MLA SB A Qu estion B an k
Hyposplenism & Splenectomy
50 single best answer questions — Domain 6: Conditions, Body system: Blood and Lymph
Based on the GMC Medical Licensing Assessment (MLA) content map — applicable from September 2026
,BLOOD AND LY MPH Question 1 of 50
Hyposplenism / Splenectomy Hyposplenism
A 35-year-old woman with longstanding coeliac disease is found to have Howell-Jolly bodies on a routine blood film, despite never having
undergone splenectomy. What is the most likely underlying mechanism for this finding?
A B12 deficiency alone
B Functional hyposplenism secondary to her coeliac disease
C A normal finding unrelated to splenic function
D Chronic infection
E Iron deficiency anaemia
Select the single best answer.
,BLOOD AND LY MPH Question 1 of 50 — Answer
Hyposplenism / Splenectomy Hyposplenism
A 35-year-old woman with longstanding coeliac disease is found to have Howell-Jolly bodies on a routine blood film, despite never having undergone splenectomy. What is
the most likely underlying mechanism for this finding?
A B12 deficiency alone
B Functional hyposplenism secondary to her coeliac disease ✓ Correct
C A normal finding unrelated to splenic function
D Chronic infection
E Iron deficiency anaemia
EXPLANATION
Coeliac disease is a recognised cause of functional hyposplenism, in which the spleen atrophies and loses normal function, leading to Howell-Jolly bodies on blood film
despite the spleen still being anatomically present.
, BLOOD AND LY MPH Question 2 of 50
Hyposplenism / Splenectomy Hyposplenism
A 6-year-old boy with sickle cell disease is found to have a small, non-functioning spleen on ultrasound, despite never having had it
surgically removed. What is the most likely underlying cause of this hyposplenism?
A Vitamin B12 deficiency
B Iron deficiency
C Repeated splenic infarction from vaso-occlusion, leading to progressive splenic atrophy
D Viral hepatitis
E Normal childhood splenic involution
Select the single best answer.
Hyposplenism & Splenectomy
50 single best answer questions — Domain 6: Conditions, Body system: Blood and Lymph
Based on the GMC Medical Licensing Assessment (MLA) content map — applicable from September 2026
,BLOOD AND LY MPH Question 1 of 50
Hyposplenism / Splenectomy Hyposplenism
A 35-year-old woman with longstanding coeliac disease is found to have Howell-Jolly bodies on a routine blood film, despite never having
undergone splenectomy. What is the most likely underlying mechanism for this finding?
A B12 deficiency alone
B Functional hyposplenism secondary to her coeliac disease
C A normal finding unrelated to splenic function
D Chronic infection
E Iron deficiency anaemia
Select the single best answer.
,BLOOD AND LY MPH Question 1 of 50 — Answer
Hyposplenism / Splenectomy Hyposplenism
A 35-year-old woman with longstanding coeliac disease is found to have Howell-Jolly bodies on a routine blood film, despite never having undergone splenectomy. What is
the most likely underlying mechanism for this finding?
A B12 deficiency alone
B Functional hyposplenism secondary to her coeliac disease ✓ Correct
C A normal finding unrelated to splenic function
D Chronic infection
E Iron deficiency anaemia
EXPLANATION
Coeliac disease is a recognised cause of functional hyposplenism, in which the spleen atrophies and loses normal function, leading to Howell-Jolly bodies on blood film
despite the spleen still being anatomically present.
, BLOOD AND LY MPH Question 2 of 50
Hyposplenism / Splenectomy Hyposplenism
A 6-year-old boy with sickle cell disease is found to have a small, non-functioning spleen on ultrasound, despite never having had it
surgically removed. What is the most likely underlying cause of this hyposplenism?
A Vitamin B12 deficiency
B Iron deficiency
C Repeated splenic infarction from vaso-occlusion, leading to progressive splenic atrophy
D Viral hepatitis
E Normal childhood splenic involution
Select the single best answer.
