Haematology MCQs: Test Your Knowledge on Blood Disorders

Question 1

What percentage of normal adult haematopoietic bone marrow is fat?

Accepted Answer

50% — Normal adult marrow is 50% fat and 50% active haematopoietic tissue.

Question 2

In iron deficiency anemia, which is typically decreased?

Accepted Answer

Serum iron — Serum iron, ferritin, and transferrin saturation all decrease; TIBC actually increases in iron deficiency.

Question 3

Which is NOT a characteristic finding in megaloblastic anemia?

Accepted Answer

Microcytosis — Megaloblastic anemia is macrocytic; microcytosis belongs to iron deficiency.

Question 4

Which hemoglobin variant protects against severe malaria?

Accepted Answer

HbS — Sickle cell trait (HbAS) impairs parasite survival inside RBCs, conferring protection against severe P. falciparum malaria.

Question 5

Characteristic chromosomal abnormality in CML?

Accepted Answer

t(9;22) — The Philadelphia chromosome — creates the BCR-ABL fusion gene driving uncontrolled myeloid proliferation.

Question 6

Most common cause of macrocytic anemia in alcoholics?

Accepted Answer

Folate deficiency — Alcoholics have poor diet and impaired folate absorption; alcohol also directly interferes with folate metabolism.

Question 7

In beta-thalassemia major, which hemoglobin is typically increased?

Accepted Answer

HbF — Beta chains are absent/reduced, so the body compensates by maintaining fetal hemoglobin (HbF) production.

Question 8

Most common cause of acquired hemolytic anemia?

Accepted Answer

Autoimmune hemolytic anemia — Autoantibodies against RBC surface antigens is the leading acquired cause of hemolysis.

Question 9

Which is NOT a typical feature of myelodysplastic syndromes?

Accepted Answer

Hyperproliferative bone marrow — MDS features a hypercellular but ineffective marrow — cells are made but die early.

Question 10

What is the Philadelphia chromosome?

Accepted Answer

t(9;22) — t(9;22) is the Philadelphia chromosome, the hallmark of CML.

Question 11

Most common presenting symptom in acute leukemia?

Accepted Answer

Fatigue — Anemia from bone marrow failure causes fatigue as the most common initial complaint.

Question 12

Which is NOT a risk factor for myelodysplastic syndrome?

Accepted Answer

Obesity — Obesity has no established link to MDS; all others are well-recognized risk factors.

Question 13

Most common cause of vitamin B12 deficiency in Western countries?

Accepted Answer

Pernicious anemia — Autoimmune destruction of gastric parietal cells eliminates intrinsic factor, essential for B12 absorption.

Question 14

Which is NOT a typical feature of sickle cell disease?

Accepted Answer

Microcytosis — Sickle cell disease produces normocytic anemia; microcytosis is not a feature unless co-existing iron deficiency is present.

Question 15

Most common cause of hereditary hemochromatosis?

Accepted Answer

HFE gene mutation — The C282Y mutation in the HFE gene accounts for the vast majority of hereditary hemochromatosis cases.

Question 16

Most common cause of acquired hemolytic anemia? (repeated)

Accepted Answer

Autoimmune hemolytic anemia — Same as Q8.

Question 17

Which best describes the Philadelphia chromosome?

Accepted Answer

t(9;22) — Same as Q5 and Q10.

Question 18

Primary growth factor for megakaryocyte differentiation and platelet production?

Accepted Answer

Thrombopoietin — Thrombopoietin (TPO) is produced mainly by the liver and is the key regulator of platelet production.

Question 19

Which is NOT a typical feature of vitamin B12 deficiency?

Accepted Answer

Microcytosis — B12 deficiency causes macrocytosis, not microcytosis; neurological symptoms are unique to B12 vs folate deficiency.

Question 20

Most common cause of hereditary spherocytosis?

Accepted Answer

Ankyrin deficiency — Ankyrin defects are the most common cause, disrupting the link between spectrin and the lipid bilayer.

Question 21

Characteristic immunophenotype of chronic lymphocytic leukemia (CLL)?

Accepted Answer

CD5+, CD23+ — CLL is uniquely CD5+ and CD23+, distinguishing it from mantle cell lymphoma (CD5+ but CD23−).

Question 22

Which is NOT a typical feature of polycythemia vera?

Accepted Answer

Thrombocytopenia — PV typically causes thrombocytosis (increased platelets), not thrombocytopenia.

Question 23

Most common cause of warm autoimmune hemolytic anemia?

Accepted Answer

Idiopathic — Over 50% of warm AIHA cases have no identifiable cause.

Question 24

Most common cause of hereditary hemochromatosis? (repeated)

Accepted Answer

HFE gene mutation — Same as Q15.

Question 25

Which is NOT a typical feature of paroxysmal nocturnal hemoglobinuria (PNH)?

Accepted Answer

Positive direct antiglobulin test — PNH hemolysis is complement-mediated, not antibody-mediated — so the DAT is characteristically NEGATIVE.

Question 26

Primary mechanism of action of imatinib in CML?

Accepted Answer

Inhibition of BCR-ABL tyrosine kinase — Imatinib is a targeted TKI that blocks the constitutively active BCR-ABL kinase, the driver of CML.

Question 27

Characteristic immunophenotype of acute myeloid leukemia (AML)?

Accepted Answer

CD34+, CD117+, MPO+ — AML blasts express myeloid markers: CD117 (c-kit), CD34 (stem cell), and myeloperoxidase (MPO).

Question 28

Which is NOT a typical feature of beta-thalassemia major?

Accepted Answer

Increased HbA2 — In beta-thal major, HbF is markedly elevated; HbA2 elevation is the hallmark of beta-thal MINOR (trait), not major.

Question 29

Most common cause of acquired factor VIII inhibitors?

Accepted Answer

Idiopathic — Most cases of acquired hemophilia A occur without an identifiable underlying cause.

Question 30

Characteristic cytogenetic abnormality in follicular lymphoma?

Accepted Answer

t(14;18) — This translocation juxtaposes BCL-2 next to the IGH locus, causing overexpression of BCL-2 and resistance to apoptosis.

Haematology MCQs: Test Your Knowledge on Blood Disorders

Questions, Answers & Explanations