Haematology MCQs: Test Your Knowledge on Blood Disorders – 30 MCQs | Kenya MBChB
30 Year 3: Blood Transfusion exam questions on Haematology MCQs: Test Your Knowledge on Blood Disorders for medical students. Includes MCQs, answers, explanatio
This MCQ set contains 30 questions on Haematology MCQs: Test Your Knowledge on Blood Disorders in the Year 3: Blood Transfusion unit. Each question includes the correct answer and a detailed explanation for active recall and exam preparation.
Q1: What percentage of normal adult haematopoietic bone marrow is fat?
- A. 10%
- B. 25%
- C. 50%
- D. 75%
- E. 90%
Correct answer: C – 50%
Normal adult marrow is 50% fat and 50% active haematopoietic tissue.
Q2: In iron deficiency anemia, which is typically decreased?
- A. Serum ferritin
- B. TIBC
- C. Transferrin saturation
- D. Serum iron
- E. All of the above
Correct answer: D – Serum iron
Serum iron, ferritin, and transferrin saturation all decrease; TIBC actually increases in iron deficiency.
Q3: Which is NOT a characteristic finding in megaloblastic anemia?
- A. Hypersegmented neutrophils
- B. Macro-ovalocytes
- C. Howell-Jolly bodies
- D. Anisocytosis
- E. Microcytosis
Correct answer: E – Microcytosis
Megaloblastic anemia is macrocytic; microcytosis belongs to iron deficiency.
Q4: Which hemoglobin variant protects against severe malaria?
- A. HbS
- B. HbC
- C. HbE
- D. HbD
- E. HbF
Correct answer: A – HbS
Sickle cell trait (HbAS) impairs parasite survival inside RBCs, conferring protection against severe P. falciparum malaria.
Q5: Characteristic chromosomal abnormality in CML?
- A. t(15;17)
- B. t(8;21)
- C. t(9;22)
- D. inv(16)
- E. t(14;18)
Correct answer: C – t(9;22)
The Philadelphia chromosome — creates the BCR-ABL fusion gene driving uncontrolled myeloid proliferation.
Q6: Most common cause of macrocytic anemia in alcoholics?
- A. Folate deficiency
- B. Vitamin B12 deficiency
- C. Direct toxic effect of alcohol
- D. Liver disease
- E. Hypothyroidism
Correct answer: A – Folate deficiency
Alcoholics have poor diet and impaired folate absorption; alcohol also directly interferes with folate metabolism.
Q7: In beta-thalassemia major, which hemoglobin is typically increased?
- A. HbA
- B. HbA2
- C. HbF
- D. HbS
- E. HbC
Correct answer: C – HbF
Beta chains are absent/reduced, so the body compensates by maintaining fetal hemoglobin (HbF) production.
Q8: Most common cause of acquired hemolytic anemia?
- A. G6PD deficiency
- B. Autoimmune hemolytic anemia
- C. Hereditary spherocytosis
- D. PNH
- E. Sickle cell disease
Correct answer: B – Autoimmune hemolytic anemia
Autoantibodies against RBC surface antigens is the leading acquired cause of hemolysis.
Q9: Which is NOT a typical feature of myelodysplastic syndromes?
- A. Cytopenias
- B. Dysplastic changes
- C. Increased blast percentage
- D. Hyperproliferative bone marrow
- E. Increased risk of AML transformation
Correct answer: D – Hyperproliferative bone marrow
MDS features a hypercellular but ineffective marrow — cells are made but die early.
Q10: What is the Philadelphia chromosome?
- A. t(9;22)
- B. t(15;17)
- C. t(8;21)
- D. inv(16)
- E. t(14;18)
Correct answer: A – t(9;22)
t(9;22) is the Philadelphia chromosome, the hallmark of CML.
Q11: Most common presenting symptom in acute leukemia?
- A. Fever
- B. Fatigue
- C. Bleeding
- D. Bone pain
- E. Lymphadenopathy
Correct answer: B – Fatigue
Anemia from bone marrow failure causes fatigue as the most common initial complaint.
Q12: Which is NOT a risk factor for myelodysplastic syndrome?
- A. Advanced age
- B. Prior chemotherapy
- C. Radiation exposure
- D. Benzene exposure
- E. Obesity
Correct answer: E – Obesity
Obesity has no established link to MDS; all others are well-recognized risk factors.
Q13: Most common cause of vitamin B12 deficiency in Western countries?
