HAEMATOLOGY

1. Causes spurious decrease in MCV c. Increased Erythrocyte destruction

a. Cryofibrinogen d. Blood loss
b. hyperglycemia
11. Vitamin B12 and folic have the similar adverse effects, but
c. autoagglutination what separates one form the other?
d. high WBC ct a. Glossitis
e. reduced red cell deformability b. No neurological symptoms in folic acid
2. When the entire CBC is suppressed due to either anemia, c. muscle wasting
infection, or hemorrhage is called? d. Dizziness
a. Erythroplasia
12. Folic acid therapy can cause sickle cell anemia
b. Thrombocytopenia
a. True
c. Pancytopenia
b. False
d. Leukopenia
13. Both vitamin B12 AND iron have drug interactions with which
3. Total RBC count for Women is? of the following drugs?
a. 4.4 6 a. PPI, H2 blockers
b. 4.25 b. Methyldopa
c. 4.05.0 c. Metformin
d. 4.25.2
14. Hydroxyurea increases hemoglobin production and decreases
4. Total RBC for men? reticulocyte cells.
a. 4.05.0a. a. True
b. 4.66.0 b. False
c. 4.26.5
15. Hydroxyurea:
d. 4.06.0
a. decreases nitric oxide
5. What is the major metabolically available storage form of iron b. increases neutrophil and monocytes
in the body? c. inhibits DNA synthesis by acting as a ribonucleotide
a. Hemosiderin reductase inhibitor
b. Ferritin
16. Hydroxyurea increases the serum uric acid levels.
c. Transferrin
a. True
d. Hemoglobin
b. False
6. The best source of active bone marrow from a 20yearold would
17. Decitabine increases the fetal hemoglobin production by
be:
inducing methylation of DNA and thus prevents the switch
a. Iliac Crest (hip) from gamma to betaglobinproduction.
b. Femur (thigh) a. True
c. Distal radius (forearm) b. False
d. Tibia (shin)
18. Hypocupremia is seen in
7. Laboratory Studies: Red Cell Indices: Determination of a. osetoporosis, nephrotic disease
relative size of RBC. 8298fl
b. sprue, cliac disease
a. MCH
c. cardiovascular disease, colon cancer
b. MCV
d. A and B
c. MCHC
e. B and C
8. Laboratory Studies: Red Cell Indices: Measurement of average f. All of the above
weight of Hb/RBC. 2733pg
19. Wilsons disease can cause liver problems
a. MCH
a. True
b. MCV
b. False
c. MCHC
20. What are the treatment options for wilson’s disease?
9. Laboratory Studies: Red Cell Indices: Evaluation of RBC
saturation with Hb. 3236% a. Pencillamine
a. MCV b. Riboflavin
b. MCH c. Trientine
c. MCHC d. Potassium disulfide
e. Zinc
10. There are 3 classifications of Anemia. What are they?
f. A, B and C
a. In adequate production of Hb
b. Decreased RBC production
 1188 g. A, C, and D 32. Which drug can be given as a prophylaxis for cadriovascular
h. A, C, D, and E effects?

21. Aplasia can occur because of riboflavin deficiency? 1. Ticlopidine

a. True 2. Clopidogrel
b. False
3. dipyridamol
22. Angular stomatitis.cheilosis is a symptom of vitamin B12 a. all
deficiency?
b. 1 and 2
a. True
c. 1 and 3
b. False
d. 2 and 3
23. Antimalarial drugs and high dose birth control will increase
33. Which drug can increase intracellular levels of cAMP by
riboflavin.
inhibiting cyclic nucleotide phosphodiesterase?
a. True
MCQ's

