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FCPS Part 1 Haematology MCQs
Haematology questions test the anaemias and their blood films, haemoglobin and iron metabolism, white cell disorders, platelets, coagulation and bleeding disorders, and transfusion.
Below are 5 free single-best-answer questions drawn from the most frequently examined haematology concepts, each with the answer and a rationale for every option. The full bank has 109 haematology concepts, each asked several different ways.
Free haematology questions
Question 1
Recurrent jaundice, raised unconjugated bilirubin and low haptoglobin indicate:
- A. Anaemia of chronic disease
- B. Iron deficiency anaemia
- C. Haemolytic anaemia
- D. Sideroblastic anaemia
- E. Aplastic anaemia
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Answer: C. Haemolytic anaemia
Red cell destruction raises unconjugated bilirubin, lowers haptoglobin as it binds free haemoglobin, and drives compensatory erythroid hyperplasia seen as reticulocytosis. Schistocytes show mechanical fragmentation.
Why not the others: Aplastic anaemia: marrow failure, low reticulocytes. Iron deficiency anaemia: microcytic, low reticulocytes. Anaemia of chronic disease: low reticulocytes, no haemolysis. Sideroblastic anaemia: ring sideroblasts, not haemolytic. Gilbert's syndrome: isolated jaundice, normal Hb.
High-yield: Anaemia + raised indirect bilirubin + high reticulocytes = haemolysis; low reticulocytes means marrow failure.
Question 2
Binucleate owl-eye cells on lymph node biopsy are the hallmark of:
- A. Hodgkin lymphoma
- B. Burkitt lymphoma
- C. Non-Hodgkin lymphoma
- D. Sarcoidosis
- E. Infectious mononucleosis
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Answer: A. Hodgkin lymphoma
Hodgkin lymphoma contains scattered Reed-Sternberg cells in a reactive background, expressing CD15 and CD30. It spreads contiguously from node to node, unlike most non-Hodgkin lymphomas.
Why not the others: Non-Hodgkin lymphoma: CD20 B-cell markers, no Reed-Sternberg cells. Burkitt lymphoma: starry-sky pattern. Sarcoidosis: non-caseating granulomas. Infectious mononucleosis: atypical lymphocytes.
High-yield: Reed-Sternberg + CD15/CD30 = Hodgkin.
Question 3
A child with pallor, lethargy and pica for mud is most likely deficient in:
- A. Calcium
- B. Iron
- C. Vitamin B6
- D. Folic acid
- E. Vitamin B12
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Answer: B. Iron
Iron deficiency causes pallor, lethargy, pica and a microcytic anaemia with low ferritin. Human milk is low in iron, and neonatal stores run out by about six months without supplementation.
Why not the others: Calcium: bone and muscle, not pallor. Vitamin B12: macrocytic anaemia with neurological signs. Folic acid: macrocytic anaemia. Vitamin B6: sideroblastic anaemia in deficiency.
High-yield: Iron deficiency: commonest anaemia, with pica; breast milk is iron-poor.
Question 4
Macrocytic anaemia with absent vibration sense and a positive Romberg test:
- A. Folate deficiency
- B. Vitamin B12 deficiency
- C. Vitamin C deficiency
- D. Iron deficiency
- E. Vitamin B6 deficiency
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Answer: B. Vitamin B12 deficiency
B12 is needed for DNA synthesis and for methylmalonyl-CoA mutase, so its lack causes megaloblastic anaemia and demyelination of the posterior and lateral columns. Folate deficiency does not affect the cord.
Why not the others: Folate deficiency: macrocytic but no neurological signs. Iron deficiency: microcytic anaemia. Vitamin B6 deficiency: sideroblastic anaemia and seizures. Vitamin C deficiency: scurvy, not macrocytosis. Anaemia of chronic disease: normocytic or microcytic.
High-yield: Macrocytosis plus neurological signs means B12; never treat with folate alone.
Question 5
Itching after hot showers with Hb 20 g/dL:
- A. Myelofibrosis
- B. Chronic myeloid leukaemia
- C. Polycythaemia vera
- D. Secondary polycythaemia
- E. Essential thrombocythaemia
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Answer: C. Polycythaemia vera
A JAK2 V617F mutation (about 95%) drives EPO-independent red cell production, so EPO is suppressed. Basophil and mast cell histamine release causes aquagenic pruritus.
Why not the others: Secondary polycythaemia: EPO high or normal, no splenomegaly. CML: high WCC, BCR-ABL. ET: platelets predominate. Relative: plasma volume reduced, red cell mass normal.
High-yield: High Hb + low EPO + aquagenic itch = polycythaemia vera (JAK2).
Keep going with haematology
Anaesgen brings every concept back on a spaced-repetition schedule timed to your exam date, as a different question each time, with full mock papers for Paper 1 and 2.
Get full access Try the 5 sample questionsHigh-yield haematology one-liners
The most-tested haematology concepts, as a clue and the answer it points to:
- Indirect jaundice, low haptoglobin, reticulocytosis, schistocytes → haemolytic anaemia.
- Reed-Sternberg cells, CD15/CD30, bimodal age, contiguous spread → Hodgkin lymphoma.
- Pica, pallor, menorrhagia, breast-fed infant → iron deficiency.
- Macrocytosis, posterior column loss, hypersegmented neutrophils → vitamin B12 deficiency.
- Aquagenic itch + high Hb + low EPO → PV (JAK2).
- Fibrinogen, factor VIII, vWF, XIII; thrombolysis bleeding → cryoprecipitate.
- Bone pain, CRAB, M spike, Bence Jones protein → multiple myeloma.
- Mucocutaneous bleeding, long bleeding time, normal platelets, both sexes → vWD.
- Below and lateral to the pubic tubercle → femoral.
- Pancytopenia, low reticulocytes, fatty marrow, chloramphenicol → aplastic anaemia.
- Drug or fava trigger, Heinz bodies, bite cells, X-linked → G6PD deficiency.
- CML, Philadelphia chromosome, BCR-ABL, imatinib → t(9;22).
- Anti-intrinsic factor, autoimmune gastritis, macrocytosis with neuropathy → pernicious anaemia.
- Prolonged PT, normal aPTT, normal bleeding time → extrinsic pathway (factor VII).
- Painful crisis, sickled cells, hypoxia or cold trigger → sickle cell anaemia.
- Group B recipient, anti-A, acute haemolysis → AB donor.
- Spherocytes, positive Coombs, unconjugated jaundice → autoimmune haemolytic anaemia.
- Haemolysis, splenomegaly, gallstones, spherocytes, ankyrin/spectrin → hereditary spherocytosis.
- Macrocytosis, hypersegmented neutrophils, hypercellular marrow → megaloblastic anaemia.
- Fixed SpO2 near 85%, chocolate blood, prilocaine or dapsone → methaemoglobinaemia.
Other FCPS Part 1 subjects
AnatomyPharmacologyPathologyBiochemistry & GeneticsCardiovascularNeurophysiologyMicrobiologyGeneral PhysiologyImmunologyEndocrineRespiratoryEmbryologyObstetrics & GynaeRenal & Acid-BaseHistologyGI & LiverPhysicsBiostatistics
New to the exam? Read the FCPS Part 1 exam guide: dates, format and a 12-week study plan.