Introduction: Disorders of blood MCQs With Answer provide B. Pharm students a focused, clinically relevant review of hematology concepts including anemia types, leukemias, coagulation disorders, platelet dysfunction, transfusion reactions, and laboratory markers. This set emphasizes pathophysiology, diagnostic tests (MCV, MCHC, reticulocyte count, PT/aPTT, D-dimer, ferritin), and pharmacotherapy (iron therapy, folate/B12, anticoagulants, hydroxyurea, colony-stimulating factors, chelators, targeted agents). Designed to deepen understanding of erythrocyte and platelet biology, hemostasis, and drug mechanisms, these MCQs link basic science to therapeutic decisions—helpful for exams and clinical pharmacy practice. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which laboratory parameter best indicates the average red blood cell size?
- Mean corpuscular volume (MCV)
- Mean corpuscular hemoglobin concentration (MCHC)
- Red cell distribution width (RDW)
- Reticulocyte count
Correct Answer: Mean corpuscular volume (MCV)
Q2. A right shift of the oxygen-hemoglobin dissociation curve is promoted by which factor?
- Decreased 2,3-BPG
- Increased 2,3-BPG
- Decreased temperature
- Alkalosis
Correct Answer: Increased 2,3-BPG
Q3. The most reliable laboratory indicator of depleted iron stores is:
- High serum ferritin
- Low serum ferritin
- High transferrin saturation
- Increased hemoglobin A2
Correct Answer: Low serum ferritin
Q4. Vitamin B12 deficiency typically produces which hematologic picture?
- Microcytic hypochromic anemia
- Normocytic normochromic anemia
- Macrocytic megaloblastic anemia
- Sideroblastic anemia
Correct Answer: Macrocytic megaloblastic anemia
Q5. Which laboratory findings are characteristic of hemolytic anemia?
- Decreased lactate dehydrogenase (LDH)
- Increased haptoglobin
- Increased indirect bilirubin
- Low reticulocyte count
Correct Answer: Increased indirect bilirubin
Q6. The molecular defect responsible for sickle cell disease is a substitution of which amino acid in beta-globin?
- Valine to glutamic acid
- Glutamic acid to valine
- Glycine to alanine
- Proline to serine
Correct Answer: Glutamic acid to valine
Q7. Hydroxyurea benefits patients with sickle cell disease primarily by:
- Reducing leukocyte counts only
- Acting as an iron chelator
- Increasing fetal hemoglobin (HbF) production
- Directly inhibiting hemoglobin polymerization
Correct Answer: Increasing fetal hemoglobin (HbF) production
Q8. Beta-thalassemia major hemoglobin electrophoresis typically shows:
- Predominant HbA with low HbF
- Increased HbF and increased HbA2
- Only HbS present
- Elevated HbA2 only
Correct Answer: Increased HbF and increased HbA2
Q9. The activated partial thromboplastin time (aPTT) assesses which coagulation pathway?
- Extrinsic pathway
- Intrinsic pathway
- Common pathway only
- Platelet function
Correct Answer: Intrinsic pathway
Q10. Warfarin exerts its anticoagulant effect by inhibiting:
- Antithrombin III
- Vitamin K epoxide reductase (VKORC1)
- Factor Xa directly
- Platelet aggregation
Correct Answer: Vitamin K epoxide reductase (VKORC1)
Q11. Unfractionated heparin anticoagulant activity primarily involves activation of:
- Protein C
- Antithrombin III
- Plasminogen
- Factor XIII
Correct Answer: Antithrombin III
Q12. Rivaroxaban is an oral anticoagulant that directly inhibits which target?
- Thrombin (Factor IIa)
- Factor Xa
- Vitamin K epoxide reductase
- Platelet P2Y12 receptor
Correct Answer: Factor Xa
Q13. The laboratory test used to monitor warfarin therapy is:
- Activated partial thromboplastin time (aPTT)
- Thrombin time (TT)
- Prothrombin time / International Normalized Ratio (PT/INR)
- D-dimer
Correct Answer: Prothrombin time / International Normalized Ratio (PT/INR)
Q14. Disseminated intravascular coagulation (DIC) typically shows which laboratory pattern?
