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MRCP Part 1 Hematology: 50 Rapid-Review Facts

TL;DR

This post on MRCP Part 1 Hematology: 50 Rapid-Review Facts summarises the most frequently tested concepts and traps from haematology in the MRCP Part 1 exam. You’ll get concise, clinically anchored pearls—perfect for quick revision before your mocks. Use this as a structured checklist to guide your final-phase preparation.


Why this matters

Hematology is a scoring subject in MRCP Part 1, but its diversity—from anaemia to leukaemia to coagulation—makes it overwhelming. Questions rarely test isolated recall; instead, they integrate mechanisms, investigations, and applied clinical reasoning.

A disciplined, fact-driven review can consolidate memory and eliminate common pitfalls (e.g. misreading ferritin levels or confusing coagulation patterns). This article from Crack Medicine distills 50 exam-relevant facts drawn from MRCP(UK) blueprints, Hoffbrand’s Essential Haematology, and recent trends seen in our app’s mock data.


50 Rapid-Review Facts for MRCP Part 1 Hematology


Anaemia and Red Cell Disorders

  1. Microcytic anaemia → Iron deficiency, thalassaemia, sideroblastic anaemia, chronic disease.

  2. Iron deficiency anaemia → Low ferritin, high TIBC, microcytosis.

  3. Anaemia of chronic disease → Raised ferritin, low iron, low TIBC.

  4. Thalassaemia trait → Low MCV with normal ferritin.

  5. Target cells → Seen in thalassaemia and post-splenectomy.

  6. Megaloblastic anaemia → B12/folate deficiency; hypersegmented neutrophils.

  7. B12 deficiency → Subacute combined degeneration; check anti-intrinsic factor antibodies.

  8. Haemolysis → Raised LDH, indirect bilirubin, reticulocytosis, low haptoglobin.

  9. Autoimmune haemolysis → Positive direct Coombs test.

  10. Cold agglutinin disease → Linked to Mycoplasma pneumoniae and EBV infection.

White Cell Disorders

  1. Leukemoid reaction → Neutrophilia with toxic granulation; high LAP score.

  2. CML → t(9;22) (Philadelphia chromosome, BCR-ABL fusion).

  3. Acute promyelocytic leukaemia (M3) → t(15;17); treat with all-trans retinoic acid (ATRA).

  4. CLL → Smudge cells on blood film; CD5+, CD23+ B-cells.

  5. Hairy cell leukaemia → TRAP-positive; massive splenomegaly.

  6. AML → Myeloperoxidase-positive blasts; Auer rods.

  7. ALL → TdT-positive blasts; CNS prophylaxis needed.

  8. Monoclonal B-cell lymphocytosis → CLL precursor.

  9. Myelodysplastic syndromes → Cytopenias + dysplastic marrow; risk of AML transformation.

  10. Neutropenic sepsis → Immediate IV piperacillin–tazobactam.

Platelet and Coagulation Disorders

  1. Prolonged PT + normal aPTT → Warfarin or vitamin K deficiency.

  2. Prolonged aPTT + normal PT → Heparin effect or haemophilia.

  3. Both prolonged → DIC or severe liver disease.

  4. von Willebrand disease → Prolonged bleeding time with normal platelet count.

