questions - hematology india

7/26/2019 Questions - Hematology India

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Hematology

IndiaHome

01. Anemias

02. Myeloproliferative Disorders

03. MDS/MPD

04. Myelodysplastic Syndrome

05. Acute Myeloid Leukemia

06. Acute Lymphoblastic Leukemia

07. Hodgkin and Non Hodgkin

lymphoma

08. Mature B Cell Neoplasms

09. Mature T Cell and NK Cell

neoplasms

10. Histiocytic and Dendritic Cell

Neoplasms

11. Mastocytosis

12. Immunodeficiency AssociatedLymphoproliferative Disorders

13. Coagulation disorders

14. Platelet Disorders

15. Missellaneous Diseases

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Questions

1. Haemolysis in patients deficient in G-6PD

occurs due to formation of

A. Dohle bodies

B. Heinz bodiesC. Howell jolly bodies

D. Pappenheimer bodies

2. All are True of Sickle cell anemia Except

A, Hemolysis is Extravascular

B. Is due to a Defective point mutation

C. Sickling test is confirmatory

D. RBC have a life span of 10-20 days

3. Which of the following is least likely to be

found in multiple myeloma

A. Hypercalcemia

B. Hypergammaglobulinemia

C. Plasma cell leukemia

D. High ESR

4. Majority of NHL are of

A. B cell type

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B. T cell type

C. Histiocytic type.

D. Mixed cell type

5. Pancytopenia with 10% myeloblasts and

several dyserythroporetic normoblasts in the

marrow will be called

A. Erythroleukemia.

B. Cong. Dyserythropoietic anemia

C. Subleukemic leukemia

D. Myelodysplastic syndrome

6. All are conditions causing macrocytic

anaemia EXCEPT

A. Pernicious anaemia

B. Chronic liver disease

C. Post hemorrhagic state

D. G6 PD deficiency

7. A 58 year old female has a decreased serum

iron and total iron binding capacity (TIBC. in

association with an increased serum ferritin.

These findings are most indicative of

A. Malabsorption

B. Anemia of chronic disease

C. Auto immune hemolytic anemia

D. Vit B 12 deficiency

E. Chronic blood loss

8. Burr cells are

A. Fragmented cells in uraemia

B. RBC with Howell-jolly bodies

C. Stippled RBCs

D. Parasited RBCs

9. Of the following conditions, the one most

likely to cause massive splenomegaly (3000gm.

is:

A. Myelofibrosis


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B. Sickle cell anemia

C. Portal hypertension

D. Infectious mononucleosis E. Hemochromatosis

10. Pelger-Huet like cells are seen in all except

A. MDSB. AML with dysplastic maturation

C. CML

D. ALL

11. Monocytosis in peripheral blood is seen in

all conditions except

A. TuberculosisB. Chrons disease

C. AML-M5

D. Chronic myelomonocytic leukemia E.

Infectious mononucleosis

12. Increasing basophil count in an already

diagnosed CML patient is suggestive ofA. Severe infection

B. Good prognostic indicator

C. Going for accelerated phase

D. Bleeding diathesis

13. Condition in which the platelet lack

granules and have a ghost like appearance on

stained blood film is

A. Bernard-soulier syndrome

B. Chediak Higashi syndrome

C. Thrombasthenia

D. Grey platelet syndrome

14. All are romanowsky stains except

A. Leishmann

B. Jenners

C. Giemsa


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D. Wrights

E. Mason fontanna

15. A 15-year-old girl has menorrhagia and

tendency to bleed from minor cuts and

wounds. PTT and bleeding times are

prolonged. She is likely to be having

A. F-XIII deficiency

B. Heamophilia A

C. Platelet function defect

D. Von Williebrands disease

16. The test most likely to be useful in the

diagnosis of AML M5 on a blood smear is

staining by

A. Non specific esterase

B. PAS

C. Sudan black

D. TRAP

17. Which of the following represents a

favourable prognosis in childhood ALL

A. Age by six yrs

B. TLC of 80,000/camm

C. Philadelphia chromosome

D. Hb 14 gms/ dl

18. The acute leukemia most likely to lead to

DIC

A. AML-M2

B. AML-M3

C. AML-M4

D. AML-M5

E. ALL

19. The normal myeloid erythroid ratio is

A. 1:1

B. 2:1

C. 3:1


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D. 10:1

20. Of the following which finding rules out

diagnosis of Aplastic anaemia

A. Neutropenia

B. ThrombocytopeniaC. Reduced haemoglobin level

D. Absence of splenomegaly

E. Presence of nucleated red cell (normoblast. in

peripheral smear

21. 40 year old man presented with marked

anaemia CBC revealed Hb 4 gm%, TC 1500/cumm with marked neutropenia platelet

count 10,000/ cumm. Repeated bone marrow

aspirate yielded dry tap. A diagnosis is made

with

A. Serum electrophoresis

B. Trephine biopsy

C. Chromosomal studies

D. Hb electrophoresis

22. All are primary screening tests for

haemorhagic disorders except

A. Bleeding time

B. Clotting time

C. Platelet count

D. PT E. PTT

23. aThalassemias are due to

A. Defects in transcription

B. Defects in processing or translation of b-

globin m RNA

C. Gene deletion

D. Chromosomal translocations

24. Following complications can occur in the

course of sickle cell anaemia

A. Haemolytic crisis


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B. Sequestration crisis

C. Aplastic crisis

D. Vaso occlusive crisis E. All of the above

25. The molecular pathology in hereditary

spherocytosis is due toA. Spectrin deficiency

B. Point mutation

C. Gene deletions

D. Balanced chromosomal translocation

26. Warm antibody immune haemolytic

anaemia the antibody responsible is

A. Ig G

B. Ig M

C. Ig E

D. Ig A

27. Of this which is a milder disease

A. Hb S

B. Hb SC

C. Hb H

D. Hb Barts

E. Hb AS

28. Bcl2 over expression is seen in

A. Follicular B cell lymphoma

B. Burkitts lymphoma

C. Lymphoblasric lymphoma

D. Small lymphocytic lymphoma

29. All of the following conditions are

characterised by a high ESR, except

A. Multiple myeloma

B. Rheumatic fever

C. Tuberculosis infection

D. Sickle cell anaemia

30. Reticulocytosis is not seen with


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A. Hereditary spherocytosis

B. Following acute bleeding

C. Paroxysmal nocturnal hbnuria

D. Anaemia of CRF

31. Tart cell is a

A. Monocyte

B. LE cell

C. Atypical lymphocyte

D. A type of myeloblast

32. Immature white blood cells are rarely seen

in the peripheral blood in all of the following

conditions except:

A. Leukemoid reaction

B. Cml

C. Aml

D. All E. CLL

33. Which of the following statements is

incorrect

A. A peripheral blood smear that has target cells

is consistent with chronic alcoholism

B. Howell-Jolly bodies suggest previous

splenectomy

C. A leukoerythroblastic picture in the peripheral

blood suggests metastatic carcinoma to bone

D. Schistocytes on the peipheral smear suggest

iron deficiency anemiaE. Basophilic stippling suggests injury by a drug

or by a toxin

34. A peripheral blood smear was made when

a CBC was ordered on a 66 year old female

scheduled to undergo a hernia repair. Many

small, mature lymphocytes were seen. Her

Hgb was 12. 8, Hct 36. 9, MCV88, platelet count179000 and WBC count 30500. The best

diagnosis is

A. Leukemoid reaction;


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B. ALL

C. Infectious mononucleosis

D. CMV infection E. CLL

35. A 51 year old female has been feeling tired

for months. A CBC demonstrate the following:

Hb 9. 5, Hct 28. 1 and MCV 134. The

reticulocyte index is low. Hypersegmented

PMNs are seen on the peripheral blood smear.

Which of the following tests should be

ordered next

A. Serum B12 and folate

B. Bone marrow biopsy

C. Serum ferritin

D. Hb electrophoresis

36. A 16 year old male with hypochromic

anemia in association with splenomegaly and

hemochromatosis is most likely to have:

A. G6PD deficiency

B. Beta-Thalassemia

C. Sickle cell anemia

D. Hereditary spherocytosis

E. Malaria

37. A 61 year old male has bone pain, renal

failure and pneumococcal pneumonia. In this

setting, a bone marrow biopsy is most likely to

show manyA. Granulomas

B. Plasma cells

C. Small lymphocytes

D. Reed-Sternberg cells

E. Blasts

38. An abdominal ultrasound is performed on

a 35yr old male. In which of the following

conditions is the spleen most likely to appear

normal in size


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A. Hemolytic anemia

B. Macronodular cirrosis

C. Myelofibrosis

D. ITP

E. Sickle cell anemia

39. Lymphadenopathy is a feature of all of the

following conditions except:

A. HIV infection

B. Toxoplasmosis

C. Multiple myeloma

D. Infectious mononucleosis

E. Non-Hodgkins lymphoma

40. A 45 year old male has skin infiltration by

neoplastic T lymphocytes. His condition is

known as:

A. Hodgkins disease

B. Mycosis fungoides

C. Burkitts lymphoma

D. ALLE. Hairy cell leukemia

41. A 69 year old male with pancytopenia and

massive splenomegaly has increased numbers

of peripheral blood lymphocytes containing

tartrate resistant acid phosphatase. The

probable diagnosis isA. CLL

B. HTLV-1 infection with leukemia

C. Hairy cell leukemia

D. Gauchers disease

E. Myelodysplasia

42. Which of the following is not part of

Langerhans cell histiocytosis

A. Eosinophilic granuloma of bone

B. Cytoplasmic HX bodies (Birbeck granules.


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C. Hypothalamic infiltration and diabetes

insipidus

D. Epstein-Barr virus infection

43. Of the following findings which will be

most likely to occur with extra vascular,

rather than intravascular hemolysis

A. Splenomegaly

B. Increased retic count

C. Acute renal failure

D. Decreased serum haptoglobin

E. Jaundice

44.Serum protein electrophoretic pattern with

a large 4gm monoclonal gamma spike is

consistent with finding, all of the following

additional laboratory findings except:

A. Elevated BUN and creatinine

B. Increased sedimentation rate

C. Chromosomal translocation

D. Hypercalcemia

E. Normocytic anemia

45. The appearance of helmet cell (a type of

schistocytE. on examination of the peripheral

blood smear is most consistent with origin

from a patient who has

A. Beta-thalassemia

B. Septicemia with E-coliC. Hereditary spherocytosis

D. Massive splenomegaly

46. The genetic distribution of sickle cell

anemia is based upon the presence of this

agent

A. Mycoplasma

B. ParvovirusC. Plasmodium

D. Hepatitis virus

E. Babesia


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47.HLA antigens have not been demonstrated

on

A. WBC

B. Platelet

C. RBCD. Other body cells

48. Diagnostic test for thalassemia trait

A. HbA2

B. HbF

C. Fragility test

D.Coombs test

49. Earliest sign of megaloblastic anaemia

A. Increased MCV

B. Increased neutrophil segmentation

C. Altered ME ratio

D. Decreased Hb

50. Hypochromic red cells in the peripheral

smear is characteristic of all except

A. Aplastic anaemia

B. Iron def. Anaemia

C. Sideroblastic anaemia

D. Beta thalassemia

51. Erythroid hyperplasia in bone marrow is

seen in the following conditions exceptA. Iron deficiency anaemia

B. Pernicious anaemia

C. Fanconis anaemia

D. Hereditary spherocytosis

52. At what stage of erythropoeisis dos Hb

appears

A. Early normo blast

B. Intermediate normo blast

C. Reticulocyte


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D. Erythroblast

53. Autoimmune hemolytic anaemia is

commonly seen in:

A. CLL

B. AMLC. ALL

D. CML

54. The minimum number of blasts present in

Bone marrow, for acute leukemia diagnosis

is

A. 10%

B. 20%

C. 30%

D. 35%

55. The presence of lacunar cells are seen in

which type of Hodgkin disease

A. Lymphocyte predominance

B. Mixed cellularityC. Nodular sclerosis

D. Lymphocyte depleted

56. Dutcher bodies are connected with

A. Plasma cell dyscrasia

B. acute myeloid leukemia

C. polycythemic Vera rubraD. Myelofibrosis

57. Starry sky pattern is seen in

A. Small lymphocytic lymphoma

B. Burkitts lymphoma

C. Follicular lymphomas

D. Lymphoblastic lymphoma.

58. All trans retinoid acid is connected with


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A. AML- M4

B. AML-M2

C. AML-M3

D. AML-M6 E. ALL-L3

59. All are predisposing to leukemia except:A. Leukemoid reaction

B. Myelofibrosis

C. Poly cythemia vera

D. Myelodysplastic syndrome

60. How long blood can be stored with CPDA

A. 21 daysB. 28 days

C. 35 days

D. 42 days

61. Abeta lipoprotienemia is suggested by the

following findings except:

A. AcanthocytosisB. Severe malnutrition

C. Hypercholesterolemia

D. Retinitis pigmentosa

62. Match the following: Anticoagulants of

choice

A. ESR EDTA

B. Ostmotic fragility Na Citrate 1:9

C. Coagulation test Heparin

D. Peripheral smear Na Citrate 1:4

63. Which of the following has a prominent

mediastinal involvement

A. B-ALL

B. T-ALL

C. Null cell type

D. CLL


14/22


15/22

(Primary. Amyloid protein is made of

A. aheavy chain

B. mheavy chain

C. k light chain

D. llight chain

69. Cancer for which radiation is not a risk

factor

a. CML

B. ALL

C. AML,

D. CLL

70. Primary effusion lymphoma is associated

with which of the following agents

A. HHV-8

B. EBV

C. HIV

D. HPV

71. Following are pathognomonic forms of

Plamodium falciparum

A. Gametocyte

B. Accole forms

C. Multiple rings

D. Schizonts

72. Glitter cells are seen inA. Pyelonephritis

B. Tuberculous meningitis

C. Nephrotic syndrome

D. Viral meningitis

73. Telescoped urinary sediment are seen in

A. End stage renal diseaseB. Nephrotic syndrome

C. Acute on chronic glomerulo nephritis

D. All of the above


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74. Fixed specific gravity of 1010 is due to

A. Acute renal failure

B. Chronic renal failure

C. Nephrotic syndrome

D. Acute glomerulonephritis

75. Eddis count is for quantification of

A. Coliforms in urine

B. Leucocytes in urine

C. Urinary sediments

D. RBCs

76. A cast which may present in ithe urine of a

healthy individual is

A. Granular cast

B. Hyaline cast

C. Red cell casts

D. Epithelial casts

77. All are urinary fixatives except

A. Formalin

B. Thymol

C. Absolute alcohol

D. Concentrated Hcl E. Boric acid

78. All are crystals formed in acidic urine

except,A. Calcium oxalate

B. Uric acid

C. Triple phosphate

D. Cystine crystals

79. Adequecy of sputum is determined by

presence of

A. Squamous epithelial cells

B. Neutrophis

C. Alveolar leyden macrophages


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D. bronchial epithelial cells

80. Following condition protect against

plasmodium falciparum

a. Lewis antigen positivity

B. Duffy antigen positivityc. Duffy antigen negativity

D. Lewis antigen negativity

81. Aquired B antigen in a blood group A

person is seen all except

A. Gram negative septicemia

B. Carcinoma colon

C. Both of these

D. Leukemia

82. All of these can cause discrepancies in

blood grouping except

A. Whartons jelly

B. Rouleaux formation

C. A I H A

D. C- reactive protein

83. Du estimation is to done in these patients

A. Rh positive donor

B. Rh negative donor

C. Rh negative recipient

D. Rh positive recipient

84. In which of the following patient

descriptions would you expect the patient to

have a normocytic anemia with a corrected

reticulocyte count < 2%?

A. Patient with episodic hemoglobinuria in the

first morning void

B. Patient with chronic renal failure secondary to

type I diabetes mellitus

C. Patient with untreated long-standing peptic


18/22

ulcer disease

D. Patient with a positive sickle cell screen and a

normal peripheral smear

E. Patient with a family history of haemolytic

anemia after eating fava beans

85. Which of the following disorders will most

likely show a normal percentage of

eosinophils in the peripheral blood ?

A. Strongyloidiasis

B. Hookworm infestation

C. Drug allergy

D. Contact dermatitis

E. Addisons disease

86. Absolute lymphocytosis without atypical

lymphocytosis would be expected in :

A. Whooping cough

B. A cytomegalovirus infection

C. An Epstein Barr virus infectin

D. Toxoplasmosis

87. In a patient with pancytopenia, a normal

MCV, and a corrected reticulocyte count < 2%,

you would expect the mechanism of disease to

be :

A. Renal failure with reduction in erythropoietin

B. Suppression or destruction of the trilineage

myeloid stem cellC. A DNA maturation defect

D. Chronic blood loss

E. Increased susceptibility of hematopoietic cells

to complement destruction

88. In a febrile 4 year old child with sickle cell

disease and a CBC exhibiting a normocytic

anemia, increased corrected reticulocytecount, absolute leukocytosis, > 10% band

neutrophis, toxic ggranulation, sickle cells,

target cells, and Howell Jolly bodies, you


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would strongly suspect :

A. A viral infection

B. Salmonella osteomyelitis

C. Streptococcus pneumoniae sepsis

D. Tuberculosis E. A systemic fungal infection

89. A 15 year old girl with severe anaemia

were found to have 80% blasts in the

peripheral smear. Positivity for which marker

indicates a relatively better prognosis?

