Haematology: Waldenstrom macroglobulinaemia: 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: Waldenstrom macroglobulinaemia

Sample item

A 70-year-old has headache, blurred vision, epistaxis and lymphadenopathy. Serum electrophoresis shows an IgM spike, and the marrow has lymphoplasmacytic cells. Which feature explains his visual and bleeding symptoms?

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

The answer and the reasoning

D. Hyperviscosity from IgM pentamers

IgM is a large pentamer that increases serum viscosity, causing retinal vein engorgement, bleeding and neurological symptoms in Waldenstrom macroglobulinaemia. Plasmapheresis treats it urgently, and lytic lesions are unusual.

Option by option

  • A. Lytic bone lesions

    Lytic bone lesions are characteristic of multiple myeloma and rare here.

  • B. Amyloid deposition in retinal vessels

    Amyloid is a rare complication, and not the usual cause of these symptoms.

  • C. Hypercalcaemia

    Hypercalcaemia is more common in myeloma.

  • D. Hyperviscosity from IgM pentamers (correct)

    Correct. High IgM levels cause hyperviscosity syndrome.

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 D, Hyperviscosity from IgM pentamers. IgM is a large pentamer that increases serum viscosity, causing retinal vein engorgement, bleeding and neurological symptoms in Waldenstrom macroglobulinaemia.

Why is "Lytic bone lesions" not the answer?

Lytic bone lesions are characteristic of multiple myeloma and rare here.

Why is "Amyloid deposition in retinal vessels" not the answer?

Amyloid is a rare complication, and not the usual cause of these symptoms.

Why is "Hypercalcaemia" not the answer?

Hypercalcaemia is more common in myeloma.

What concept does this question test?

It tests Haematology: Waldenstrom macroglobulinaemia in Pathology. Plasmapheresis treats it urgently, and lytic lesions are unusual.

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: Waldenstrom macroglobulinaemia?

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.