HEME PRACTICE EXAM QUESTIONS AND
VERIFIED ANSWERS
A 32-year-old woman presents to her primary care physician with complaints of
fatigue, weakness, and shortness of breath on exertion for the past few months.
She reports heavy menstrual periods. Physical examination reveals pallor of the
conjunctiva and nail beds. Laboratory studies show a haemoglobin level of 9.8
g/dL (normal range: 12-16 g/dL), a mean corpuscular volume (MCV) of 68 fL,
and a ferritin level of 10 ng/mL (normal range: 12-150 ng/mL). The rest of the
complete blood count and peripheral blood smear are unremarkable.
What is the most likely diagnosis for this patient's anaemia?
a. Vitamin B12 deficiency anemia
b. Folate deficiency anaemia
c. Iron deficiency anemia
d. Anemia of chronic disease
c. Iron deficiency anaemia
Which of the following findings on the peripheral blood smear is characteristic
of iron deficiency anaemia?
a. Macrocytosis
b. Microcytosis
c. Spherocytes
d. Schistocytes
b. Microcytosis
What is the first-line treatment for the patient's condition?
a. Oral ferrous sulfate
b. Intramuscular vitamin B12 injections
c. Folate supplementation
d. Blood transfusion
a. Oral ferrous sulfate
If the patient's anemia is due to chronic blood loss, what additional investigation
would be most helpful in identifying the source?
,a. Upper endoscopy
b. Colonoscopy
c. Bone marrow biopsy
d. Thyroid function tests
b. Colonoscopy
What is the main storage form of iron in the body?
a. Transferrin
b. Ferritin
c. Hemoglobin
d. Hemosiderin
b. Ferritin
A 45-year-old woman presents with fatigue and pallor. Laboratory studies
reveal a hemoglobin level of 10.5 g/dL (normal range: 12-16 g/dL), a mean
corpuscular volume (MCV) of 62 fL (normal range: 80-100 fL), and a serum
iron level of 30 mcg/dL (normal range: 50-150 mcg/dL). Which of the
following findings would be consistent with iron deficiency anemia?
a. High total iron-binding capacity (TIBC)
b. Low TIBC
c. Elevated serum ferritin
d. Normal serum transferrin saturation
a. High total iron-binding capacity (TIBC)
A patient diagnosed with iron deficiency anemia is advised to increase dietary
iron absorption. Which of the following dietary recommendations is appropriate
to enhance iron absorption?
a. Avoid vitamin C-rich foods
b. Consume dairy products with iron-rich meals
c. Drink tea or coffee with iron supplements
d. Include vitamin C-rich foods with iron-rich meals
d. Include vitamin C-rich foods with iron-rich meals
What is the most common cause of anemia worldwide?
a. Vitamin B12 deficiency anemia
b. Folate deficiency anemia
, c. Iron deficiency anemia
d. Hemolytic anemia
c. Iron deficiency anemia
A 16-year-old adolescent of Southeast Asian descent presents with jaundice,
splenomegaly, and bone deformities. Hemoglobin electrophoresis shows
elevated levels of hemoglobin F and A2. Which type of thalassemia is most
likely present?
a. Alpha-thalassemia
b. Beta-thalassemia major
c. Beta-thalassemia intermedia
d. Delta-beta-thalassemia
b. Beta-thalassemia major
A 40-year-old man with known beta-thalassemia trait (minor) presents for
routine follow-up. He is asymptomatic. What laboratory finding is most likely
to be observed in his complete blood count (CBC)?
a. Microcytic, hypochromic anemia
b. Macrocytic anemia
c. Normocytic, normochromic anemia
d. Hemolytic anemia
a. Microcytic, hypochromic anemia
A person with one deleted alpha-globin gene is most likely to be:
a. Diagnosed with thalassemia major
b. A silent carrier
c. Diagnosed with thalassemia minor
d. Manifesting symptoms of Hemoglobin H disease
b. A silent carrier
A patient with two deleted beta-globin genes is at risk for:
a. Silent carrier status
b. Thalassemia major (hydrops fetalis)
c. Thalassemia minor
d. Hemoglobin H disease
b. Thalassemia major (hydrops fetalis)
VERIFIED ANSWERS
A 32-year-old woman presents to her primary care physician with complaints of
fatigue, weakness, and shortness of breath on exertion for the past few months.
