Vitamin Deficiency Anemia Hematology
Complete Study Guide & Exam Review
2026/2027 | Practice Questions and
Answers
Description: This comprehensive MCQ bank covers vitamin deficiency anemias —
focusing on Vitamin B12 (cobalamin) deficiency, folate deficiency, and related
megaloblastic anemias. It includes pathophysiology, clinical features, laboratory
diagnosis, treatment, and complications for hematology exam revision.
Key Words: Vitamin B12 deficiency, folate deficiency, megaloblastic anemia, cobalamin,
intrinsic factor, pernicious anemia, methylmalonic acid, homocysteine, Schilling test,
macrocytic anemia, hypersegmented neutrophils, neurologic symptoms,
cyanocobalamin, folic acid, hematology MCQs.
SECTION 1: BASIC CONCEPTS & PATHOPHYSIOLOGY (Q1–
Q40)
Q1. Which vitamin deficiency classically causes megaloblastic anemia?
A) Vitamin C
B) Vitamin B12 ✅
C) Vitamin K
D) Vitamin D
Q2. The term "megaloblastic anemia" refers to:
A) Small RBCs with normal DNA
B) Large nucleated RBCs with impaired DNA synthesis ✅
,C) Normal RBCs with low hemoglobin
D) Fragmented RBCs
Q3. Which of the following is essential for DNA synthesis?
A) Vitamin B12 and folate ✅
B) Vitamin C and iron
C) Vitamin K and calcium
D) Vitamin D and phosphate
Q4. Vitamin B12 is also known as:
A) Riboflavin
B) Cobalamin ✅
C) Thiamine
D) Pyridoxine
Q5. Folate deficiency primarily affects:
A) RNA synthesis
B) DNA synthesis ✅
C) Protein synthesis
D) Lipid synthesis
Q6. Which vitamin is a cofactor for methionine synthase?
A) Vitamin B12 ✅
B) Vitamin C
C) Vitamin B6
D) Vitamin E
Q7. Methylmalonic acid is elevated in deficiency of:
A) Folate
B) Vitamin B12 ✅
C) Iron
D) Vitamin C
,Q8. Homocysteine is elevated in deficiency of:
A) Vitamin B12 only
B) Folate only
C) Both Vitamin B12 and folate ✅
D) Iron only
Q9. Which test differentiates B12 from folate deficiency?
A) Serum iron
B) Methylmalonic acid level ✅
C) Reticulocyte count
D) ESR
Q10. Intrinsic factor is produced by:
A) Liver
B) Parietal cells of stomach ✅
C) Pancreas
D) Ileum
Q11. Vitamin B12 is absorbed in the:
A) Stomach
B) Duodenum
C) Terminal ileum ✅
D) Colon
Q12. Pernicious anemia is caused by:
A) Dietary B12 deficiency
B) Lack of intrinsic factor ✅
C) Folate deficiency
D) Iron deficiency
Q13. Which cells are characteristically seen in megaloblastic anemia?
A) Target cells
B) Hypersegmented neutrophils ✅
, C) Sickle cells
D) Schistocytes
Q14. Hypersegmentation of neutrophils means:
A) More than 3 lobes
B) More than 5 lobes ✅
C) Less than 3 lobes
D) Absent lobes
Q15. The MCV in megaloblastic anemia is:
A) Normal
B) Increased (>100 fL) ✅
C) Decreased
D) Variable
Q16. Which of the following is NOT a cause of B12 deficiency?
A) Vegan diet
B) Crohn's disease
C) Increased folate intake ✅
D) Fish tapeworm
Q17. Diphyllobothrium latum causes B12 deficiency by:
A) Blocking intrinsic factor
B) Consuming B12 ✅
C) Destroying ileum
D) Causing blood loss
Q18. Which surgery predisposes to B12 deficiency?
