Haematology: acute lymphoblastic leukaemia: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Haematology: acute lymphoblastic leukaemia

Sample item

A child has pancytopenia and lymphoblasts that are positive for TdT and CD10. Which statement about management is correct?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. CNS prophylaxis with intrathecal chemotherapy is essential

ALL blasts are TdT positive and myeloperoxidase negative. Intrathecal chemotherapy is given to prevent CNS and testicular sanctuary relapse. A tyrosine kinase inhibitor such as imatinib is added only for Philadelphia chromosome positive t(9;22) disease.

Option by option

  • A. Imatinib is used in all cases

    Imatinib is used only in Ph-positive ALL.

  • B. CNS prophylaxis with intrathecal chemotherapy is essential (correct)

    Correct. CNS prophylaxis is essential.

  • C. Lymphoblasts are myeloperoxidase positive

    Myeloperoxidase positivity indicates AML.

  • D. Treatment is only supportive

    ALL requires intensive chemotherapy.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, CNS prophylaxis with intrathecal chemotherapy is essential. ALL blasts are TdT positive and myeloperoxidase negative.

Why is "Imatinib is used in all cases" not the answer?

Imatinib is used only in Ph-positive ALL.

Why is "Lymphoblasts are myeloperoxidase positive" not the answer?

Myeloperoxidase positivity indicates AML.

Why is "Treatment is only supportive" not the answer?

ALL requires intensive chemotherapy.

What concept does this question test?

It tests Haematology: acute lymphoblastic leukaemia in General Medicine. Intrathecal chemotherapy is given to prevent CNS and testicular sanctuary relapse. A tyrosine kinase inhibitor such as imatinib is added only for Philadelphia chromosome positive t(9;22) disease.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haematology: acute lymphoblastic leukaemia?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.