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MRCPI Part 1 → Haematology

Haematology for MRCPI Part 1

Haematology accounts for roughly 6% of the MRCPI Part 1 blueprint. This bank has 1 item tagged to it.

How much of MRCPI Part 1 is haematology?

Around 6% of the paper, per RCPI examination regulations and training curricula. That weighting is why the DocPasser mock builder samples sections in proportion rather than shuffling everything into one pile — practising a flat distribution trains you for a paper that does not exist.

Verification status. All 3 published figures on this page have been read in the source document and dated above. Source of truth: RCPI examination regulations and training curricula, Royal College of Physicians of Ireland. How we verify.

Sample haematology questions

A 68-year-old man is found to have a lymphocyte count of 42 × 10⁹/L on a routine blood test. He is asymptomatic with no lymphadenopathy, no hepatosplenomegaly, haemoglobin 138 g/L and platelets 226 × 10⁹/L. Blood film shows mature small lymphocytes and smear cells. Flow cytometry confirms a CD5-positive, CD23-positive monoclonal B cell population. What is the most appropriate management?

  1. Observation with regular monitoring correct Correct. This is early-stage chronic lymphocytic leukaemia with no anaemia, no thrombocytopenia and no bulky disease. Treating early-stage CLL does not improve survival, so the standard of care is watchful waiting with periodic review.
  2. A course of oral corticosteroids to reduce the lymphocyte count Wrong. Steroids have a place in autoimmune complications of CLL such as haemolysis or immune thrombocytopenia, not in reducing an asymptomatic lymphocytosis.
  3. Splenectomy Wrong. He has no splenomegaly, and splenectomy is not a treatment for CLL itself.
  4. Immediate chemoimmunotherapy Wrong. Treatment is indicated by progressive marrow failure, bulky or symptomatic disease, rapid lymphocyte doubling, or constitutional symptoms, none of which he has.
  5. Urgent allogeneic stem cell transplantation Wrong. Reserved for high-risk, relapsed or refractory disease in selected fit patients.

The point: Early CLL is watched, not treated. Know the complications that do need action: autoimmune haemolytic anaemia, immune thrombocytopenia, hypogammaglobulinaemia with recurrent infection, and Richter transformation signalled by rapid nodal growth and B symptoms.

Source: BSH guideline on the diagnosis and management of chronic lymphocytic leukaemia British Society for Haematology · tier 2, specialty society or college

The other sections of MRCPI Part 1

Cardiology · Respiratory medicine · Gastroenterology and hepatology · Neurology · Endocrinology and metabolic medicine · Nephrology · Rheumatology · Infectious diseases and tropical medicine · Oncology and palliative care · Dermatology · Clinical pharmacology and therapeutics · Clinical sciences and statistics · Acute and critical care medicine

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