Haematology Exam 2025: MCQs on Anaemia, OmpathStudy

HAEMATOLOGY END OF YEAR EXAMINATION 2024/2025 Institution: Mount Kenya University School: School of Medicine Department: Department of Pathology Programme: Bachelor of Medicine and Bachelor of Surgery — Year 3 Unit Code: MBML 3200 Unit Title: Haematology Date: 14th July, 2025 Time: 2:00 PM Duration: 2 Hours 30 Minutes Paper: Paper One Structure: Section A — 60 MCQs (60 marks) Section B — 7 Short Answer Questions (60 marks) Section C — 1 Long Answer Question (20 marks) --- SECTION A: MULTIPLE CHOICE QUESTIONS Q1. A 28-year-old woman presents with fatigue and pallor. Complete blood count shows low haemoglobin level and peripheral blood film shows microcytic hypochromic red blood cells. What is the most likely diagnosis? A) Vitamin B12 deficiency B) Iron deficiency anaemia C) Aplastic anaemia D) Haemolytic anaemia E) Sickle cell anaemia Answer: B) Iron deficiency anaemia Explanation: Microcytic hypochromic red cells are the classic morphological pattern of iron deficiency anaemia, reflecting impaired haemoglobin synthesis. --- Q2. The primary site of haematopoiesis in adults is: A) Liver B) Spleen C) Bone marrow D) Lymph nodes E) Thymus Answer: C) Bone marrow Explanation: After birth, the bone marrow (particularly axial skeleton) becomes the main site of blood cell production, replacing the fetal liver and spleen. --- Q3. Which blood cell type is primarily responsible for defence against parasitic infections? A) Neutrophils B) Basophils C) Eosinophils D) Monocytes E) Lymphocytes Answer: C) Eosinophils Explanation: Eosinophils release cytotoxic granule proteins effective against helminths and other parasites, and are typically elevated in parasitic infection. --- Q4. Which clotting factor is deficient in Haemophilia A? A) Factor V B) Factor VII C) Factor VIII D) Factor IX E) Factor X Answer: C) Factor VIII Explanation: Haemophilia A is an X-linked deficiency of Factor VIII, causing prolonged APTT with normal PT. --- Q5. A patient presents with recurrent infections, petechiae, and anaemia. A bone marrow biopsy shows reduced cellularity. What is the most likely diagnosis? A) Iron deficiency anaemia B) Sickle cell disease C) Polycythaemia vera D) Aplastic anaemia E) Thalassaemia Answer: D) Aplastic anaemia Explanation: Pancytopenia with a hypocellular marrow reflects failure of haematopoietic stem cells, defining aplastic anaemia. --- Q6. Haemopoiesis is the process of: A) Blood clot formation B) White blood cell destruction C) Blood cell production D) Plasma protein synthesis E) Iron transport Answer: C) Blood cell production Explanation: Haemopoiesis refers to the formation of all cellular blood components from haematopoietic stem cells. --- Q7. A 62-year-old man presents with fatigue, fever and bruising. His full blood count shows WCC 40 × 10⁹/L with 25% circulating blasts, Hb 90 g/L and platelets 50 × 10⁹/L. Which investigation is required to definitively diagnose acute myeloid leukaemia? A) Bone marrow aspirate and trephine biopsy B) Peripheral blood smear C) Flow cytometry of peripheral blood D) Computed tomography scan E) Serum lactate dehydrogenase Answer: A) Bone marrow aspirate and trephine biopsy Explanation: Marrow examination with immunophenotyping and cytogenetics is required for definitive diagnosis and classification of AML. --- Q8. Which cytochemical stain is most useful to confirm lymphoblasts in suspected ALL? A) Myeloperoxidase (MPO) B) Terminal deoxynucleotidyl transferase (TdT) C) Sudan Black B D) Tartrate-resistant acid phosphatase (TRAP) E) Periodic acid–Schiff (PAS) Answer: B) Terminal deoxynucleotidyl transferase (TdT) Explanation: TdT is a nuclear enzyme expressed in immature lymphoid precursors, positive in the vast majority of ALL cases. --- Q9. A patient receiving chemotherapy shows a drop in neutrophil count. This condition is termed: A) Anaemia B) Leukocytosis C) Neutropenia D) Thrombocytopenia E) Erythrocytosis Answer: C) Neutropenia Explanation: Neutropenia is defined as an abnormally low absolute neutrophil count, a common chemotherapy toxicity. --- Q10. Which chromosomal translocation is pathognomonic of chronic myeloid leukaemia? A) t(8;21) B) t(15;17) C) t(9;22)(q34;q11) D) t(4;11) E) inv(16) Answer: C) t(9;22)(q34;q11) Explanation: This translocation creates the Philadelphia chromosome and BCR-ABL1 fusion gene, the molecular hallmark of CML. --- Q11. Thrombopoietin primarily regulates the production of: A) Red blood cells B) Plasma cells C) Platelets D) Monocytes E) Eosinophils Answer: C) Platelets Explanation: Thrombopoietin stimulates megakaryocyte proliferation and maturation, driving platelet production. --- Q12. Which of the following is a stem cell marker used to identify haematopoietic stem cells? A) CD3 B) CD4 C) CD19 D) CD34 E) CD20 Answer: D) CD34 Explanation: CD34 is expressed on haematopoietic stem and progenitor cells and is used clinically to enumerate and select stem cells for transplant. --- Q13. In a bone marrow biopsy of a patient with aplastic anaemia, you