A. 8 ; 14 translocation.

B. Bcr- abl fusion transcript.

C. MLL 1 fusion transcriptD. TEL AML 1 fusion transcript

90. Which of the following cytogenetic

abnormalities if detected in a solid

haemopoietic neoplasm indicates an indolent

course.

A. 9;22 translocation

B. 8;14 translocationC. 14;18 translocation

D. 11;14 translocation

91. (A) 8 year old girl with anaemia and

bleeding manifestations. Smear showed large

granular cells with multiple auer rods. (B) 23

year old girl with anaemia and petechial

spots. The bone marrow showed more than

30% blasts , positive for non specific esterase.

Eosinophil constitute 35% of marrow cells. (C)

60 year old man presented with massive

splenomegaly. The WBC count is

2,20000/cumm. Hb 10. 8gm%. Platelet count

130,000/cumm.

A. Trisomy 8.

B. Inversion 16

C. 9; 22 translocation.

D. 15; 17 translocation.


20/22

92. Which of the following combination of

immunological markers when positive

indicates diagnosis of biphenotypic leukemia

A. CD 3 and tdt

B. CD 10 and tdtC. CD 3 and CD 22

D. CD 13 and MPO (myeloperoxidasE)

93. A 5cm tumour attatched to the wall of the

stomach was removed from a 52 year old man.

The oncologist wants to know if he needs

treatment with GLIVEC(IMATINIB., Positivity

for which marker will be decisive

A. CD 117

B. Cytokines

C. Desmin.

D. Vimentin

94. Which one of the following is not a

criterion for making a diagnosis of chronic

myeloid leukemia in accelerated phase:

A. Blasts 10-19% of WBCs in peripheral blood

B. Basophils 10-19% of WBCs in peripheral blood

C. Increasing spleen size unresponsive to

theraphy

D. Persistent thrombocytosis (>1000 X 109/L.

unresponsive to therapy.

95. CD 19 Positive, CD22 Positive,CD 103

positive Monoclonal B-Cells with bright kappa

positivity were found to comprise 60% of the

peripheral blood lymphoid cells on flow

cytometric analysis in a 55 year old man with

massive splenomegaly and a total leucocyte

count of 3. 3 x 109

/L . Which one of thefollowing is the most likely diagnosis?

A. Splenic lymphoma with villous lymphocytes.

B. Mantle cell Lymphoma.


21/22

C. B-Cell prolymphocytic leukemia.

D. Hairy cell leukemia.

96. A Four year old boy was admitted with a

history of abdominal pain and fever for two

months, maculopapular rash for ten days, and

dry cough dyspnea and wheezing for three

days. On examination, liver and spleen were

enlarged 4cm and 3cm respectively below the

costal margins. His hemoglobin was 10. 0g/dl,

Platelet count 37 x 109/L and total leukocyte

count 70 x 109 / L. which included 80%

eosinophils. Bone Marrow comprising 45%

blasts and 34%. Eosinophils and eosinophilicprecurosors. The blasts staind negative for

myeloperoxidase ans non specific esterase

and were positive for CD19,CD10,CD22 and

CD20. Which one of the following is the most

likely dignosis?

A. Biphhenotypic acute leukemia (Lymphoid and

eosinophil lineage)

B. Acute eosinophilic leukemiaC. Acute lymphoblastic lekemis with

hypereosinophilic syndrome.

D. Acute myeloid leukemia with eosinophilia

97. A 48 Year old women was admitted with a

history of weakness for two months. On

examination, cervical lymph nodes were

found enlarged and spleen was palpable 2cm

below the costal margin. Her hemoglobin was

10. 5 g/dl, platelei count 237 x 109/L and total

leukocyte count 40 x 109/L, which included

80% Mature lymphoid cells with coarse

clumped chromatin. Bone marrow revealed a

nodular lymphoid infiltrate. The peripherel

blood lymphoid cells were positive for CD 19,

CD5, CD20 and CD23 and were negative for

CD79B and FMC -7. Which one of the following

statements in not true about this disease?


22/22

A. Trisomy 12 correlates an aggressive clinical

course.

B. Abnormalities of 13q 14 are associated with

long term survival.

C. Cases with 11q22-23 deletion have excessive

lymphadenopathy.

D. t(11;14) translocation is present in most of the

cases

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