AMC MCQ AMC MCQ - Australian Medical Council Multiple Choice Questions Haematology and Oncology Questions and Answers 2 — Questions and Answers
Question 1: A 65-year-old presents with lymphocytosis (lymphocyte count 80 × 10⁹/L), smudge cells on peripheral blood film, and painless generalised lymphadenopathy. What is the most likely diagnosis?
- Acute lymphoblastic leukaemia
- Chronic lymphocytic leukaemia (Correct answer)
- Hairy cell leukaemia
- T-cell lymphoma
Correct answer: Chronic lymphocytic leukaemia
Chronic lymphocytic leukaemia (CLL) presents with marked lymphocytosis, smudge cells on blood film, and indolent lymphadenopathy in older adults.
Question 2: A 55-year-old patient develops disseminated intravascular coagulation (DIC). Laboratory findings include prolonged PT/APTT, low fibrinogen, elevated D-dimer, and thrombocytopenia. What is the primary treatment approach?
- Administer heparin to prevent further clotting
- Treat the underlying cause (Correct answer)
- Give fresh frozen plasma alone
- Administer platelet transfusion alone
Correct answer: Treat the underlying cause
The cornerstone of DIC management is treating the underlying trigger (e.g., sepsis, malignancy), as supportive blood products alone without addressing the cause will not resolve DIC.
Question 3: A breast cancer patient is found to have HER2 gene amplification. Which targeted therapy specifically targets this receptor?
- Bevacizumab
- Trastuzumab (Correct answer)
- Cetuximab
- Rituximab
Correct answer: Trastuzumab
Trastuzumab (Herceptin) is a monoclonal antibody targeting HER2 (ErbB2), used in HER2-positive breast and gastric cancers.
Question 4: A patient with sickle cell disease presents in vasoocclusive crisis with severe pain. Which medication reduces the frequency of crises by increasing foetal haemoglobin (HbF)?
- Deferoxamine
- Hydroxyurea (Correct answer)
- Erythropoietin
- Penicillin V
Correct answer: Hydroxyurea
Hydroxyurea increases production of foetal haemoglobin (HbF), which inhibits HbS polymerisation and reduces vasoocclusive crises in sickle cell disease.
Question 5: A 40-year-old with deep vein thrombosis is found to have Factor V Leiden mutation. What does this mutation cause?
- Reduced thrombin generation
- Resistance to activated protein C (APC resistance) (Correct answer)
- Deficiency of antithrombin III
- Overproduction of plasminogen
Correct answer: Resistance to activated protein C (APC resistance)
Factor V Leiden mutation results in a factor V that is resistant to cleavage by activated protein C, predisposing to venous thromboembolism.
Question 6: A 68-year-old presents with splenomegaly, elevated RBC count, haematocrit of 58%, and JAK2 V617F mutation. What is the diagnosis?
- Secondary polycythaemia
- Polycythaemia vera (Correct answer)
- Essential thrombocythaemia
- Myelofibrosis
Correct answer: Polycythaemia vera
Polycythaemia vera is a myeloproliferative neoplasm characterised by elevated RBC mass, splenomegaly, and JAK2 V617F mutation in >95% of cases.
AMC MCQ AMC MCQ - Australian Medical Council Multiple Choice Questions Haematology and Oncology Questions and Answers 2
A 65-year-old presents with lymphocytosis (lymphocyte count 80 × 10⁹/L), smudge cells on peripheral blood film, and painless generalised lymphadenopathy.
What is the most likely diagnosis?