A) Appendectomy
B) Gastrectomy ✅
C) Cholecystectomy
D) Splenectomy
Complete Study Guide & Exam Review
2026/2027 | Practice Questions and
Answers
Description: This comprehensive MCQ bank covers vitamin deficiency anemias —
focusing on Vitamin B12 (cobalamin) deficiency, folate deficiency, and related
megaloblastic anemias. It includes pathophysiology, clinical features, laboratory
diagnosis, treatment, and complications for hematology exam revision.
Key Words: Vitamin B12 deficiency, folate deficiency, megaloblastic anemia, cobalamin,
intrinsic factor, pernicious anemia, methylmalonic acid, homocysteine, Schilling test,
macrocytic anemia, hypersegmented neutrophils, neurologic symptoms,
cyanocobalamin, folic acid, hematology MCQs.
SECTION 1: BASIC CONCEPTS & PATHOPHYSIOLOGY (Q1–
Q40)
Q1. Which vitamin deficiency classically causes megaloblastic anemia?
A) Vitamin C
B) Vitamin B12 ✅
C) Vitamin K
D) Vitamin D
Q2. The term "megaloblastic anemia" refers to:
A) Small RBCs with normal DNA
B) Large nucleated RBCs with impaired DNA synthesis ✅
,C) Normal RBCs with low hemoglobin
D) Fragmented RBCs
Q3. Which of the following is essential for DNA synthesis?
A) Vitamin B12 and folate ✅
B) Vitamin C and iron
C) Vitamin K and calcium
D) Vitamin D and phosphate
Q4. Vitamin B12 is also known as:
A) Riboflavin
B) Cobalamin ✅
C) Thiamine
D) Pyridoxine
Q5. Folate deficiency primarily affects:
A) RNA synthesis
B) DNA synthesis ✅
C) Protein synthesis
D) Lipid synthesis
Q6. Which vitamin is a cofactor for methionine synthase?
A) Vitamin B12 ✅
B) Vitamin C
C) Vitamin B6
D) Vitamin E
Q7. Methylmalonic acid is elevated in deficiency of:
A) Folate
B) Vitamin B12 ✅
C) Iron
D) Vitamin C
,Q8. Homocysteine is elevated in deficiency of:
A) Vitamin B12 only
B) Folate only
C) Both Vitamin B12 and folate ✅
D) Iron only
Q9. Which test differentiates B12 from folate deficiency?
A) Serum iron
B) Methylmalonic acid level ✅
C) Reticulocyte count
D) ESR
Q10. Intrinsic factor is produced by:
A) Liver
B) Parietal cells of stomach ✅
C) Pancreas
D) Ileum
Q11. Vitamin B12 is absorbed in the:
A) Stomach
B) Duodenum
C) Terminal ileum ✅
D) Colon
Q12. Pernicious anemia is caused by:
A) Dietary B12 deficiency
B) Lack of intrinsic factor ✅
C) Folate deficiency
D) Iron deficiency
Q13. Which cells are characteristically seen in megaloblastic anemia?
A) Target cells
B) Hypersegmented neutrophils ✅
, C) Sickle cells
D) Schistocytes
Q14. Hypersegmentation of neutrophils means:
A) More than 3 lobes
B) More than 5 lobes ✅
C) Less than 3 lobes
D) Absent lobes
Q15. The MCV in megaloblastic anemia is:
A) Normal
B) Increased (>100 fL) ✅
C) Decreased
D) Variable
Q16. Which of the following is NOT a cause of B12 deficiency?
A) Vegan diet
B) Crohn's disease
C) Increased folate intake ✅
D) Fish tapeworm
Q17. Diphyllobothrium latum causes B12 deficiency by:
A) Blocking intrinsic factor
B) Consuming B12 ✅
C) Destroying ileum
D) Causing blood loss
Q18. Which surgery predisposes to B12 deficiency?
A) Appendectomy
B) Gastrectomy ✅
C) Cholecystectomy
D) Splenectomy
