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