Haematology: sickle cell disease: practice question

A Pathology 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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Pathology · Haematology: sickle cell disease

Sample item

A 9-year-old boy with sickle cell disease has pallor, tiredness and fever after a viral illness with a slapped-cheek rash in a sibling. Haemoglobin has fallen from 8 to 4 g/dL and the reticulocyte count is 0.1%. What is the most likely complication?

AAplastic crisis due to parvovirus B19 infection of erythroid precursorsBVaso-occlusive crisisCHyperhaemolytic crisisDSplenic sequestration crisis

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

The answer and the reasoning

A. Aplastic crisis due to parvovirus B19 infection of erythroid precursors

Parvovirus B19 infects erythroid progenitors and halts red cell production. In a patient with shortened red cell survival this causes an abrupt fall in haemoglobin with reticulocytopenia. Sequestration and hyperhaemolysis show raised reticulocyte counts and, in sequestration, a large spleen.

Option by option

A. Aplastic crisis due to parvovirus B19 infection of erythroid precursors (correct)
Correct. A very low reticulocyte count with a sharp haemoglobin fall points to aplastic crisis.
B. Vaso-occlusive crisis
Vaso-occlusive crisis causes pain and does not suppress reticulocytes.
C. Hyperhaemolytic crisis
Hyperhaemolysis raises the reticulocyte count, whereas here it is suppressed.
D. Splenic sequestration crisis
Sequestration produces acute splenomegaly with a high reticulocyte count.

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.

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, Aplastic crisis due to parvovirus B19 infection of erythroid precursors. Parvovirus B19 infects erythroid progenitors and halts red cell production.

Why is "Vaso-occlusive crisis" not the answer?

Vaso-occlusive crisis causes pain and does not suppress reticulocytes.

Why is "Hyperhaemolytic crisis" not the answer?

Hyperhaemolysis raises the reticulocyte count, whereas here it is suppressed.

Why is "Splenic sequestration crisis" not the answer?

Sequestration produces acute splenomegaly with a high reticulocyte count.

What concept does this question test?

It tests Haematology: sickle cell disease in Pathology. In a patient with shortened red cell survival this causes an abrupt fall in haemoglobin with reticulocytopenia. Sequestration and hyperhaemolysis show raised reticulocyte counts and, in sequestration, a large spleen.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: sickle cell disease?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.