b. False 1. Sildenafil

24. Which test can be used to detect hemolytic anemia? 2. Ticlopidine

a. Coombs test
3. Clopidogrel
b. Genetic testing
c. Peripheral blood smear (PBS) 4. dipyridamol
d. Schilling test a. 1, 3, 4
b. 1, 2 , 3
25. Which anemia is classified as not being able to use iron
c. 1, 4
properly to synthesize hemoglobin because of ainherited
cause. 34. Warfarin should be used with caution in the following:
a. Iron deficiency anemia a. Alcoholic liver disease
b. hypochromic anemia b. Gastrointestinal bleeding
c. aplastic anemia c. recent neurosugery
26. Apalstic anemia can be induced by drugs such as Litium, d. Liver impairment
acetazolamide and aspirtin
35. Isozymes of 2C can greatly effect warfarin
a. True
a. True
b. False
b. False
27. This fatal disorder results from clot/thrombus formation in
the blood ciruclation 36. absolute lymphocytosis (>5000/mm^3) without adenopathy,
hepatosplenomegaly, anemia,thrombocytopenia is what stage
a. thromboembolism in CLL prognosis ScoringRaiStaging System?
b. DVT a. Stage 0
c. PAD b. Stage I
d. Pulmonary embolism c. Stage II
e. All of the above d. Stage III
28. Homan’s sign is classified as pain behind the knee e. Stage IV
a. True 37. Conventional treatment is ______ for Rai stage II
b. False a. Antibiotics
29. Patients that are sensitive to aspirin can take: b. chemotherapy
a. Sulfinpyrazone c. Antivirals
b. Clopidogrel d. rest
c. Ticlopidine 38. In patients with low numbers of neoplastic cells, sometimes
d. 1 and 2 due to treatment, PCR to amplify DNA can improve sensitivity,
e. 2 and 3 and detect signs of relapse.
a. True
30. What is the life span of RBC
b. False
a. 120
b. 100 39. Chronic lymphocytic leukemia is most common leukemia in
what kind of people? Slide 4
c. 200
a. young adults
d. 80
b. older adults
31. This drug can potentiate the effect of prostacyclins to
antagonize platelet stickiness and thereforedecreases platelet 40. absolute lymphocytosis and thrombocytopenia( < 100,000/
adhesion to thrombogenic surfaces. mm^3) with or without lymphadenopathy,hepatomegaly,
splenomegaly, or anemia is what stage in CLL prognosis
a. Sulfinpyrazone
ScoringRaiStaging System?
b. Dipyridamole
a. Stage 0
c. ticlopidine
 b. Stage I 49. Intravascular hemolysis is the result of trauma to RBCs while 1189
c. Stage II in the circulation
d. Stage III a. True
e. Stage IV b. False

41. Chronic Lymphocytic Leukemia is characterized by peripheral 50. A 1:20 dilution was made in a unopette, with glacial acetic acid
blood and bone marrow _____. as the diluent. The four corner squares on BOTH sides of the
hemacytometer are counted for a total of 100 cells. What is the
a. lymphocytopenia total WBC (x10^9/L.?
b. lymphocytosis a. 0.25
42. Chronic Lymphocytic Leukemia is characterized by gradual b. 2.5
accumulation of small mature ______ cells. c. 5
a. T d. 10

