ABIM Hematology Certification Exam Questions
WITH CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A |INSTANT
DOWNLOAD PDF
1. Which of the following is a common cause of microcytic
anemia?
A. Iron deficiency
B. Vitamin B12 deficiency
C. Thalassemia
D. Anemia of chronic disease
Correct Answer: A, C
Rationale: Microcytic anemia is typically caused by iron
deficiency or thalassemia. Vitamin B12 deficiency usually causes
macrocytic anemia, and anemia of chronic disease can be
normocytic or microcytic.
2. A 65-year-old patient presents with fatigue and
leukocytosis. Peripheral smear shows >20% blasts. Which
diagnosis is most likely?
A. Acute myeloid leukemia (AML)
B. Chronic myeloid leukemia (CML)
C. Acute lymphoblastic leukemia (ALL)
D. Myelodysplastic syndrome (MDS)
,Correct Answer: A
Rationale: Presence of >20% blasts in the peripheral blood or
bone marrow is diagnostic of acute leukemia, most commonly
AML in older adults.
3. Which laboratory test is most useful in differentiating
vitamin B12 deficiency from folate deficiency?
A. MCV
B. Homocysteine
C. Methylmalonic acid
D. Reticulocyte count
Correct Answer: C
Rationale: Both vitamin B12 and folate deficiencies can cause
macrocytosis, but methylmalonic acid is specifically elevated in
B12 deficiency.
4. In a patient with multiple myeloma, which of the following
is commonly observed?
A. Hypercalcemia
B. Monoclonal protein spike on serum electrophoresis
C. Lytic bone lesions on X-ray
D. Thrombocytosis
Correct Answer: A, B, C
Rationale: Multiple myeloma often presents with CRAB
features: hyperCalcemia, Renal failure, Anemia, and Bone
,lesions, along with monoclonal protein. Thrombocytosis is not
typical.
5. Which of the following are considered high-risk features in
acute myeloid leukemia?
A. FLT3-ITD mutation
B. t(8;21) translocation
C. Complex karyotype
D. NPM1 mutation without FLT3-ITD
Correct Answer: A, C
Rationale: FLT3-ITD and complex karyotype are poor prognostic
markers. t(8;21) and NPM1 mutation without FLT3-ITD are
associated with favorable prognosis.
6. Which of the following are indications for initiating
treatment in polycythemia vera?
A. Age >60
B. History of thrombosis
C. Hematocrit <45%
D. Platelet count >600,000/µL
Correct Answer: A, B
Rationale: In polycythemia vera, treatment is indicated in
patients at high risk of thrombosis (age >60 or prior
thrombosis). Hematocrit <45% is not an indication for therapy.
, 7. Which features are characteristic of Hodgkin lymphoma?
A. Reed-Sternberg cells
B. B symptoms (fever, night sweats, weight loss)
C. Diffuse bone marrow involvement early
D. Typically presents in young adults and has bimodal age
distribution
Correct Answer: A, B, D
Rationale: Reed-Sternberg cells and B symptoms are classic for
Hodgkin lymphoma. Bone marrow involvement occurs late.
8. Which of the following are common complications of sickle
cell disease?
A. Avascular necrosis
B. Stroke
C. Iron overload due to transfusions
D. Thrombotic thrombocytopenic purpura
Correct Answer: A, B, C
Rationale: Sickle cell disease can cause vaso-occlusive
complications, stroke, and iron overload due to chronic
transfusions. TTP is unrelated.
9. Which mutations are commonly associated with
myeloproliferative neoplasms (MPNs)?
A. JAK2 V617F
B. CALR
WITH CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A |INSTANT
DOWNLOAD PDF
1. Which of the following is a common cause of microcytic
anemia?
A. Iron deficiency
B. Vitamin B12 deficiency
C. Thalassemia
D. Anemia of chronic disease
Correct Answer: A, C
Rationale: Microcytic anemia is typically caused by iron
deficiency or thalassemia. Vitamin B12 deficiency usually causes
macrocytic anemia, and anemia of chronic disease can be
normocytic or microcytic.
2. A 65-year-old patient presents with fatigue and
leukocytosis. Peripheral smear shows >20% blasts. Which
diagnosis is most likely?
A. Acute myeloid leukemia (AML)
B. Chronic myeloid leukemia (CML)
C. Acute lymphoblastic leukemia (ALL)
D. Myelodysplastic syndrome (MDS)
,Correct Answer: A
Rationale: Presence of >20% blasts in the peripheral blood or
bone marrow is diagnostic of acute leukemia, most commonly
AML in older adults.
3. Which laboratory test is most useful in differentiating
vitamin B12 deficiency from folate deficiency?
A. MCV
B. Homocysteine
C. Methylmalonic acid
D. Reticulocyte count
Correct Answer: C
Rationale: Both vitamin B12 and folate deficiencies can cause
macrocytosis, but methylmalonic acid is specifically elevated in
B12 deficiency.
4. In a patient with multiple myeloma, which of the following
is commonly observed?
A. Hypercalcemia
B. Monoclonal protein spike on serum electrophoresis
C. Lytic bone lesions on X-ray
D. Thrombocytosis
Correct Answer: A, B, C
Rationale: Multiple myeloma often presents with CRAB
features: hyperCalcemia, Renal failure, Anemia, and Bone
,lesions, along with monoclonal protein. Thrombocytosis is not
typical.
5. Which of the following are considered high-risk features in
acute myeloid leukemia?
A. FLT3-ITD mutation
B. t(8;21) translocation
C. Complex karyotype
D. NPM1 mutation without FLT3-ITD
Correct Answer: A, C
Rationale: FLT3-ITD and complex karyotype are poor prognostic
markers. t(8;21) and NPM1 mutation without FLT3-ITD are
associated with favorable prognosis.
6. Which of the following are indications for initiating
treatment in polycythemia vera?
A. Age >60
B. History of thrombosis
C. Hematocrit <45%
D. Platelet count >600,000/µL
Correct Answer: A, B
Rationale: In polycythemia vera, treatment is indicated in
patients at high risk of thrombosis (age >60 or prior
thrombosis). Hematocrit <45% is not an indication for therapy.
, 7. Which features are characteristic of Hodgkin lymphoma?
A. Reed-Sternberg cells
B. B symptoms (fever, night sweats, weight loss)
C. Diffuse bone marrow involvement early
D. Typically presents in young adults and has bimodal age
distribution
Correct Answer: A, B, D
Rationale: Reed-Sternberg cells and B symptoms are classic for
Hodgkin lymphoma. Bone marrow involvement occurs late.
8. Which of the following are common complications of sickle
cell disease?
A. Avascular necrosis
B. Stroke
C. Iron overload due to transfusions
D. Thrombotic thrombocytopenic purpura
Correct Answer: A, B, C
Rationale: Sickle cell disease can cause vaso-occlusive
complications, stroke, and iron overload due to chronic
transfusions. TTP is unrelated.
9. Which mutations are commonly associated with
myeloproliferative neoplasms (MPNs)?
A. JAK2 V617F
B. CALR
