Haematology: 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

Sample item

A 55-year-old woman has a platelet count of 900 x 10^9/L. Marrow shows large hyperlobated megakaryocytes. BCR-ABL1 and JAK2 V617F are both negative. Which driver mutation is most likely?

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

The answer and the reasoning

A. CALR

Essential thrombocythaemia is driven by JAK2, CALR or MPL mutations. In JAK2-negative patients CALR is the commonest, with MPL much less frequent.

Option by option

  • A. CALR (correct)

    Correct. CALR is the commonest driver in JAK2-negative essential thrombocythaemia.

  • B. JAK2 exon 12

    JAK2 exon 12 mutations occur in polycythaemia vera with erythrocytosis, not in isolated thrombocytosis.

  • C. FLT3-ITD

    FLT3-ITD is a mutation of acute myeloid leukaemia, not of a platelet-driven chronic neoplasm.

  • D. MPL

    MPL is a recognised driver but is far rarer than CALR, so it is not the most likely.

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.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, CALR. Essential thrombocythaemia is driven by JAK2, CALR or MPL mutations.

Why is "JAK2 exon 12" not the answer?

JAK2 exon 12 mutations occur in polycythaemia vera with erythrocytosis, not in isolated thrombocytosis.

Why is "FLT3-ITD" not the answer?

FLT3-ITD is a mutation of acute myeloid leukaemia, not of a platelet-driven chronic neoplasm.

Why is "MPL" not the answer?

MPL is a recognised driver but is far rarer than CALR, so it is not the most likely.

What concept does this question test?

It tests Haematology in Pathology. In JAK2-negative patients CALR is the commonest, with MPL much less frequent.

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?

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.