- Low D-dimer and high fibrinogen
- High fibrinogen and normal platelets
- Elevated D-dimer and low fibrinogen
- Isolated prolonged aPTT only
Correct Answer: Elevated D-dimer and low fibrinogen
Q15. Immune thrombocytopenic purpura (ITP) is caused by autoantibodies directed against:
- Factor VIII
- Platelet glycoproteins (e.g., GPIIb/IIIa)
- Fibrinogen
- Red cell membrane proteins
Correct Answer: Platelet glycoproteins (e.g., GPIIb/IIIa)
Q16. The primary site of erythropoietin production in adults is the:
- Bone marrow stromal cells
- Liver hepatocytes
- Renal peritubular interstitial cells
- Spleen macrophages
Correct Answer: Renal peritubular interstitial cells
Q17. Filgrastim is a pharmaceutical form of which growth factor used to treat chemotherapy-induced neutropenia?
- GM-CSF (granulocyte-macrophage colony-stimulating factor)
- Erythropoietin
- G-CSF (granulocyte colony-stimulating factor)
- Thrombopoietin
Correct Answer: G-CSF (granulocyte colony-stimulating factor)
Q18. Aplastic anemia is characterized by which bone marrow finding?
- Hypercellular marrow with megakaryocytic hyperplasia
- Hypocellular marrow with fatty replacement
- Marrow packed with blasts
- Excess iron-laden macrophages
Correct Answer: Hypocellular marrow with fatty replacement
Q19. Acute intravascular hemolysis after an ABO-incompatible transfusion is primarily mediated by:
- IgG causing extravascular hemolysis
- T-cell mediated cytotoxicity
- IgM-mediated complement activation
- Platelet antibody binding
Correct Answer: IgM-mediated complement activation
Q20. Which chemotherapeutic or immunosuppressive drug commonly causes megaloblastic anemia by inhibiting dihydrofolate reductase?
- Hydroxyurea
- Methotrexate
- Cisplatin
- Cyclophosphamide
Correct Answer: Methotrexate
Q21. Which iron chelator is administered orally for chronic transfusional iron overload in thalassemia?
- Deferoxamine (parenteral)
- Deferasirox (oral)
- Deferiprone (intravenous only)
- EDTA (oral)
Correct Answer: Deferasirox (oral)
Q22. Glucose-6-phosphate dehydrogenase (G6PD) deficiency hemolysis can be triggered by which drug?
- Penicillin
- Primaquine
- Metformin
- Atorvastatin
Correct Answer: Primaquine
Q23. Which parameter typically rises as a compensatory response in hemolytic anemia?
- Serum ferritin
- Mean corpuscular volume (MCV)
- Reticulocyte count
- Platelet count
Correct Answer: Reticulocyte count
Q24. Prothrombin time (PT) primarily evaluates which coagulation pathway?
- Intrinsic pathway
- Extrinsic pathway
- Fibrinolytic pathway
- Platelet adhesion pathway
Correct Answer: Extrinsic pathway
Q25. Which antimicrobial agent is well-known to cause bone marrow suppression and aplastic anemia in rare cases?
- Chloramphenicol
- Amoxicillin
- Ciprofloxacin
- Metronidazole
Correct Answer: Chloramphenicol
Q26. Pernicious anemia results from autoimmune destruction of gastric parietal cells leading to deficiency of:
- Intrinsic factor and impaired B12 absorption
- Gastrin and decreased iron absorption
- HCl only with normal B12 absorption
- Pepsinogen causing folate deficiency
Correct Answer: Intrinsic factor and impaired B12 absorption
Q27. Thrombopoietin, a key regulator of platelet production, is primarily produced in the:
- Kidney
- Liver
- Spleen
- Bone marrow
Correct Answer: Liver
Q28. Paroxysmal nocturnal hemoglobinuria (PNH) involves a defect in which cell-surface proteins that protect against complement?
- CD3 and CD4
- CD19 and CD20
- CD55 and CD59
- CD8 and CD56
Correct Answer: CD55 and CD59
Q29. The direct antiglobulin (Coombs) test is used to detect:
- Circulating free hemoglobin
- Autoantibodies or complement bound to patient red cells
- Serum iron levels
- Platelet function defects
Correct Answer: Autoantibodies or complement bound to patient red cells
Q30. Imatinib, a targeted therapy used in chronic myeloid leukemia (CML), inhibits which abnormal kinase?
- JAK2
- BCR-ABL tyrosine kinase
- SRC kinase only
- FLT3 receptor
Correct Answer: BCR-ABL tyrosine kinase
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