FCPS IMM Haematology & Oncology MCQs: High-Yield Practice & Prep

Sample FCPS IMM Medicine haematology and oncology MCQs on anaemias, bleeding disorders, leukaemia, lymphoma and tumour markers, with explanations.

Haematology and oncology in IMM centres on anaemia work-up, bleeding and thrombotic disorders, leukaemias, lymphomas and tumour markers. Cases are usually solved from a blood count plus one or two extra results. Here is a practice set with the reasoning shown.

Sample Haematology & Oncology MCQs

1. A young-age patient taking NSAIDs for body pains presented with bleeding gums, epistaxis, fever, mild jaundice and hepatosplenomegaly. On investigation Hb 9 g/dL, TLC 70,000, thrombocytopenia, and smear also shows immature cells. Diagnosis?

A) Drug induced anaemia
B) Acute leukaemia ✅
C) Aplastic anaemia
D) Chronic viral hepatitis
E) Thalassaemia minor

Why: Fever, bleeding, hepatosplenomegaly, a very high count with immature cells and thrombocytopenia indicate acute leukaemia.

2. A 37-year-old female presents to you in OPD with complaints of weakness, lethargy and fever. Her CBC shows Hb 8, TLC 2900, PLT 45000. Her reticulocyte count was also decreased. You will order which diagnostic test now?

A) Bone marrow biopsy ✅
B) Serum ferritin
C) Repeat CBC
D) Vitamin B12 levels

Why: Pancytopenia with a low reticulocyte count needs a bone marrow biopsy to distinguish aplastic anaemia from marrow infiltration or dysplasia.

3. A 2-year-old boy has been brought to the hospital for circumcision. There is history of excessive bleeding from the umbilical stump at the time of birth. Two cousins bleed profusely after circumcision. The blood test most likely to give a clue to the diagnosis is:

A) Peripheral smear
B) BT
C) PT
D) APTT ✅

Why: X-linked family history of bleeding after circumcision suggests haemophilia, which prolongs the APTT with a normal PT.

4. A patient is investigated for leukocytosis. Cytogenetic analysis shows the presence of the translocation t(9;22). Which haematological malignancy is most strongly associated with this translocation?

A) Chronic lymphocytic leukaemia
B) Burkitt lymphoma
C) Acute lymphoblastic leukaemia
D) Chronic myelogenous leukaemia ✅
E) Acute myelogenous leukaemia

Why: The Philadelphia chromosome t(9;22) creates the BCR-ABL fusion gene and defines chronic myeloid leukaemia (about 95%).

5. A patient presented to you with complaint of brown coloured urine for the last 1 year especially early morning. What is the most likely cause?

A) Nephrotic syndrome
B) G6PD
C) PNH ✅
D) CA bladder

Why: Passing brown-red urine, particularly early in the morning, is the classic presentation of paroxysmal nocturnal haemoglobinuria (PNH), caused by complement-mediated intravascular haemolysis. Flow cytometry for CD55 and CD59 confirms it.

6. A female patient with petechial haemorrhages presents to you in OPD. CBC shows Hb normal, TLC count normal, PLT 19,000. Which test helps to reveal the diagnosis?

A) Bone marrow biopsy ✅
B) Tourniquet test
C) Platelet function
D) HESS test
E) APTT

Why: Bone marrow biopsy showing normal or increased megakaryocytes confirms peripheral destruction (ITP) and excludes marrow failure.

7. A 5-year-old boy presented with pallor; investigation shows low Hb (5 g/dL) and high TIBC. Diagnosis?

A) Thalassaemia
B) Anaemia of chronic disease
C) Parasite infestation ✅
D) Lead poisoning

Why: Low Hb with a high TIBC indicates iron deficiency, which in a child is commonly due to parasitic (hookworm) infestation.

8. A young boy presents to you in OPD with a history of weight loss and fatigue. Examination reveals lymphadenopathy. He explains that it becomes very painful after consumption of alcohol. Diagnosis?

A) Hodgkin lymphoma ✅
B) Acute lymphoblastic leukaemia
C) Acute myelogenous leukaemia
D) Non-Hodgkin lymphoma

Why: Alcohol-induced pain at the site of involved nodes is a classic, though uncommon, feature of Hodgkin lymphoma.

How to Approach Haematology & Oncology for IMM

Work every anaemia vignette from the MCV, then reticulocytes, then iron studies.
For bleeding disorders, know which of PT, APTT, bleeding time and platelets is abnormal in each condition.
Pair each translocation and tumour marker with its disease.

Browse every Haematology & Oncology question on its own: Haematology & Oncology MCQs.

Keep Practising

These questions come from HighYield's FCPS IMM Medicine QBank, which holds over 2,400 clinical-vignette MCQs with an explanation for every answer. The first 20 questions are free in Tutor mode, so you can judge the explanation quality before unlocking the full bank.