Haematology: practice question

A General Medicine 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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General Medicine · Haematology

Sample item

A 55-year-old woman has macrocytic anaemia, a smooth red tongue and numbness in both feet with loss of vibration sense. Which antibody is the most specific for the likely underlying cause?

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

The answer and the reasoning

B. Anti-intrinsic factor antibody

Macrocytic anaemia with posterior column neuropathy points to vitamin B12 deficiency, and pernicious anaemia is the classic autoimmune cause. Anti-intrinsic factor antibodies are highly specific for it, whereas anti-parietal cell antibodies are more sensitive but also occur in many people without the disease.

Option by option

  • A. Anti-parietal cell antibody

    Anti-parietal cell antibodies are found in many patients with atrophic gastritis and some healthy people, so they are less specific.

  • B. Anti-intrinsic factor antibody (correct)

    Correct. These antibodies block B12 binding to intrinsic factor and are highly specific for pernicious anaemia.

  • C. Anti-tissue transglutaminase antibody

    Anti-tissue transglutaminase antibodies point to coeliac disease, which more often causes iron or folate deficiency.

  • D. Anti-mitochondrial antibody

    Anti-mitochondrial antibodies are the marker of primary biliary cholangitis and do not explain B12 deficiency.

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 General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Anti-intrinsic factor antibody. Macrocytic anaemia with posterior column neuropathy points to vitamin B12 deficiency, and pernicious anaemia is the classic autoimmune cause.

Why is "Anti-parietal cell antibody" not the answer?

Anti-parietal cell antibodies are found in many patients with atrophic gastritis and some healthy people, so they are less specific.

Why is "Anti-tissue transglutaminase antibody" not the answer?

Anti-tissue transglutaminase antibodies point to coeliac disease, which more often causes iron or folate deficiency.

Why is "Anti-mitochondrial antibody" not the answer?

Anti-mitochondrial antibodies are the marker of primary biliary cholangitis and do not explain B12 deficiency.

What concept does this question test?

It tests Haematology in General Medicine. Anti-intrinsic factor antibodies are highly specific for it, whereas anti-parietal cell antibodies are more sensitive but also occur in many people without the disease.

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?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.