Blood and immunity: marrow failure blood picture: practice question

A Physiology 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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Physiology · Blood and immunity: marrow failure blood picture

Sample item

A patient has pancytopenia with a hypocellular, fat-replaced bone marrow and no abnormal cells. Which pair of findings is expected in the blood film and reticulocyte count?

AMacrocytic red cells with a high reticulocyte countBTeardrop cells with a high reticulocyte countCSpherocytes with a high reticulocyte countDNormocytic red cells with a very low reticulocyte count

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

The answer and the reasoning

D. Normocytic red cells with a very low reticulocyte count

Marrow failure reduces production of all cell lines, so red cells are normocytic or mildly macrocytic and the reticulocyte count is low, reflecting the absent marrow response. Haemolysis and marrow infiltration or fibrosis would give very different films.

Option by option

A. Macrocytic red cells with a high reticulocyte count
A high reticulocyte count means the marrow is responding, as in haemolysis or bleeding.
B. Teardrop cells with a high reticulocyte count
Teardrop cells suggest marrow fibrosis or infiltration.
C. Spherocytes with a high reticulocyte count
Spherocytes with high reticulocytes point to haemolysis, not marrow failure.
D. Normocytic red cells with a very low reticulocyte count (correct)
Correct. A hypocellular marrow cannot produce reticulocytes, so the count is low.

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 Physiology question

What is the answer to this Physiology question?

The best answer is D, Normocytic red cells with a very low reticulocyte count. Marrow failure reduces production of all cell lines, so red cells are normocytic or mildly macrocytic and the reticulocyte count is low, reflecting the absent marrow response.

Why is "Macrocytic red cells with a high reticulocyte count" not the answer?

A high reticulocyte count means the marrow is responding, as in haemolysis or bleeding.

Why is "Teardrop cells with a high reticulocyte count" not the answer?

Teardrop cells suggest marrow fibrosis or infiltration.

Why is "Spherocytes with a high reticulocyte count" not the answer?

Spherocytes with high reticulocytes point to haemolysis, not marrow failure.

What concept does this question test?

It tests Blood and immunity: marrow failure blood picture in Physiology. Haemolysis and marrow infiltration or fibrosis would give very different films.

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 Blood and immunity: marrow failure blood picture?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology 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.