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?

  1. A. 10%
  2. B. 25%
  3. C. 50%
  4. D. 75%
  5. 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?

  1. A. Serum ferritin
  2. B. TIBC
  3. C. Transferrin saturation
  4. D. Serum iron
  5. 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?

  1. A. Hypersegmented neutrophils
  2. B. Macro-ovalocytes
  3. C. Howell-Jolly bodies
  4. D. Anisocytosis
  5. E. Microcytosis

Correct answer: E – Microcytosis

Megaloblastic anemia is macrocytic; microcytosis belongs to iron deficiency.

Q4: Which hemoglobin variant protects against severe malaria?

  1. A. HbS
  2. B. HbC
  3. C. HbE
  4. D. HbD
  5. 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?

  1. A. t(15;17)
  2. B. t(8;21)
  3. C. t(9;22)
  4. D. inv(16)
  5. 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?

  1. A. Folate deficiency
  2. B. Vitamin B12 deficiency
  3. C. Direct toxic effect of alcohol
  4. D. Liver disease
  5. 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?

  1. A. HbA
  2. B. HbA2
  3. C. HbF
  4. D. HbS
  5. 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?

  1. A. G6PD deficiency
  2. B. Autoimmune hemolytic anemia
  3. C. Hereditary spherocytosis
  4. D. PNH
  5. 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?

  1. A. Cytopenias
  2. B. Dysplastic changes
  3. C. Increased blast percentage
  4. D. Hyperproliferative bone marrow
  5. 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?

  1. A. t(9;22)
  2. B. t(15;17)
  3. C. t(8;21)
  4. D. inv(16)
  5. 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?

  1. A. Fever
  2. B. Fatigue
  3. C. Bleeding
  4. D. Bone pain
  5. 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?

  1. A. Advanced age
  2. B. Prior chemotherapy
  3. C. Radiation exposure
  4. D. Benzene exposure
  5. 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?

  1. A. Dietary deficiency
  2. B. Pernicious anemia
  3. C. Malabsorption due to gastrectomy
  4. D. Crohn's disease
  5. 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?

  1. A. Vaso-occlusive crises
  2. B. Aplastic crises
  3. C. Splenic sequestration
  4. D. Hemolytic anemia
  5. 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?

  1. A. HFE gene mutation
  2. B. Transferrin receptor 2 mutation
  3. C. Ferroportin mutation
  4. D. Hepcidin deficiency
  5. 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)

  1. A. G6PD deficiency
  2. B. Autoimmune hemolytic anemia
  3. C. Hereditary spherocytosis
  4. D. PNH
  5. E. Sickle cell disease

Correct answer: B – Autoimmune hemolytic anemia

Same as Q8.

Q17: Which best describes the Philadelphia chromosome?

  1. A. t(9;22)
  2. B. t(15;17)
  3. C. t(8;21)
  4. D. inv(16)
  5. 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?

  1. A. Erythropoietin
  2. B. G-CSF
  3. C. Thrombopoietin
  4. D. Interleukin-3
  5. 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?

  1. A. Megaloblastic anemia
  2. B. Hypersegmented neutrophils
  3. C. Glossitis
  4. D. Microcytosis
  5. 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?

  1. A. Spectrin deficiency
  2. B. Ankyrin deficiency
  3. C. Band 3 deficiency
  4. D. Protein 4.1 deficiency
  5. 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)?

  1. A. CD5+, CD23+
  2. B. CD10+, CD19+
  3. C. CD15+, CD30+
  4. D. CD103+, CD25+
  5. 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?

  1. A. Increased red cell mass
  2. B. JAK2 V617F mutation
  3. C. Splenomegaly
  4. D. Pruritus after warm bath
  5. E. Thrombocytopenia

Correct answer: E – Thrombocytopenia

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

Q23: Most common cause of warm autoimmune hemolytic anemia?

  1. A. CLL
  2. B. SLE
  3. C. Idiopathic
  4. D. Lymphoma
  5. 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)

  1. A. HFE gene mutation
  2. B. Transferrin receptor 2 mutation
  3. C. Ferroportin mutation
  4. D. Hepcidin deficiency
  5. E. Ceruloplasmin deficiency

Correct answer: A – HFE gene mutation

Same as Q15.

Q25: Which is NOT a typical feature of paroxysmal nocturnal hemoglobinuria (PNH)?

  1. A. Intravascular hemolysis
  2. B. Venous thrombosis
  3. C. Aplastic anemia
  4. D. Positive direct antiglobulin test
  5. 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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