ABIM Hematology-Oncology Certification Exam
Questions WITH CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A |INSTANT
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1. A 65-year-old man presents with fatigue and pallor. His labs
show Hb 8 g/dL, MCV 72 fL, and ferritin 8 ng/mL. What is the
most likely cause?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Anemia of chronic disease
D. Thalassemia
Correct Answer: B. Iron deficiency anemia
Rationale: Microcytic anemia (low MCV) with low ferritin
indicates iron deficiency. B12 deficiency causes macrocytic
anemia, anemia of chronic disease typically has normal or high
ferritin, and thalassemia often shows normal iron studies.
2. A patient with chronic lymphocytic leukemia (CLL) develops
rapidly enlarging lymph nodes and B symptoms. What is the
most likely diagnosis?
A. Richter transformation
B. Hodgkin lymphoma
C. Hairy cell leukemia
D. Mantle cell lymphoma
,Correct Answer: A. Richter transformation
Rationale: Richter transformation is the progression of CLL to an
aggressive lymphoma, often diffuse large B-cell lymphoma,
presenting with rapid lymphadenopathy and systemic B
symptoms.
3. Which of the following is the most sensitive marker for
multiple myeloma?
A. Serum protein electrophoresis
B. Serum free light chain assay
C. Urine protein electrophoresis
D. Bone marrow biopsy
Correct Answer: B. Serum free light chain assay
Rationale: The serum free light chain assay can detect non-
secretory or light chain myeloma, making it the most sensitive
initial test, whereas SPEP may miss light-chain-only disease.
4. A 55-year-old woman with metastatic breast cancer
develops thrombocytopenia, microangiopathic hemolytic
anemia, and renal dysfunction. What is the likely cause?
A. DIC
B. TTP
C. ITP
D. Chemotherapy-induced cytopenia
,Correct Answer: B. TTP
Rationale: TTP presents with thrombocytopenia,
microangiopathic hemolytic anemia, renal dysfunction,
neurologic changes, and fever (pentad). DIC often has
prolonged coagulation times, and ITP rarely causes hemolysis or
renal dysfunction.
5. Which cytogenetic abnormality in acute myeloid leukemia
(AML) confers the best prognosis?
A. t(8;21)
B. t(15;17)
C. inv(16)
D. Complex karyotype
Correct Answer: B. t(15;17)
Rationale: t(15;17) is associated with acute promyelocytic
leukemia (APL), which responds well to ATRA and arsenic
therapy, giving a favorable prognosis.
6. A patient with Hodgkin lymphoma has mediastinal
lymphadenopathy and Reed-Sternberg cells on biopsy. What
subtype is most common?
A. Nodular sclerosis
B. Mixed cellularity
C. Lymphocyte-depleted
D. Lymphocyte-rich
, Correct Answer: A. Nodular sclerosis
Rationale: Nodular sclerosis is the most common subtype of
Hodgkin lymphoma, typically affecting young adults with
mediastinal involvement.
7. A 70-year-old man presents with easy bruising. Labs show
prolonged PT and aPTT, low factor VIII, and normal platelets.
Which is the most likely diagnosis?
A. Hemophilia A
B. Hemophilia B
C. Vitamin K deficiency
D. ITP
Correct Answer: A. Hemophilia A
Rationale: Hemophilia A (factor VIII deficiency) prolongs aPTT
but not PT, with normal platelets. Hemophilia B affects factor
IX, vitamin K deficiency affects multiple factors (prolonged PT
and aPTT), and ITP affects platelets.
8. Which of the following is the first-line therapy for high-risk
essential thrombocythemia?
A. Aspirin alone
B. Hydroxyurea
C. Interferon-alpha
D. Anagrelide
Questions WITH CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A |INSTANT
DOWNLOAD PDF
1. A 65-year-old man presents with fatigue and pallor. His labs
show Hb 8 g/dL, MCV 72 fL, and ferritin 8 ng/mL. What is the
most likely cause?
A. Vitamin B12 deficiency
B. Iron deficiency anemia
C. Anemia of chronic disease
D. Thalassemia
Correct Answer: B. Iron deficiency anemia
Rationale: Microcytic anemia (low MCV) with low ferritin
indicates iron deficiency. B12 deficiency causes macrocytic
anemia, anemia of chronic disease typically has normal or high
ferritin, and thalassemia often shows normal iron studies.
2. A patient with chronic lymphocytic leukemia (CLL) develops
rapidly enlarging lymph nodes and B symptoms. What is the
most likely diagnosis?
A. Richter transformation
B. Hodgkin lymphoma
C. Hairy cell leukemia
D. Mantle cell lymphoma
,Correct Answer: A. Richter transformation
Rationale: Richter transformation is the progression of CLL to an
aggressive lymphoma, often diffuse large B-cell lymphoma,
presenting with rapid lymphadenopathy and systemic B
symptoms.
3. Which of the following is the most sensitive marker for
multiple myeloma?
A. Serum protein electrophoresis
B. Serum free light chain assay
C. Urine protein electrophoresis
D. Bone marrow biopsy
Correct Answer: B. Serum free light chain assay
Rationale: The serum free light chain assay can detect non-
secretory or light chain myeloma, making it the most sensitive
initial test, whereas SPEP may miss light-chain-only disease.
4. A 55-year-old woman with metastatic breast cancer
develops thrombocytopenia, microangiopathic hemolytic
anemia, and renal dysfunction. What is the likely cause?
A. DIC
B. TTP
C. ITP
D. Chemotherapy-induced cytopenia
,Correct Answer: B. TTP
Rationale: TTP presents with thrombocytopenia,
microangiopathic hemolytic anemia, renal dysfunction,
neurologic changes, and fever (pentad). DIC often has
prolonged coagulation times, and ITP rarely causes hemolysis or
renal dysfunction.
5. Which cytogenetic abnormality in acute myeloid leukemia
(AML) confers the best prognosis?
A. t(8;21)
B. t(15;17)
C. inv(16)
D. Complex karyotype
Correct Answer: B. t(15;17)
Rationale: t(15;17) is associated with acute promyelocytic
leukemia (APL), which responds well to ATRA and arsenic
therapy, giving a favorable prognosis.
6. A patient with Hodgkin lymphoma has mediastinal
lymphadenopathy and Reed-Sternberg cells on biopsy. What
subtype is most common?
A. Nodular sclerosis
B. Mixed cellularity
C. Lymphocyte-depleted
D. Lymphocyte-rich
, Correct Answer: A. Nodular sclerosis
Rationale: Nodular sclerosis is the most common subtype of
Hodgkin lymphoma, typically affecting young adults with
mediastinal involvement.
7. A 70-year-old man presents with easy bruising. Labs show
prolonged PT and aPTT, low factor VIII, and normal platelets.
Which is the most likely diagnosis?
A. Hemophilia A
B. Hemophilia B
C. Vitamin K deficiency
D. ITP
Correct Answer: A. Hemophilia A
Rationale: Hemophilia A (factor VIII deficiency) prolongs aPTT
but not PT, with normal platelets. Hemophilia B affects factor
IX, vitamin K deficiency affects multiple factors (prolonged PT
and aPTT), and ITP affects platelets.
8. Which of the following is the first-line therapy for high-risk
essential thrombocythemia?
A. Aspirin alone
B. Hydroxyurea
C. Interferon-alpha
D. Anagrelide