HAEMATOLOGY
b. B
51. The shape of a cell is maintained by which of the following?
c. NK
a. Microtubules
43. Which of the following is the most mature normoblast? b. Spindle Fibers
a. Orthochromic Normoblast c. Ribosomes
b. Basophilic Normoblast d. Centrioles
c. Pronormoblast
52. At which month of fetal development does the bone marrow
d. Polychromatic Normoblast ecome the primary site of hematopoiesis??
44. absolute lymphocytosis with either hepatomegaly or a. 2nd
splenomegaly with or without lymphadenopathy is what b. 5th
stage in CLL prognosis ScoringRai Staging System? c. End of 6th month
a. Stage 0 d. End of 7th month
b. Stage I
c. Stage II 53. Which types of cells develop from yolk sacs (Mesoblastic
phase)?
d. Stage III
a. Hb F, Hg A2, and Hg A
e. Stage IV
b. Gower 1 and Gower 2 Hgb
45. absolute lymphocytosis without lymphadenopathy without c. Portland Hgb
hepatosplenomegaly, anemia, orthrombocytopenia is what d. Only Erythroblasts
stage in CLL prognosis ScoringRaiStaging System?
a. Stage 0 54. Normal Adult Hb A contains the following polypeptide
b. Stage I chains:
c. Stage II a. alpha and beta
d. Stage III b. alpha and epsilon
e. Stage IV c. alpha and delta
d. alpha and brotherton
46. IN Chronic Lymphocytic Leukemia the Lymphocyte appearance:
small or slightly larger than normal,hypercondensed(almost 55. Allergic reactions are frequently associated with an increase
________ appearing. nuclear chromatin patter, bare nuclei in the prescence of :
called “smudge cells” arecommon. a. Lymphocytes
a. soccerball b. Neutrophils
b. basketball c. Monocytes
c. football d. Eosinophils
d. tennisball
56. Lipid exchange between the RBC membrane and the plasma
47. Which of the following forms of Hb molecule has the lowest occurs:
affinity for oxygen? a. To replace lost lipids in the membrane
a. Tense b. To provide a mechanism for excretion of lipidsoluble RBC
b. Relaxed waste products
c. Arterial c. To ensure symmetry between the composition of the interior
d. Venous and exterior lipid layers
d. To provide lipidsoluble nutrients to the RBC
48. What is the recommended cleaner for removing all oil from
objective lens? 57. After the microscope has been adjusted for Kohler
a. 70 % alcohol or lens cleaner illumination, light intensity should never be regulatedby
using the...
b. Xylene
a. Rheostat
c. Water
b. Neutral density filter
d. Benzene
c. Kohler magnifier
d. Condenser
 1190 58. Which of the followong types of microscopy is valuable in the 67. The acceptable range for hemoglobin values on a control
identification of crystals that are able torotate light? sample is 13 + or 0.4g/dL. A hemoglobindetermination is
a. Compound brightfield performed five times in succession on the same control sample.
The results are (in g/dL. 1212.3, 12, 12.2, and 12.1) These results
b. Darkfield are:
c. Polarizing a. Precise, but not accurate
d. Phasecontrast b. Both accurate and precise
59. During the Medullary Phase of hematopoietic development, c. Accurate, but not precise
which bone is the first to showhematopoietic activity? d. Neither accurate nor precise
a. Femur
68. The layer of the erythrocyte membrane that is largely
b. Iliac Crest responsible for the shape, structure, and deformability of the
c. Skull cell is the:
d. Skull a. Integral protein
e. Clavicle b. Exterior lipid
MCQ's

c. Peripheral protein
60. Given the following values, calculate the RPI Observed
