- NEED HELP? CALL US NOW
- +919995411505
- [email protected]
Past AIIMS MCQ Solved
1. Reticulocytosis is seen in all except:
- P.N.H.
- Hemolysis
- Nutritional anemia
- Dyserythropoietic syndrome
ANSWER c
Reticulocytes are nonnucleated spherical cells bigger than normal RBCs and are polychromatic (having a blue color) due to the presence of free ribosomes and RNA.
Reticulocytosis (Increased RBC production)
Conditions
- Acute blood loss or hemorrhage
- Postsplenectomy
- Microangiopathic Anemia
- Autoimmune Hemolytic Anemia
- Hemoglobinopathy (Sickle cell anemia and Thalassemia)
- Post anemia treatment like folate supplementation, iron supplementation & vitamin B12 supplementation
Reticulocytopenia (Decreased RBC production)
Conditions
- Aplastic anemia
- Bone marrow infiltration
- Bone marrow suppression (Sepsis/Chemo/radiotherapy)
- Blood transfusion
- Liver disease
- Disordered RBC maturation (Iron, B12, Folate Deficiency, Hypothyroidism, Sideroblastic Anemia or Anemia of Chronic Disease)
2. ABO incompatibility not seen with:
- Fresh frozen plasma
- Platelet rich plasma
- Single donor platelets
- Cryoprecipitate
ANSWER d
- Donated blood is processed into components: PRBCs, platelets, and fresh-frozen plasma (FFP) or cryoprecipitate.
- Whole blood is first separated into PRBCs and platelet-rich plasma by slow centrifugation.
- The platelet-rich plasma is then centrifuged at high speed to yield one unit of random donor (RD) platelets and one unit of FFP.
- Cryoprecipitate is produced by thawing FFP to precipitate the plasma proteins, and then separated by centrifugation.
- Wintrobe’s clearly mentions that ‘ABO incompatible plasma carries high risk of transfusion reactions, therefore, plasma transfusions should always be ABO incompatible’. So, option ‘a’ and ‘b’ are ruled out.
- The platelets bear the intrinsic ABO antigens. So, platelet rich plasma and single donor platelets also should be preferably ABO compatible. So, answer of exclusion is cryoprecipitate. It is not carrying ABO antigens but should preferably be ABO compatible to avoid even the minimal risk of hemolytic reaction.
- Apheresis technology is used for the collection of multiple units of platelets from a single donor. These single-donor apheresis platelets (SDAP) contain the equivalent of at least six units of RD platelets and have fewer contaminating leukocytes than pooled RD platelets.
- Still the risk of severe hemolytic reactions is much more with single donor incompatible platelets than pooled plasma because the dose of incompatible plasma is also increased.
3. 55 years old male accident victim in casualty urgently needs blood. The blood bank is unable to determine his ABO group, as his red cell group and plasma group do not match. Emergency transfusion of the patient should be with:
- RBC corresponding to his red cell group and colloids/crystalloid
- Whole blood corresponding to his plasma group
- O positive RBC and colloids/crystalloid
- AB negative whole blood
ANSWER c
- If patient’s blood group is known, unmatched blood group of the same group may be used.
- If the patient’s blood cannot be determined, Group O red blood cells should be chosen.
- The use of such unmatched blood should be Rh (–ve) when used in woman of child-bearing age in whom we do not want sensitization to Rh antigen.
- As Rh negative blood is often in limited supply, Rh positive blood is used in the emergency transfusion of older females and males of unknown blood group. In such cases sensitization may occur but the risk of an immediate hemolytic reaction is low. O blood group is the universal donor and therefore, should be given to this patient.
4. Although more than 400 blood groups have been identified, the ABO blood system re-mains the most important in clinical medicine because:
- It was the first blood group system to be discovered
- It has four different blood group A, B, AB, O (H)
- ABO (H) antigens are present in most body tissues and fluids
- ABO (H) antibodies are invariably present in plasma when persons RBC lack the corres-ponding antigen
ANSWER d
- In clinical transfusion practice the ABO blood groups are the most important and can never be ignored in red cell transfusion, because individuals, who genetically lack any antigen, have antibodies against the red cell types that they have not inherited.
- These antibodies can destroy red cells rapidly in circulation.
- The same is not the case with other blood groups where antibodies are formed only after exposure to the sensitive antigen (Preformed antibodies are absent).
5. Which of the following is seen in peripheral smear of a patient who has undergone splenectomy:
- Howell-Jolly bodies
- Eosinophilia
- Macrocytosis
- Thrombocytopenia
- Neutrophilia
ANSWER a
Chronic manifestations of splenectomy (Postsplenectomy hematological features) are:
- Red cells: Marked variation in size and shape (anisocytosis, poikilocytosis)
- Macrocytosis
- Presence of Howell-Jolly bodies (nuclear remnants)
- Heinz bodies (denatured hemoglobin)
- Basophilic stippling
- Occasional nucleated red cells in the peripheral blood
- Target cells
- Pappenheimer bodies (contain sideroblastic granules)
