Basic Sciences in Haematology

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Question 1 of 20

1. Question

Disseminated intravascular coagulation at presentation is most characteristically associated with which subtype of acute leukaemia?

Acute promyelocytic leukaemia
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Acute eosinophilic leukaemia
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Acute lymphoblastic leukaemia
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Acute monocytic leukaemia
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Acute myeloid leukaemia (non-M3)
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Question 2 of 20

2. Question

In patients with essential thrombocythaemia who are negative for the JAK2 V617F mutation, which gene is the next most commonly mutated?

CALR
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BCL2
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DNMT3A
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MPL
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TP53
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Question 3 of 20

3. Question

Which plasma electrolyte characteristically decreases in tumour lysis syndrome?

Calcium
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Magnesium
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Phosphate
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Potassium
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Uric acid
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Question 4 of 20

4. Question

The therapeutic benefit of hydroxyurea in sickle cell disease is primarily mediated by increased synthesis of which haemoglobin?

Haemoglobin F
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Haemoglobin A
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Haemoglobin A2
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Haemoglobin E
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Haemoglobin S
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Question 5 of 20

5. Question

Thrombotic thrombocytopenic purpura results from deficient activity of which protein?

ADAMTS13
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Complement factor H
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Factor VIII
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Protein C
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von Willebrand factor
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Question 6 of 20

6. Question

A haemodynamically stable adult presents with newly diagnosed immune thrombocytopenia, a platelet count of 8 ×10⁹/L [150–400] and no significant bleeding.

Which treatment is most appropriate first-line?

Intravenous immunoglobulin or corticosteroids
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Cryoprecipitate
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Platelet transfusion
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Rituximab
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Splenectomy
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Question 7 of 20

7. Question

In addition to cytotoxic T lymphocytes, which immune cell is primarily dysfunctional in the pathophysiology of haemophagocytic lymphohistiocytosis?

Natural killer cell
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Dendritic cell
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Macrophage
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Mast cell
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T helper cell
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Question 8 of 20

8. Question

A decrease in which factor shifts the oxyhaemoglobin dissociation curve to the right?

pH
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2,3-diphosphoglycerate
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Carbon dioxide
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Haemoglobin concentration
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Temperature
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Question 9 of 20

9. Question

Which investigation is most specific for confirming the diagnosis of complement-mediated (immune) haemolysis?

Direct antiglobulin test
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Free plasma haemoglobin
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Haptoglobin
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Lactate dehydrogenase
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Reticulocyte count
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Question 10 of 20

10. Question

Which ABO blood group is the universal plasma donor?

AB
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A
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B
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O
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Rhesus-negative O
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Question 11 of 20

11. Question

What is the most common cause of reduced oxygen delivery despite normal arterial oxygen saturations?

Anaemia
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Carbon monoxide toxicity
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Cigarette smoking
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Drug toxicity
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Haemoglobinopathy
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Question 12 of 20

12. Question

What is the function of the BCL2 protein?

Inhibits apoptosis
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Activates cell death
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Activates effector caspases
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Inhibits anti-apoptotic proteins
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Inhibits apoptosis
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Question 13 of 20

13. Question

A 60-year-old asymptomatic man has an incidental lymphocytosis confirmed as CLL by flow cytometry, with mild anaemia, small cervical nodes and no splenomegaly.

What is the most appropriate initial management?

Serial monitoring of full blood examination
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Bone marrow biopsy
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Chlorambucil
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CT chest and abdomen
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Prednisolone
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Question 14 of 20

14. Question

A patient on dabigatran presents with life-threatening haemorrhage. Which agent provides specific reversal?

Idarucizumab
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Andexanet alfa
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Fresh frozen plasma
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Protamine sulphate
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Vitamin K
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Question 15 of 20

15. Question

What is the main purpose of somatic hypermutation in B cells?

Selection of high-affinity B cells (affinity maturation)
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Deletion of autoreactive B cells
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Expression of class II MHC
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Generation of initial receptor diversity
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Induction of anergy
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Question 16 of 20

16. Question

Where in the gastrointestinal tract are vitamin B12 and bile salts actively reabsorbed?

Ileum
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Colon
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Duodenum
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Jejunum
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Stomach
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Question 17 of 20

17. Question

Which peripheral blood film finding is most characteristic of a microangiopathic haemolytic anaemia such as thrombotic thrombocytopenic purpura?

Schistocytes
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Howell-Jolly bodies
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Rouleaux formation
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Spherocytes
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Target cells
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Question 18 of 20

18. Question

A patient taking rivaroxaban presents with gastrointestinal haemorrhage.

Why is fresh frozen plasma not an effective reversal strategy?

FFP does not restore functional clotting factor levels sufficient to overcome direct factor Xa inhibition
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FFP accelerates rivaroxaban clearance
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FFP contains anti-Xa activity
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FFP exacerbates thrombosis risk in this setting
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FFP only reverses vitamin K antagonists
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Question 19 of 20

19. Question

Which laboratory profile is most characteristic of type 1 von Willebrand disease?

Proportionately reduced von Willebrand factor antigen, ristocetin cofactor activity and factor VIII
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Isolated prolongation of the prothrombin time
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Low factor VIII with a normal von Willebrand factor antigen
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Reduced von Willebrand factor activity with a disproportionately normal antigen level
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Selective loss of high-molecular-weight von Willebrand factor multimers with normal antigen
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Question 20 of 20

20. Question

Factor V Leiden causes an inherited predisposition to venous thrombosis through which mechanism?

Resistance of activated factor V to cleavage and inactivation by activated protein C
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Antibody-mediated activation of platelets and monocytes
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Deficiency of a natural anticoagulant protein
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Impaired fibrinolysis due to elevated plasminogen activator inhibitor-1
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Increased prothrombin levels from a gene promoter mutation
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Basic Sciences in Haematology

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