reticulocyte count 6%Hct30% d. Interior lipid
a. 2 69. During midfetal life, the primary source of blood cells is the:
b. 3 a. Bone marrow
c. 4 b. Spleen
d. 5 c. Lymph Nodes
61. The lipids of the RBC membrane are arranged: d. Liver
a. In chains beneath a protein exoskeleton 70. In the bone marrow, RBC precursors are located:
b. So that the hydrophobic portions are facing the plasma a. In the center of the hematopoietic cords
c. In a hexagonal lattice b. Adjacent to megakaryocytes along the adventitial cell lining
d. In two layers that are not symmetric in composition c. Surrounding fat cells in apoptotic islands
62. The hexose monophosphate pathway activity increases the d. Surrounding macrophages near the sinus membrane
RBC source of
71. Which of the following gathers, organizes, and directs light
a. Glucose and lactic acid through the specimen?
b. 2,3BPG and methemoglobin a. Ocular
c. NADPH and reduced glutathione b. Objective lens
d. ATP and other purine metabolites c. Condenser
63. Which single feature of normal RBC’s is most responsible for d. Optical Tube
limiting their life span?
72. How are the globin chains genes arranged? Note: a means
a. Loss of mitochondria alpha, B means beta
b. Increased flexibility of the cell membrane a. With a genes and B genes on the same chromosome
c. Reduction of Hb iron including two a genes and two B genes
d. Loss of nucleus b. With a genes and B genes on seperate chromosomes, two
a genes on one chromosome and one B gene on a different
64. In the Iron cycle, the transferrin receptor carries: chromosome
a. Iron out of duodenal cells from the intestinal lumen c. With a genes and B genes on the same chromosome
b. Iron out of duodenal cells into the plasma includingfour a genes and four B genes
c. transferrinbound iron in the plasma d. With a genes and B genes on separate chromosomes foura
d. transferrinbound iron into erythrocytes genes on one chromosome and two B genes on a different
chromosome
65. A multilineage cytokine among the ILs is:
73. The maximum number of erythrocytes generated by one
a. IL1 Multipotential Stem Cell is:
b. IL2 a. 8
c. IL3 b. 1
d. IL4 c. 12
66. Which of the following cells may develop in sites other than a. 16
the bone marrow?
74. What is the distribution of normal Hb in adults?
a. Monocyte
a. 8090%
b. Lymphocyte
Hb A, 510%
c. Megakaryocyte
Hb A2, 15%
d. Neutrophil
Hb F
b. >95% Hb A, <3.5 % Hb A2, <12%
Hb F
75. The most frequent cause of needle punctures is: 83. A 16-year-old boy presents to his GP complaining of 1191
a. Patient movement during venipuncture nosebleeds and bleeding afterbrushing his teeth. He is
unsure of how long this has been occurring but decided
b. Improper disposal of phlebotomy equipment toseek advice after having to continually excuse himself
c. Inattention during removal of needle after venipuncture from lessons. On examinationyou notice he has some skin
d. Failure to attach needle firmly to tube holder bruises. A blood test shows a prolonged bleeding timeand
activated partial thromboplastin time (APTT), while platelet
76. Iron is incorporated into the heme molecule in which of the count andprothrombin times are all normal. The most likely
following forms: diagnosis is:
a. Ferro a. Von Willebrand disease
b. Ferrous b. Liver disease
c. Ferric c. Disseminated intravascular coagulation
d. Apoferritin d. Congenital afibrinogenaemia
e. Glanzmann’s thrombasthenia

