Haematology: transfusional siderosis in thalassaemia: 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: transfusional siderosis in thalassaemia

Sample item

A 14-year-old with beta thalassaemia major on regular transfusions, who has not been taking chelation, develops arrhythmias and heart failure. Cardiac MRI shows a markedly shortened T2* signal. Which pathological change is responsible?

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

The answer and the reasoning

A. Haemosiderin deposition in cardiac myocytes

Repeated transfusions and increased absorption overload the body with iron. Haemosiderin accumulates in the heart, liver and endocrine glands, and cardiac siderosis remains a leading cause of death in poorly chelated thalassaemia major.

Option by option

  • A. Haemosiderin deposition in cardiac myocytes (correct)

    Correct. Iron deposition in myocytes shortens T2* and causes arrhythmia and cardiomyopathy.

  • B. Amyloid deposition between myocytes

    Amyloid is not a feature of thalassaemia and would not shorten T2* in this way.

  • C. Coronary thrombosis with myocardial infarction

    Young patients with thalassaemia do not have coronary thrombosis as the usual cause of their cardiac failure.

  • D. Non-caseating granulomas in the myocardium

    Granulomas are seen in sarcoidosis and infections and are not caused by iron overload.

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, Haemosiderin deposition in cardiac myocytes. Repeated transfusions and increased absorption overload the body with iron.

Why is "Amyloid deposition between myocytes" not the answer?

Amyloid is not a feature of thalassaemia and would not shorten T2* in this way.

Why is "Coronary thrombosis with myocardial infarction" not the answer?

Young patients with thalassaemia do not have coronary thrombosis as the usual cause of their cardiac failure.

Why is "Non-caseating granulomas in the myocardium" not the answer?

Granulomas are seen in sarcoidosis and infections and are not caused by iron overload.

What concept does this question test?

It tests Haematology: transfusional siderosis in thalassaemia in Pathology. Haemosiderin accumulates in the heart, liver and endocrine glands, and cardiac siderosis remains a leading cause of death in poorly chelated thalassaemia major.

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: transfusional siderosis in thalassaemia?

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.