100+ Free Cert Clin Haematology(SA) Path Practice Questions

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2026 Statistics

Key Facts: Cert Clin Haematology(SA) Path Exam

2 components

Written + oral/OSCE

CMSA Regulations

50% each

Subminimum per component

CMSA Regulations

R24,650

Examination Fee

CMSA SS2026/FS2027 Fee Schedule

50% overall

Pass Mark

CMSA Regulations

College of Pathologists

CMSA College

CMSA South Africa

The Cert Clin Haematology(SA) Path is a two-component sub-specialty exit examination (written short-answer papers plus an oral/OSCE/clinical component, each 50%) evaluating advanced diagnostic haematopathology, molecular genetics, haemostasis, and blood banking for specialist pathologists in South Africa.

Sample Cert Clin Haematology(SA) Path Practice Questions

Try these sample questions to test your Cert Clin Haematology(SA) Path exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A peripheral blood film from an adult presenting with severe anemia and jaundice demonstrates numerous schistocytes, helmet cells, and polychromasia. What is the minimum percentage of schistocytes required on blood film examination to support a clinical diagnosis of Microangiopathic Hemolytic Anemia (MAHA)?

A.> 0.1%

B.> 1.0%

C.> 5.0%

D.> 10.0%

Explanation: According to ICSH (International Council for Standardization in Haematology) recommendations, a schistocyte threshold of > 1.0% on peripheral blood film examination is a robust diagnostic marker for Microangiopathic Hemolytic Anemia (MAHA), such as Thrombotic Thrombocytopenic Purpura (TTP) or Hemolytic Uremic Syndrome (HUS), in adults (normal healthy controls have < 0.2-0.5%).

2In a bone marrow aspirate stain evaluated for myelodysplastic neoplasm (MDS), ring sideroblasts are identified using Prussian blue (Perls') reaction. How are ring sideroblasts strictly defined morphologically?

A.Erythroblasts with coarse basophilic stippling visible on Romanowsky staining

B.Erythroblasts containing > 10 cytoplasmic ferritin aggregates scattered randomly

C.Erythroblasts with any visible perinuclear iron deposit regardless of count

D.Erythroblasts with 5 or more iron granules encircling at least one-third (120 degrees) of the nucleus

Explanation: Ring sideroblasts are defined by ICSH and WHO criteria as erythroid precursors containing 5 or more siderotic granules encircling at least one-third (120 degrees) of the nuclear circumference, reflecting mitochondrial iron accumulation in the heme synthesis pathway.

3Which cytochemical stain pattern is classic for acute promyelocytic leukemia (APL) with PML-RARA fusion?

A.Tartrate-resistant acid phosphatase (TRAP) strongly positive

B.Strongly, diffusely Myeloperoxidase (MPO) positive and Sudan Black B (SBB) positive

C.Nonspecific esterase (NSE) strongly positive and completely inhibited by sodium fluoride

D.Periodic acid-Schiff (PAS) positive in a block-like cytoplasmic pattern

Explanation: APL blasts (promyelocytes) contain intense azurophilic primary granules packed with myeloperoxidase, resulting in intense, diffuse MPO and Sudan Black B positivity. Auer rods are also intensely MPO-positive.

4On a bone marrow aspirate, giant metamyelocytes, hypersegmented neutrophils, and nuclear-cytoplasmic asynchronous erythroid precursors (Megaloblasts) are observed. Which nutritional deficiency is most strongly associated with these morphological findings?

A.Pyridoxine (Vitamin B6) deficiency

B.Vitamin B12 (Cobalamin) or Folate deficiency

C.Copper deficiency

D.Iron deficiency

Explanation: Deficiency of Vitamin B12 or Folate impairs DNA synthesis (thymidylate synthesis), leading to nuclear-cytoplasmic asynchrony (megaloblastic erythropoiesis, giant metamyelocytes, and hypersegmented neutrophils with >= 6 lobes).

5Flow cytometric analysis of a bone marrow aspirate demonstrates an abnormal blast population expressing CD34, HLA-DR, CD117, CD13, and CD33, but negative for CD3, CD19, CD20, and MPO. What lineage assignment is established by CD117 and CD13/CD33 expression?