HAEMATOLOGY
77. The most important practice in preventing the spread of
disease is: 84. A 22-year-old Caucasian woman presents with a 1-day history
a. Wearing masks during patient contact of a painful rightleg which is erythematous on appearance
b. Proper handwashing and tender on palpation. She states that she has had this
problem many times in the last few years and her family has
c. Wearing disposable lab coats alsosuffered from similar problems. Her grandmother died of
d. Identifying specimens from known or suspected HIV and a pulmonary embolism. The most likely diagnosis is:
HBV patients with a red label a. Antithrombin deficiency
78. Which of the following would correlate with an elevated ESR b. Factor V Leiden mutation
value? c. Protein S deficiency
a. Osteoarthritis d. Lupus anticoagulant
b. Polycythemia e. Protein C deficiency
c. Decreased globulins
85. A 44-year-old Asian female presents with a two-month history
d. Inflammation of shortness ofbreath and lethargy. She denies any intolerance
to the cold or any changes in herweight and on examination
79. The enzyme deficiency in the EmbdenMeyerhofpathway that
appears slightly pale. She states that she has recentlybecome
is responsible for most cases ofnonspherocytic hemolytic
a vegetarian. A blood film shows the presence of elliptocytes
anemia is:
and bloodresults show the following: Haemoglobin 9.9 g/dL,
a. Hexokinase Mean cell volume (MCV) 75 fL, Ferritin Low, The most likely
b. Phosphotriptokinase diagnosis is:
c. Pyruvate Kinase a. Iron deficiency anaemia
d. Glyceraldehyde 3Phosphate b. Sideroblastic anaemia
c. Anaemia of chronic disease
80. The most common type of protein found in the cell membrane
d. Thalassaemia trait
is:
e. Hereditary elliptocytosis
a. Lipoprotein
b. Mucoprotein 86. A 47-year-old teacher complains of difficulty maintaining her
c. Glycoprotein concentration atwork teaching secondary school children. She
states that over the last four monthsshe has become increasingly
d. Nucleoprotein
tired and easily fatigued. She has noticed it hasbecome more
81. A woman with BO positive blood and her partner with AB difficult for her to lift books, rise from her chair and she has
positive blood have achild together. Which of the following alsonoticed a tingling sensation in her fingers. Examination
cannot be the child’s blood type? shows a positive babinskisign and absent reflexes. A blood
test reveals the following: Haemoglobin 10 g/dL, MCV 103 fL,
a. AB positive The most likely diagnosis is:
b. BB positive a. Hypothyroidism
c. AO positive b. Vitamin B12 deficiency
d. AA positive c. Folic acid deficiency
e. BB negative d. Liver disease
81. A 24-year-old man is involved in a road traffic accident and e. Alcohol toxicity
rushed to accident andmergency accompanied by his mother
who was unharmed. An examination showssevere abdominal 87. A 55-year-old man complains of a 4-week history of general
injuries, peripheral cyanosis and cold extremities. The doctor malaise and fatigue,he has also noticed his trousers have
oncall decides a blood transfusion is necessary. The mother become more loose fitting. A blood test showsthe following
thinks the patient is bloodgroup B negative but is unsure. The results: Haemoglobin 12 g/dL, MCV 90 fL, Platelet count 250 ×
most appropriate blood group to give thepatient is? 109/L, WBC 10 109/L, Serum iron 10 mol/L, Total iron-binding
capacity 40 ìmol/L, Serum ferritin 160 g/L. The most likely
a. Group O positive blood diagnosis is:
b. Group B positive blood a. Thalassaemia
c. Group B negative blood b. Iron deficiency anaemia
d. Group O negative blood c. Anaemia of chronic disease
e. Group A negative blood d. Macrocytic anaemia
e. Aplastic anaemia
 1192 88. A 43-year-old woman suffers from Crohn’s disease. A blood 93. A 65-year-old woman suffers significant bleeding during
test shows thefollowing results: Haemoglobin 10.5 g/dL, MCV a difficult bowel resectionand is prescribed three units of
120 fL, Platelet count 300× 109/L. The most likely diagnosis is: blood after the operation is completed. It is the firsttime she
a. Vitamin B12 deficiency has required a blood transfusion and her details are checked
carefully.Approximately 4 hours after the transfusion the
b. Iron deficiency patient feels acutely unwell andcomplains of fever, chills and
c. Hypothyroidism a dry cough. Blood pressure is 110/80 mmHg, temperature
d. Folic acid deficiency 38°C and oxygen saturation is 94 per cent. The most likely
diagnosis is:
e. Anaemia of chronic disease
a. Immediate haemolytic transfusion reaction
89. A 45-year-old man collapses at home and is brought to he has b. Febrile non-haemolytic transfusion reaction
a fever at 39.5°C and blood pressure is 90/60 mmHg, although
c. Delayed haemolytic transfusion reaction
he is in a lucidstate. Bruises can be seen on his skin which he
remembers being present before hefell. Blood tests show the d. IgA deficiency
patient to have a normocytic anaemia with a low plateletcount e. Transfusion-related lung injury
and increased fibrin split products. The most likely diagnosis
MCQ's

