Haematology: G6PD deficiency: 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: G6PD deficiency

Sample item

An 8-year-old boy develops dark urine, jaundice and a fall in haemoglobin 2 days after eating fava beans. Supravital staining of his blood shows inclusions attached to the red cell membrane, and the smear shows cells with a bitten-out edge. What do these inclusions represent?

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

The answer and the reasoning

A. Precipitates of denatured haemoglobin (Heinz bodies)

In G6PD deficiency red cells cannot regenerate NADPH, so glutathione cannot neutralise oxidants from fava beans, infections or drugs such as primaquine. Haemoglobin is oxidised and precipitates as Heinz bodies, which splenic macrophages pit out, leaving bite cells. The condition is X-linked recessive, so affected patients are mostly male.

Option by option

  • A. Precipitates of denatured haemoglobin (Heinz bodies) (correct)

    Correct. Oxidant stress denatures haemoglobin into Heinz bodies, seen on supravital stains.

  • B. Nuclear remnants within red cells (Howell-Jolly bodies)

    Howell-Jolly bodies are DNA remnants seen after splenectomy or in hyposplenism.

  • C. Aggregates of ribosomal RNA (basophilic stippling)

    Basophilic stippling represents ribosomal RNA aggregates, as in lead poisoning.

  • D. Iron-laden granules (Pappenheimer bodies)

    Pappenheimer bodies are iron granules seen in sideroblastic anaemia and after splenectomy.

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 Pathology question

What is the answer to this Pathology question?

The best answer is A, Precipitates of denatured haemoglobin (Heinz bodies). In G6PD deficiency red cells cannot regenerate NADPH, so glutathione cannot neutralise oxidants from fava beans, infections or drugs such as primaquine.

Why is "Nuclear remnants within red cells (Howell-Jolly bodies)" not the answer?

Howell-Jolly bodies are DNA remnants seen after splenectomy or in hyposplenism.

Why is "Aggregates of ribosomal RNA (basophilic stippling)" not the answer?

Basophilic stippling represents ribosomal RNA aggregates, as in lead poisoning.

Why is "Iron-laden granules (Pappenheimer bodies)" not the answer?

Pappenheimer bodies are iron granules seen in sideroblastic anaemia and after splenectomy.

What concept does this question test?

It tests Haematology: G6PD deficiency in Pathology. Haemoglobin is oxidised and precipitates as Heinz bodies, which splenic macrophages pit out, leaving bite cells. The condition is X-linked recessive, so affected patients are mostly male.

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: G6PD deficiency?

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.