- A. Dietary deficiency
- B. Pernicious anemia
- C. Malabsorption due to gastrectomy
- D. Crohn's disease
- E. Tapeworm infestation
Correct answer: B – Pernicious anemia
Autoimmune destruction of gastric parietal cells eliminates intrinsic factor, essential for B12 absorption.
Q14: Which is NOT a typical feature of sickle cell disease?
- A. Vaso-occlusive crises
- B. Aplastic crises
- C. Splenic sequestration
- D. Hemolytic anemia
- E. Microcytosis
Correct answer: E – Microcytosis
Sickle cell disease produces normocytic anemia; microcytosis is not a feature unless co-existing iron deficiency is present.
Q15: Most common cause of hereditary hemochromatosis?
- A. HFE gene mutation
- B. Transferrin receptor 2 mutation
- C. Ferroportin mutation
- D. Hepcidin deficiency
- E. Ceruloplasmin deficiency
Correct answer: A – HFE gene mutation
The C282Y mutation in the HFE gene accounts for the vast majority of hereditary hemochromatosis cases.
Q16: Most common cause of acquired hemolytic anemia? (repeated)
- A. G6PD deficiency
- B. Autoimmune hemolytic anemia
- C. Hereditary spherocytosis
- D. PNH
- E. Sickle cell disease
Correct answer: B – Autoimmune hemolytic anemia
Same as Q8.
Q17: Which best describes the Philadelphia chromosome?
- A. t(9;22)
- B. t(15;17)
- C. t(8;21)
- D. inv(16)
- E. t(14;18)
Correct answer: A – t(9;22)
Same as Q5 and Q10.
Q18: Primary growth factor for megakaryocyte differentiation and platelet production?
- A. Erythropoietin
- B. G-CSF
- C. Thrombopoietin
- D. Interleukin-3
- E. Stem cell factor
Correct answer: C – Thrombopoietin
Thrombopoietin (TPO) is produced mainly by the liver and is the key regulator of platelet production.
Q19: Which is NOT a typical feature of vitamin B12 deficiency?
- A. Megaloblastic anemia
- B. Hypersegmented neutrophils
- C. Glossitis
- D. Microcytosis
- E. Neurological symptoms
Correct answer: D – Microcytosis
B12 deficiency causes macrocytosis, not microcytosis; neurological symptoms are unique to B12 vs folate deficiency.
Q20: Most common cause of hereditary spherocytosis?
- A. Spectrin deficiency
- B. Ankyrin deficiency
- C. Band 3 deficiency
- D. Protein 4.1 deficiency
- E. Glycophorin A deficiency
Correct answer: B – Ankyrin deficiency
Ankyrin defects are the most common cause, disrupting the link between spectrin and the lipid bilayer.
Q21: Characteristic immunophenotype of chronic lymphocytic leukemia (CLL)?
- A. CD5+, CD23+
- B. CD10+, CD19+
- C. CD15+, CD30+
- D. CD103+, CD25+
- E. CD56+, CD16+
Correct answer: A – CD5+, CD23+
CLL is uniquely CD5+ and CD23+, distinguishing it from mantle cell lymphoma (CD5+ but CD23−).
Q22: Which is NOT a typical feature of polycythemia vera?
- A. Increased red cell mass
- B. JAK2 V617F mutation
- C. Splenomegaly
- D. Pruritus after warm bath
- E. Thrombocytopenia
Correct answer: E – Thrombocytopenia
PV typically causes thrombocytosis (increased platelets), not thrombocytopenia.
Q23: Most common cause of warm autoimmune hemolytic anemia?
- A. CLL
- B. SLE
- C. Idiopathic
- D. Lymphoma
- E. Mycoplasma pneumoniae infection
Correct answer: C – Idiopathic
Over 50% of warm AIHA cases have no identifiable cause.
Q24: Most common cause of hereditary hemochromatosis? (repeated)
- A. HFE gene mutation
- B. Transferrin receptor 2 mutation
- C. Ferroportin mutation
- D. Hepcidin deficiency
- E. Ceruloplasmin deficiency
Correct answer: A – HFE gene mutation
Same as Q15.
Q25: Which is NOT a typical feature of paroxysmal nocturnal hemoglobinuria (PNH)?
- A. Intravascular hemolysis
- B. Venous thrombosis
- C. Aplastic anemia
- D. Positive direct antiglobulin test
- E. Flow cytometry showing CD55 and CD59 deficiency
Correct answer: D – Positive direct antiglobulin test
PNH hemolysis is complement-mediated, not antibody-mediated — so the DAT is characteristically NEGATIVE.
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