is: 94. A 52-year-old woman presents complaining of a two-month

a. Warm autoimmune haemolytic anaemia history of increasing fatigue and numbness in both of her
arms and legs. She lives at home with her husband and has
b. Cold autoimmune haemolytic anaemia found it difficult coping with the daily activities of living. She
c. Paroxysmal nocturnal haemoglobinuria suffers from hypothyroidism which is well controlled with
d. Disseminated intravascular coagulation thyroid replacement medication. A peripheral blood smear
shows hypersegmented neutrophils. A blood test reveals the
e. Thalassaemia minor
following: Haemoglobin 10 g/dL, Mean corpuscular volume
90. A 23-year-old Asian man presents to his GP complaining of 110 fL, Platelets 150 × 109/L. Liver function tests: ALT 25 IU/L,
shortness of breath following exercise. He has always been a AST 27 IU/L, GGT 22 IU/L, ALP 100 IU/L, Urea 5 mmol/L,
little unfit and decided to start going tothe gym but noticed Creatinine 100 ìmol/L. The most likely diagnosis is:
that even after 4 weeks he is still quite short of breath. He a. Thrombotic thrombocytopenic purpura
denies any coughing or wheezing and on examination you b. Iron deficiency
notice mild pallor but the patient says he has always been
c. Folic acid deficiency
slightly pale in colour. Investigation results are given below:
Haemoglobin 12 g/dL, MCV 70 fL, Serum iron 14 umol/L, d. Liver disease
Ferritin 60 ug/L, Transferrin saturation 35 per cent, Mean e. Pernicious anaemia
cell haemoglobin 22 pg, Haemoglobin electrophoresis HbA2
increased. The most likely diagnosis is: 95. During a busy ward round you are asked to visit a patient the
a. á thalassaemia trait consultant has not had an opportunity to see. The only details
you are given are that the patient is female and was admitted
b. Anaemia of chronic disease the previous day with bleeding abnormalities, you are given
c. â thalassaemia trait the results of her blood investigations: Prothrombin time
d. Haemoglobin H disease Unaffected, Partial thromboplastin time Prolonged, Bleeding
time Prolonged, Platelet count Unaffected. What is the most
e. Iron deficiency anaemia
likely diagnosis?
91. A 29-year-old woman complains of a 1-week history of a. Factor V deficiency
weakness and malaise, she has recently become a vegetarian b. Warfarin therapy
and eats mostly green vegetables and drinks lots of tea during
c. Glanzmann’s thrombasthenia
the day. She is apyrexial and has a C-reactive protein (CRP) <5.
You suspect an abnormality of the patient’s iron stores. What d. Bernard Soulier syndrome
is the most appropriateinvestigation to determine iron store e. Von Willbrand disease
levels?
a. Bone marrow biopsy 96. A 14-year-old girl is brought to clinic by her parents who
have been worried about a fever the patient has had for the
b. Serum ferritin last week. The patient looks pale and unwell. Blood tests
c. Serum transferrin reveal a neutropenia with normal red blood counts (RBCs)
d. Total iron binding capacity and platelets. A bone marrow exam reveals no abnormalities.
The patient has been otherwise fit and well. There is no
e. Serum iron
organomegaly or lymphadenopathy. The most likely
92. A 60-year-old man presents with abdominal pain and a cupful diagnosis is:
of haematemesis.On examination he is noted to have ascites, a. Acute myeloid leukaemia
hepatomegaly and a very enlargedspleen extending to the right b. Aplastic anaemia
iliac fossa. His initial blood tests reveal aleukoerythroblastic
c. Acute lymphoblastic leukaemia
picture with a haemoglobin of 8, white cell count (WCC) of
3 and platelets of 120. A diagnosis of myelofibrosis is made. d. Bacterial infection
What is most likely tobe seen on the peripheral blood smear? e. Thrombotic thrombocytopenic purpura
a. Schistocytosis
97. A 65-year-old man presents with a chronic history of headaches
b. Sickle cells and occasional dizziness. He hesitantly mentions that he
c. Spherocytes experiences severe pruritus, especially after hot showers and
d. Dacrocytes baths. Blood pressure is 160/85 mmHg. A full blood count
(FBC) reveals a haemoglobin of 20 g/dL, MCV of 94 fL, platelet
e. Target cells
count of 470 × 109/L and WBC count of 7.8 × 109/L. The most
likely diagnosis is:
a. Polycythemia vera
b. Idiopathic erythrocytosis
 c. Essential thrombocythaemia c. Tartrate-resistant acid phosphatase stain 1193
d. Myelofibrosis d. Leukocyte alkaline phosphatase
e. Chronic myeloid leukaemia e. Auramine O stain

98. A 29-year-old woman complains of tiredness, especially 104. A 47-year-old woman presents complaining of dark stools
during activity. On examination the patient appears pale. and painful fingers on both hands. She appears plethoric
Auer rods and schistocytes can be seen on peripheral blood and complains of severe itching, often when she is washing.
smear. The patient is referred for a bone marrow biopsy and A large liver and spleen is palpable. You suspect features
the extracted cells are sent for cytogenetic analysis. The most of polycythaemia rubra vera and measure red cell mass
likely results are: and erythropoietin levels among other tests. Which of the
a. t(8:21) following is likely to be most accurate in this patient?
b. t(15;17) a. Low erythropoietin and low red cell mass
c. t(9:22) b. Normal erythropoietin and normal red cell mass
c. Raised erythropoietin and low red cell mass