A.Plasmacytoid dendritic cell lineage

B.Myeloid lineage

C.T-lymphoid lineage

D.B-lymphoid lineage

Explanation: CD117 (c-kit), along with CD13 and CD33, is a key myeloid progenitor marker confirming myeloid lineage commitment in acute myeloid leukemia (AML).

6Which inclusion in red blood cells consists of denatured, aggregated hemoglobin precipitates visible on supra-vital stains such as Brilliant Cresyl Blue or New Methylene Blue?

A.Pappenheimer bodies

B.Howell-Jolly bodies

C.Heinz bodies

D.Cabot rings

Explanation: Heinz bodies are denatured hemoglobin precipitates formed under oxidative stress (e.g., G6PD deficiency, unstable hemoglobins). They are invisible on routine Romanowsky stains but readily visualized using supravital stains.

7A peripheral blood film shows neutrophil granulocytes with bilobed nuclei connected by a thin chromatin filament ('dumbbell' or 'pince-nez' appearance) across > 80% of neutrophils. The patient has no hematological complaints. What is the most likely entity?

A.Chediak-Higashi syndrome

B.Pelger-Huët Anomaly (Hereditary)

C.Alder-Reilly anomaly

D.Pseudo-Pelger-Huët anomaly (Acquired MDS)

Explanation: Hereditary Pelger-Huët anomaly is an autosomal dominant condition caused by LBR gene mutations resulting in bilobed, hypocondensed neutrophil nuclei across almost all neutrophils without dysplastic cytopenias.

8In Paroxysmal Nocturnal Hemoglobinuria (PNH) diagnostic flow cytometry, which combination of GPI-anchored proteins on neutrophils/monocytes is standardly analyzed alongside FLAER?

A.CD41 and CD61

B.CD3 and CD4

C.CD19 and CD20

D.CD24 and CD66b (granulocytes) / CD14 and CD64 (monocytes)

Explanation: High-sensitivity PNH flow cytometry utilizes FLAER (fluorescent aerolysin which binds directly to the GPI anchor) in combination with GPI-anchored antibodies such as CD24/CD66b for granulocytes and CD14/CD64 for monocytes.

9Which bone marrow aspirate cytochemical stain is uniquely positive in Hairy Cell Leukemia (HCL) and resistant to inhibition by tartaric acid?

A.Myeloperoxidase (MPO)

B.Periodic Acid-Schiff (PAS)

C.Acid Phosphatase (TRAP)

D.Leukocyte Alkaline Phosphatase (LAP)

Explanation: Hairy cells express abundant isoenzyme 5 of acid phosphatase, which retains enzymatic activity in the presence of L-(+)-tartaric acid, yielding a strongly positive TRAP stain.

10An automated blood analyzer flags an elevated mean corpuscular hemoglobin concentration (MCHC > 360 g/L). Examination of the blood film reveals dense, spherical red cells lacking central pallor. What is the diagnosis?

A.Iron Deficiency Anemia

B.Beta Thalassemia Trait

C.Hereditary Elliptocytosis

D.Hereditary Spherocytosis

Explanation: Hereditary Spherocytosis is characterized by membrane loss (spectrin/ankyrin/band 3 defect), producing dense microspherocytes with reduced surface-area-to-volume ratio and high MCHC (> 360 g/L).

About the Cert Clin Haematology(SA) Path Exam

The Sub-specialty Certificate in Clinical Haematology [Cert Clin Haematology(SA) Path] is a higher specialist credential conferred by the College of Pathologists of the Colleges of Medicine of South Africa (CMSA). Designed for clinical haematopathologists, the examination evaluates expert competence across diagnostic blood and marrow cytomorphology, flow cytometry, molecular and cytogenetic analysis, complex coagulation disorders, specialized transfusion medicine, and contemporary WHO/ICC classifications of haematological neoplasms.

Assessment

Two components each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Content spans: Laboratory Diagnostics & Cytomorphology of Blood/Marrow (30%), Molecular & Cytogenetic Diagnostics in Haematology (20%), Coagulation Diagnostics & Transfusion Laboratory Medicine (25%), and Hematological Malignancies Pathogenesis & Classification (25%).

Time Limit

Written short-answer papers plus an OSCE and viva component.

