiple myeloma is characterized by monoclonal plasma cell proliferation leading to Bence-Jones proteinuria, hypercalcemia, anemia, and bone lesions.
Correct answer is: All of the above
Q.20 Which of the following is the best test to assess platelet function?
Bleeding time
PT
aPTT
Fibrinogen level
Explanation - Bleeding time assesses platelet function and primary hemostasis, reflecting how quickly a small skin puncture stops bleeding.
Correct answer is: Bleeding time
Q.21 Which of the following laboratory tests is useful in diagnosing autoimmune hemolytic anemia?
Coombs test
ESR
CRP
ANA test
Explanation - The Coombs test detects antibodies or complement on RBC surfaces, aiding in the diagnosis of autoimmune hemolytic anemia.
Correct answer is: Coombs test
Q.22 Which of the following indicates a left shift in white blood cell differential?
Increased mature neutrophils
Increased band neutrophils
Decreased neutrophils
Increased lymphocytes
Explanation - A left shift refers to the presence of immature neutrophils (bands) in circulation, usually due to acute bacterial infection or inflammation.
Correct answer is: Increased band neutrophils
Q.23 Which of the following conditions is associated with rouleaux formation on a peripheral blood smear?
Iron deficiency anemia
Multiple myeloma
Vitamin B12 deficiency
Aplastic anemia
Explanation - Rouleaux formation occurs when RBCs stack like coins due to increased plasma proteins, especially seen in multiple myeloma.
Correct answer is: Multiple myeloma
Q.24 Which of the following tests is used to evaluate the intrinsic pathway of coagulation?
PT
aPTT
Bleeding time
Platelet count
Explanation - aPTT (activated partial thromboplastin time) measures the intrinsic and common coagulation pathways, useful in detecting hemophilia or heparin therapy monitoring.
Correct answer is: aPTT