HAEMATOLOGY
d. t(14;18)
e. t(8;14) d. Raised erythropoietin and raised red cell mass
e. Low erythropoietin and raised red cell mass
99. In which of the following dieases is a massive splenomegaly
not a characteristic feature? 105. A 29-year-old woman presents complaining of shortness of
a. Infectious mononucleosis breath, especially when walking up stairs. She is starting
to struggle with yoga classes, which were never a problem
b. Thalassaemia before. She does not suffer from any medical conditions and
c. Chronic myeloid leukaemia takes no regular medication. On examination there is pallor,
d. Kala-azar heart rate is 90 and blood pressure 119/79 mmHg. The patient
mentions that she has recently become a vegetarian and in the
e. Polycythaemia rubra vera
morning only has time for tea before heading to work. Which
100. A 27-year-old man presents with increasing tiredness and of the following would you expect to be increased in this
shortness of breath. A macrocytic anaemia with reticulocytes patient?
is discovered on blood tests and smear. Genetic analysis a. Myoglobin
reveals the patient has glucose-6-phosphate dehydrogenase b. Ferritin
deficiency. What cell type is most likely to have been seen on
c. Haemoglobin
the blood smear?
d. Serum iron
a. Target cells
e. Transferrin
b. Pencil cells
c. Spherocytes 106. A 65-year-old man presents with a chronic history of malaise,
d. Elliptocytes shortness of breath and paraesthesia in his hands. He appears
tired and pale while speaking and on examination his heart
e. Schistocytes
rate is 115, respiratory rate 16. A Schillings test is positive
101. A 33-year-old man travels to South Africa to take part in a while blood tests reveal a macrocytic anaemia and a Coombs
safari. On arriving, the patient takes his antimalarial tablets. test is negative. The
A few days into his course he becomes ill complaining of most likely diagnosis is:
shortness of breath, pallor and bloody urine. Blood tests reveal a. Iron deficiency anaemia
anaemia and reduced haematocrit, while a blood smear shows
b. Haemorrhage
the presence of Heinz bodies. The most likely diagnosis is:
c. Anaemia of chronic disease
a. Hereditary elliptocytosis
d. Pernicious anaemia
b. Glucose-6-phosphate dehydrogenase deficiency
e. Autoimmune haemolytic anaemia
c. Hereditary spherocytosis
d. Autoimmune haemolytic anaemia 107. A 47-year-old woman presents to clinic concerned about her
e. Microangiopathic haemolytic anaemia recent ill health. She has noticed over the last three months that
she has been suffering from headaches, fatigue and recurrent
102. An 18-year-old African man presents with worries about infections. She notes she has rarely been to the doctor before
his general health stating that hypertension and sickle and otherwise leads a healthy lifestyle. She decided to see a
cell anaemia are present in his family history. The patient doctor when she noticed petechial rashes appearing on her
denies any shortness of breath, chest pain, digit or limb arms. On examination there is no organomegaly and blood
changes. Blood pressure is 124/77 mmHg. What test would be tests reveal an MCV of 105, a pancytopenia with the bone
appropriate to investigate sickle cell anaemia? marrow appearing hypocellular on biopsy.
a. Ham’s test a. Chronic myeloid leukaemia
b. Coombs’ test b. Myeloproliferative disorder
c. Schilling test c. Aplastic anaemia
d. Metabisulfite test d. Iron deficiency anaemia
e. Osmotic fragility test e. Acute lymphoblastic anaemia

103. A young patient presents with features of anaemia, 108. A 65-year-old man presents to you reporting he has become
neutropenia and thrombocytopenia. A large number of blasts increasingly worried about his lack of energy in the last 2
are present on bone marrow biopsy. Which investigation weeks. He mentions he has been increasingly tired, sleeping
would help differentiate between acute myeloid leukaemia for long periods and has suffered from fevers unresponsive
(AML) and acute lymphoblastic leukaemia (ALL)? to paracetamol. He became increasingly worried when he
a. Myeloperoxidase stain noticed bleeding originating from his gums. A blood film
shows auer rods, hypogranular neutrophils and stains with
b. Sudan black B
 1194 Sudan black B. The most likely diagnosis is: e. Anti-smooth muscle antibodies
a. Acute lymphoblastic leukaemia
114. A 5-year-old girl presents with her parents who have become
b. DiGeorge syndrome concerned about the small petechiae and ecchymoses on her
c. Disseminated intravascular coagulation skin. An abdominal examination reveals hepatosplenomegaly.
d. Acute myeloid leukaemia You suspect an acute leukaemia. The most appropriate initial
investigation for diagnosis is:
e. Afibrinogenaemia
a. Chromosomal analysis of bone marrow cells
109. A 70-year-old woman complains of tiredness, fatigue and b. Cytochemical analysis of bone marrow cells
weight loss. Blood tests reveal an elevated WCC and on c. Direct microscopy of bone marrow cells
examination splenomegaly is palpated. Cytogenetics are
positive for the Philadelphia chromosome and the patient d. Electron microscopy
is diagnosed with chronic myeloid leukaemia. The most e. Flow cytometry
appropriate treatment is:
115. A 51-year-old man complains of severe, diffuse back pain.
a. Hydroxycarbamide
An x-ray finds several lytic lesions in the vertebra alongside
b. Imatinib hypercalcaemia. Bence–Jones protein is detected in the urine.
MCQ's

c. Venesection What is a Bence–Jones protein?