She reports heavy menstrual periods. Physical examination reveals pallor of the
conjunctiva and nail beds. Laboratory studies show a haemoglobin level of 9.8
g/dL (normal range: 12-16 g/dL), a mean corpuscular volume (MCV) of 68 fL,
and a ferritin level of 10 ng/mL (normal range: 12-150 ng/mL). The rest of the
complete blood count and peripheral blood smear are unremarkable.
What is the most likely diagnosis for this patient's anaemia?
a. Vitamin B12 deficiency anemia
b. Folate deficiency anaemia
c. Iron deficiency anemia
d. Anemia of chronic disease
c. Iron deficiency anaemia
Which of the following findings on the peripheral blood smear is characteristic
of iron deficiency anaemia?
a. Macrocytosis
b. Microcytosis
c. Spherocytes
d. Schistocytes
b. Microcytosis
What is the first-line treatment for the patient's condition?
a. Oral ferrous sulfate
b. Intramuscular vitamin B12 injections
c. Folate supplementation
d. Blood transfusion
a. Oral ferrous sulfate
If the patient's anemia is due to chronic blood loss, what additional investigation
would be most helpful in identifying the source?
,a. Upper endoscopy
b. Colonoscopy
c. Bone marrow biopsy
d. Thyroid function tests
b. Colonoscopy
What is the main storage form of iron in the body?
a. Transferrin
b. Ferritin
c. Hemoglobin
d. Hemosiderin
b. Ferritin
A 45-year-old woman presents with fatigue and pallor. Laboratory studies
reveal a hemoglobin level of 10.5 g/dL (normal range: 12-16 g/dL), a mean
corpuscular volume (MCV) of 62 fL (normal range: 80-100 fL), and a serum
iron level of 30 mcg/dL (normal range: 50-150 mcg/dL). Which of the
following findings would be consistent with iron deficiency anemia?
a. High total iron-binding capacity (TIBC)
b. Low TIBC
c. Elevated serum ferritin
d. Normal serum transferrin saturation
a. High total iron-binding capacity (TIBC)
A patient diagnosed with iron deficiency anemia is advised to increase dietary
iron absorption. Which of the following dietary recommendations is appropriate
to enhance iron absorption?
a. Avoid vitamin C-rich foods
b. Consume dairy products with iron-rich meals
c. Drink tea or coffee with iron supplements
d. Include vitamin C-rich foods with iron-rich meals
d. Include vitamin C-rich foods with iron-rich meals
What is the most common cause of anemia worldwide?
a. Vitamin B12 deficiency anemia
b. Folate deficiency anemia
, c. Iron deficiency anemia
d. Hemolytic anemia
c. Iron deficiency anemia
A 16-year-old adolescent of Southeast Asian descent presents with jaundice,
splenomegaly, and bone deformities. Hemoglobin electrophoresis shows
elevated levels of hemoglobin F and A2. Which type of thalassemia is most
likely present?
a. Alpha-thalassemia
b. Beta-thalassemia major
c. Beta-thalassemia intermedia
d. Delta-beta-thalassemia
b. Beta-thalassemia major
A 40-year-old man with known beta-thalassemia trait (minor) presents for
routine follow-up. He is asymptomatic. What laboratory finding is most likely
to be observed in his complete blood count (CBC)?
a. Microcytic, hypochromic anemia
b. Macrocytic anemia
c. Normocytic, normochromic anemia
d. Hemolytic anemia
a. Microcytic, hypochromic anemia
A person with one deleted alpha-globin gene is most likely to be:
a. Diagnosed with thalassemia major
b. A silent carrier
c. Diagnosed with thalassemia minor
d. Manifesting symptoms of Hemoglobin H disease
b. A silent carrier
A patient with two deleted beta-globin genes is at risk for:
a. Silent carrier status
b. Thalassemia major (hydrops fetalis)
c. Thalassemia minor
d. Hemoglobin H disease
b. Thalassemia major (hydrops fetalis)