  5. ITP → Isolated thrombocytopenia, autoimmune.

  6. TTP → Thrombocytopenia, MAHA, renal failure, fever, neurological symptoms.

  7. Heparin-induced thrombocytopenia → PF4 antibodies; thrombosis risk.

  8. D-dimer → Rule-out marker for DVT/PE when low.

  9. DIC management → Treat cause, FFP/cryoprecipitate if bleeding.

  10. Factor VIII deficiency → Haemophilia A.

Myeloma and Related Disorders

  1. Multiple myeloma → CRAB (Calcium↑, Renal failure, Anaemia, Bone lesions).

  2. Bence Jones protein → Light chains in urine.

  3. MGUS → <10% plasma cells, no CRAB features.

  4. Waldenström macroglobulinaemia → IgM paraprotein, hyperviscosity.

  5. Myelofibrosis → Tear-drop poikilocytes, dry tap, splenomegaly.

  6. Polycythaemia vera → JAK2 mutation, low EPO.

  7. Essential thrombocythaemia → Platelets >450 × 10⁹/L; JAK2/CALR/MPL mutation.

  8. Secondary erythrocytosis → Check for hypoxia or EPO-producing tumours.

  9. Amyloidosis → Congo red-positive deposits with apple-green birefringence.

  10. Plasma exchange → Used in hyperviscosity crises.

Transfusion and Miscellaneous

  1. Acute haemolytic reaction → ABO incompatibility; fever, flank pain.

  2. Febrile non-haemolytic reaction → Cytokine-mediated; prevent by leukoreduction.

  3. TRALI → Donor anti-HLA antibodies → acute pulmonary oedema.

  4. Irradiated blood → For immunocompromised and post-transplant recipients.

  5. Washed red cells → For IgA deficiency.

  6. Massive transfusion → Monitor calcium, platelets, and coagulation.

  7. O-negative → Universal emergency donor.

  8. Virchow’s triad → Stasis, endothelial injury, hypercoagulability.

  9. Antiphospholipid syndrome → Paradoxical thrombosis with prolonged aPTT.

  10. NOACs → Contraindicated in mechanical heart valves.


Quick Table — High-Yield Lab Patterns

Disorder

Typical Lab Findings

Diagnostic Test

Iron deficiency anaemia

↓Ferritin, ↑TIBC, microcytosis

Ferritin, iron studies

Anaemia of chronic disease

↑Ferritin, ↓Iron, ↓TIBC

ESR/CRP correlation

B12 deficiency

Macrocytosis, high LDH

Anti-IF antibodies

DIC

↑PT, ↑aPTT, ↑D-dimer, ↓Platelets

D-dimer, fibrinogen

CML

Leukocytosis, ↓LAP

BCR-ABL PCR

Doctor reviewing blood tests and haemoglobin results — anaemia patterns relevant to MRCP Part 1 Hematology

Practical Example

Question: A 60-year-old man with anaemia, back pain, and elevated calcium has rouleaux formation on blood film. What is the next diagnostic step?

Answer: Serum protein electrophoresis (SPEP) to detect monoclonal gammopathy (M-protein).

Explanation: The triad of bone pain, anaemia, and hypercalcaemia strongly suggests multiple myeloma. Confirm with SPEP, urine Bence Jones test, and bone marrow biopsy.


Common Pitfalls and Fixes

  1. Confusing CML with leukemoid reaction → use LAP score and cytogenetics.

  2. Forgetting cold agglutinin artefact → falsely raises MCV.

  3. Treating folate deficiency without ruling out B12 → may worsen neuropathy.

  4. Ignoring drug-induced cytopenias (e.g. linezolid, methotrexate).

  5. Misreading iron studies during inflammation — ferritin is an acute-phase reactant.

Study-Tip Checklist

Technique

Focus

Benefit

Spaced repetition

Revise 10–15 facts daily

Reinforces retention

Timed QBank practice

Use Free MRCP MCQs

Improves recall under pressure

Mock tests

Start a mock test weekly

Builds stamina and timing

Visual clustering

Group anaemias & coagulopathies

Easier pattern recognition

Active recall

Summarise 5 facts after each session

Promotes long-term memory


FAQs

1. Which haematology topics dominate MRCP Part 1?

Anaemias, coagulation disorders, leukaemias, and myeloma account for the majority of haematology questions.

2. How many haematology questions appear in MRCP Part 1?

Usually 25–30 questions per sitting (about 10–15% of Paper A + B combined).

3. Should I memorise genetic translocations?

Yes — t(9;22) (CML), t(15;17) (APL), and t(14;18) (follicular lymphoma) are high-yield.

4. How can I revise haematology efficiently?

Combine Crack Medicine’s QBank analytics with concise notes and spaced review cycles.

5. Where can I find official MRCP(UK) guidance?

Visit the Royal Colleges’ official blueprint at https://www.mrcpuk.org/mrcpuk-examinations/part-1-exam.


Ready to start?

Ace MRCP Part 1 with Crack Medicine. Explore the MRCP Part 1 overview, attempt 5,000+ curated Free MRCP MCQs, or Start a mock test to track your real-time analytics. Study once—remember forever.


Sources

  • MRCP(UK) Part 1 Examination Blueprint

  • NICE Guidelines on Anaemia Management

  • Hoffbrand AV, Essential Haematology, 8th edition (Wiley-Blackwell, 2019)

 
 
 

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