Passing Score

Overall pass mark 50% with a 50% subminimum in each of the two components (written and oral/OSCE/OSPE/clinical).

Exam Fee

R24,650 (CMSA SS2026/FS2027 fee schedule) (College of Pathologists (Colleges of Medicine of South Africa))

Cert Clin Haematology(SA) Path Exam Content Outline

30%

Laboratory Diagnostics & Cytomorphology of Blood/Marrow

Peripheral blood and bone marrow aspirate/trephine biopsy morphology, flow cytometry immunophenotyping, cytochemical stains, automated haematology analyzer interpretation, and red cell/platelet disorders.

20%

Molecular & Cytogenetic Diagnostics in Haematology

Karyotyping, FISH, RT-PCR, next-generation sequencing (NGS) panels, fusion genes (BCR-ABL1, PML-RARA, RUNX1-RUNX1T1, CBFB-MYH11), clonal gene rearrangements, and minimal residual disease (MRD) quantification.

25%

Coagulation Diagnostics & Transfusion Laboratory Medicine

Haemostatic pathway testing, thrombophilia screens, inhibitor assays, anti-phospholipid antibodies, blood group serology, crossmatching, blood component therapy, transfusion reactions, and patient blood management.

25%

Hematological Malignancies Pathogenesis & Classification

WHO 5th Edition and ICC classification of myeloid and lymphoid neoplasms, acute leukemias, myelodysplastic syndromes (MDS), myeloproliferative neoplasms (MPN), mature B- and T-cell lymphomas, plasma cell dyscrasias, and targeted therapy biomarkers.

How to Pass the Cert Clin Haematology(SA) Path Exam

What You Need to Know

Passing score: Overall pass mark 50% with a 50% subminimum in each of the two components (written and oral/OSCE/OSPE/clinical).
Assessment: Two components each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Content spans: Laboratory Diagnostics & Cytomorphology of Blood/Marrow (30%), Molecular & Cytogenetic Diagnostics in Haematology (20%), Coagulation Diagnostics & Transfusion Laboratory Medicine (25%), and Hematological Malignancies Pathogenesis & Classification (25%).
Time limit: Written short-answer papers plus an OSCE and viva component.
Exam fee: R24,650 (CMSA SS2026/FS2027 fee schedule)

Keys to Passing

Work through all 100 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

Cert Clin Haematology(SA) Path Study Tips from Top Performers

1Review bone marrow biopsy immunophenotypic profiles (CD markers for acute leukemia lineages, lymphoproliferative disorders, and plasma cell neoplasms).

2Understand diagnostic molecular testing: FISH probes for translocation breakpoints (t(15;17), t(8;21), inv(16), t(9;22), KMT2A rearrangements) and NGS gene panels (NPM1, FLT3-ITD, TP53, ASXL1, RUNX1).

3Master coagulation workups for lupus anticoagulant, factor VIII/IX inhibitors, heparin-induced thrombocytopenia (HIT), thrombotic microangiopathies (TTP/aHUS), and TEG/ROTEM interpretation.

4Familiarize yourself with SANBS blood banking standards, massive transfusion protocols (MTP), TRALI/TACO differentiation, and red cell alloantibody identification panels.

Frequently Asked Questions

What is the examination format for Cert Clin Haematology(SA) Path?

The exit examination has two components, each contributing 50%: a written component (short-answer written papers) and an oral/OSCE/OSPE/clinical component. Candidates must achieve an overall 50% with a 50% subminimum in each component. This free question bank provides 100 practice MCQs as a study aid and does not replicate the official format.

What primary qualification is required before sitting this sub-specialty examination?

Candidates must hold an FC Path(SA) Haematology or equivalent specialist qualification recognized by the HPCSA, alongside completed sub-specialty registrar training.

How are the examination questions weighted?

Questions are divided into 30% Laboratory Diagnostics & Cytomorphology, 20% Molecular & Cytogenetic Diagnostics, 25% Coagulation Diagnostics & Transfusion Laboratory Medicine, and 25% Hematological Malignancies Pathogenesis & Classification.

What classification schemes are tested in the exam?

The examination tests current diagnostic paradigms, including the WHO 5th Edition and International Consensus Classification (ICC) 2022 for myeloid and lymphoid malignancies.