AMC MCQ AMC MCQ - Australian Medical Council Multiple Choice Questions Haematology and Oncology Questions and Answers 1 — Questions and Answers
Question 1: A 70-year-old presents with fatigue, bone pain, hypercalcaemia, and serum protein electrophoresis showing an M-spike. Bone marrow biopsy shows 30% plasma cells. What is the diagnosis?
- Waldenström macroglobulinaemia
- Multiple myeloma (Correct answer)
- Monoclonal gammopathy of undetermined significance (MGUS)
- Chronic lymphocytic leukaemia
Correct answer: Multiple myeloma
Multiple myeloma is defined by >10% clonal plasma cells in bone marrow plus end-organ damage (hypercalcaemia, renal failure, anaemia, or bone lesions — CRAB criteria).
Question 2: A 25-year-old presents with painless cervical lymphadenopathy, fever, night sweats, and weight loss. Biopsy shows Reed-Sternberg cells. What is the most likely diagnosis?
- Non-Hodgkin lymphoma
- Hodgkin lymphoma (Correct answer)
- Infectious mononucleosis
- Sarcoidosis
Correct answer: Hodgkin lymphoma
Reed-Sternberg cells are pathognomonic of Hodgkin lymphoma, which typically presents with B symptoms and mediastinal or cervical lymphadenopathy.
Question 3: A patient with chronic myeloid leukaemia (CML) is found to have the Philadelphia chromosome t(9;22). Which molecular target does imatinib inhibit?
- BCL-2
- BCR-ABL tyrosine kinase (Correct answer)
- CD20
- VEGFR
Correct answer: BCR-ABL tyrosine kinase
Imatinib is a selective BCR-ABL tyrosine kinase inhibitor that blocks the constitutively active kinase produced by the Philadelphia chromosome translocation in CML.
Question 4: A 60-year-old patient on warfarin presents with an INR of 8.5 and minor bleeding. What is the most appropriate management?
- Continue warfarin and recheck INR in 48 hours
- Hold warfarin and administer oral vitamin K 1–2.5 mg (Correct answer)
- Administer fresh frozen plasma (FFP)
- Administer prothrombin complex concentrate (PCC)
Correct answer: Hold warfarin and administer oral vitamin K 1–2.5 mg
For elevated INR with minor bleeding, withholding warfarin and giving low-dose oral vitamin K (1–2.5 mg) is appropriate to reverse anticoagulation safely.
Question 5: A 45-year-old woman has a microcytic, hypochromic anaemia with serum ferritin of 5 µg/L and low serum iron. What is the most likely cause?
- Anaemia of chronic disease
- Iron deficiency anaemia (Correct answer)
- Thalassaemia trait
- Sideroblastic anaemia
Correct answer: Iron deficiency anaemia
Low ferritin combined with microcytic hypochromic anaemia and low serum iron is diagnostic of iron deficiency anaemia.
Question 6: Which coagulation factor is deficient in haemophilia A?
- Factor IX
- Factor VIII (Correct answer)
- Factor XI
- von Willebrand factor
Correct answer: Factor VIII
Haemophilia A is caused by deficiency of factor VIII, resulting in impaired intrinsic pathway coagulation.
AMC MCQ AMC MCQ - Australian Medical Council Multiple Choice Questions Haematology and Oncology Questions and Answers 1
A 70-year-old presents with fatigue, bone pain, hypercalcaemia, and serum protein electrophoresis showing an M-spike.
Bone marrow biopsy shows 30% plasma cells.
What is the diagnosis?