d. Stem cell transplant a. IgG antibody
e. Dasatinib b. IgA antibody
c. IgE antibody
110. A 27-year-old woman who suffers from rheumatic mitral
stenosis develops atrial fibrillation. She is placed on warfarin d. Light chain
therapy. What is the most appropriate target international e. IgM antibody
normalized raio (INR) range?
116. Hand foot Syndrome is related to which of the following?
a. <1.0
a. Tietz syndrome
b. 1.0–2.0
b. Hypertrophic osteoarthritis
c. 2.0–3.0
c. Sickle cell disease
d. 3.0–4.0
d. Syringomyelia
e. >5.0
117. Agranulocytosis occurs due to intake of :
111. A 70-year-old woman complains of a dull pain in her lower
back, especially when bending forwards to lift things. She a. Olanzapine
presents after a severe episode in the last 2 days. An x-ray a. Chloromazine
reveals a lumbar compression fracture. Blood tests show
b. Clozapine
a normocytic anaemia and urine electrophoresis reveals a
monoclonal gammopathy. c. Risperidone
A diagnosis of multiple myeloma is made. Which of the 118. Omalizumab is used in the treatment of :
following is not a recognized cause of multiple myeloma?
a. ITP
a. High-dose radiation
b. Small cell lung cancer
b. Human herpes virus-8 (HHV-8)
c. Bronchial Asthla
c. HIV
d. GLUT 6
d. Herbecides and insecticides
e. Hereditary 119. Packed cells are constructed by
a. Filtration
112. A 44-year-old woman presents with recurrent fever, pallor,
malaise and shortness of breath. She has noticed a petechial b. Centrifugation
rash on her skin and small bruises on her arms. A blood test c. Precipitation
reveals a pancytopenia. During examination, you palpate a d. Sedimentation
large spleen. Which investigation would differentiate between
hypersplenism and aplastic anaemia? 120. The phildelphia chromosome is classically associated with
a. Reticulocyte test which of the following
b. Direct Coombs test a. CLL
c. Metabisulfite test b. CML
d. Ham’s test c. Burkits lymphoma
e. Osmotic fragility test d. Hairy cell leukaemia

113. A 66-year-old man presents complaining of a three-month 121. The response to iron administration would be earliest seen by
history of weakness, tingling in the limbs and a sore tongue. a. Increased TIBC
The patient notes an undesired 5 kg weight loss over 2 weeks.
b. Increased haemoglobin
A peripheral blood smear shows a macrocytic anaemia,
a Schilling test shows impaired vitamin B12 absorption c. Reticulocytosis
and a diagnosis of pernicious anaemia is made. Which of d. Increased hematocrit
the following antibodies is most closely associated with
pernicious anaemia? 122. X linked inheritance is seen in all of the following except
a. Anti-mitochondrial antibodies a. Fabry’s disease
b. Anti-intrinsic factor antibodies b. G6PD deficiency
c. Anti-gliadin antibodies c. Myotonic dystrophy
d. Anti-centromere antibodies d. Heamophilia A
 1195
Haematology - Answers
1. a 26. a 51. a 76. b 101. b

2. c 27. e 52. c 77. b 102. d

3. c 28. a 53. d 78. d 103. c

4. b 29. e 54. a 79. c 104. e

5. b 30. a 55. d 80. c 105. e

6. a 31. b 56. a 81. d 106. d

HAEMATOLOGY
7. b 32. d 57. d 81. d 107. c

8. b 33. c 58. c 83. a 108. d

9. c 34. d 59. d 84. b 109. b

10. a 35. a 60. a 85. a 110. c

11. b 36. a 61. d 86. b 111. e

12. b 37. b 62. c 87. c 112. a

13. a 38. a 63. d 88. a 113. b

14. a 39. b 64. d 89. d 114. c

15. c 40. e 65. a 90. c 115. d

16. a 41. b 66. b 91. b 116. c

17. b 42. b 67. a 92. d 117. c

18. f 43. a 68. c 93. e 118. a

19. a 44. c 69. d 94. e 119. d

20. h 45. b 70. d 95. e 120. b

21. a 46. a 71. c 96. d 121. c

22. b 47. a 72. b 97. a 122. c

23. b 48. a 73. d 98. b

24. a 49. a 74. b 99. a

25. b 50. b 75. b 100. e