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2026 Statistics
Key Facts: Cert Clin Haematology(SA) Phys Exam
2 components
Written + oral/OSCE
CMSA Examination Regulations
50% each
Subminimum per component
CMSA Exam Guidelines
R24 650
Exam Fee
CMSA 2026 Fee Structure
50% overall
Pass Mark
CMSA Examination Regulations
CMSA
Exam Body
College of Physicians of SA
The Cert Clin Haematology(SA) Phys is a rigorous two-component sub-specialty exit examination (written short-answer papers plus an oral/OSCE/clinical component, each 50%) for physician hematologists in South Africa covering malignant, non-malignant, hemostatic, transplant, and transfusion haematology.
Sample Cert Clin Haematology(SA) Phys Practice Questions
Try these sample questions to test your Cert Clin Haematology(SA) Phys exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1According to the 2022 European LeukemiaNet (ELN) genetic risk classification for Acute Myeloid Leukemia (AML), in which risk category is a patient with mutated NPM1 without FLT3-ITD (or with low FLT3-ITD allelic ratio) classified?
A.Adverse risk
B.Intermediate risk
C.Very high risk
D.Favorable risk
Explanation: In the 2022 ELN risk stratification, AML with mutated NPM1 without FLT3-ITD is classified as Favorable risk in the absence of adverse cytogenetic abnormalities. These patients achieve high rates of complete remission with standard induction chemotherapy.
2A 34-year-old female presents with severe fatigue, petechiae, and bleeding gums. Peripheral blood shows prominent promyelocytes with abundant Auer rods (Faggot cells). Coagulation testing reveals DIC with prolonged PT/aPTT and hypofibrinogenemia. What is the immediate target therapy combined with all-trans retinoic acid (ATRA)?
A.High-dose Cytarabine (HiDAC)
B.Rituximab
C.Arsenic trioxide (ATO)
D.Imatinib mesylate
Explanation: First-line treatment for low-to-intermediate risk Acute Promyelocytic Leukemia (APL) is the chemotherapy-free doublet of ATRA and Arsenic Trioxide (ATO). This combination induces differentiation and degradation of the PML-RARA fusion protein, achieving cure rates exceeding 90-95%.
3In patients with Chronic Myeloid Leukemia (CML) receiving frontline Tyrosine Kinase Inhibitor (TKI) therapy, what BCR-ABL1 transcript level on the International Scale (IS) defines an Early Molecular Response (EMR) at 3 months?
A.BCR-ABL1 (IS) ≤ 10%
B.BCR-ABL1 (IS) ≤ 0.01% (MR4.0)
C.BCR-ABL1 (IS) ≤ 0.1% (MR3.0)
D.BCR-ABL1 (IS) ≤ 1%
Explanation: Early Molecular Response (EMR) at 3 months post-TKI initiation is defined as BCR-ABL1 transcript level ≤ 10% on the International Scale (IS). Achieving EMR at 3 months strongly correlates with superior progression-free and overall survival.
4Which characteristic immunophenotypic profile on flow cytometry is diagnostic for Chronic Lymphocytic Leukemia (CLL)?
A.CD11c+, CD25+, CD103+, CD123+, annexin A1+
B.CD5+, CD23-, CD19+, strong surface immunoglobulin, FMC7+
C.CD5+, CD23+, CD19+, weak surface immunoglobulin, CD200+
D.CD10+, CD19+, CD20+, BCL2+, CD5-
Explanation: Classic CLL immunophenotype shows co-expression of CD5 and CD23 on B cells (CD19+, CD20 dim, CD22 dim), with weak surface immunoglobulin expression and strong CD200 positivity, yielding a high Matutes score (4 or 5).
5According to the updated International Myeloma Working Group (IMWG) criteria, which of the following represents a validated Myeloma-Defining Event (SLiM criteria) in an asymptomatic patient without classic CRAB organ damage?
A.Serum monoclonal protein level ≥ 15 g/L
B.Presence of a single bone lesion on plain X-ray
C.Involved to uninvolved serum free light chain ratio ≥ 20
D.Bone marrow plasma cell percentage ≥ 60%
Explanation: The SLiM criteria define active Multiple Myeloma in the absence of CRAB end-organ damage: S = Sixty percent (≥60%) bone marrow plasma cells; Li = Light chain ratio (involved/uninvolved serum FLC ratio ≥ 100); M = MRI (>1 focal bone lesion ≥5mm).
6A 58-year-old male is evaluated for persistent ruddy cyanosis, aquagenic pruritus, and splenomegaly. Full blood count shows Hb 18.8 g/dL, Hct 56%, platelets 520 x 10^9/L, and WCC 13.5 x 10^9/L. Serum erythropoietin (EPO) is subnormal. Which genetic mutation is detected in >95% of patients with Polycythemia Vera (PV)?
A.MPL W515L mutation in exon 10
B.CALR exon 9 frameshift insertion/deletion
C.BCR-ABL1 reciprocal translocation t(9;22)
D.JAK2 V617F mutation in exon 14
Explanation: Over 95% of Polycythemia Vera patients harbor the somatic JAK2 V617F mutation in exon 14 (with the remaining ~3-4% harboring JAK2 exon 12 mutations). JAK2 activation causes constitutive erythropoietin-independent erythropoiesis.
7In a 65-year-old patient diagnosed with Essential Thrombocythemia (ET) carrying a JAK2 V617F mutation, what is the primary risk factor indicating high-risk status requiring cytoreductive therapy?
A.Presence of microvascular symptoms like erythromelalgia
B.Platelet count > 600 x 10^9/L
C.Leukocyte count > 10 x 10^9/L
D.Age > 60 years or history of thrombosis
Explanation: High-risk Essential Thrombocythemia (ET) in standard risk stratification models (such as IPSET-Thrombosis) is defined primarily by Age > 60 years OR a prior history of venous or arterial thrombosis, mandating cytoreductive therapy (e.g., hydroxyurea).
8What hallmark reciprocal chromosomal translocation is present in over 85% of Follicular Lymphoma cases, leading to overexpression of the anti-apoptotic protein BCL2?
A.t(3;14)(q27;q32)
B.t(14;18)(q32;q21)
C.t(8;14)(q24;q32)
D.t(11;14)(q13;q32)
Explanation: Follicular Lymphoma is characterized by t(14;18)(q32;q21), which places the BCL2 proto-oncogene under the control of the immunoglobulin heavy chain (IGH) enhancer region on chromosome 14, resulting in BCL2 protein overexpression and inhibition of apoptosis.
9A 62-year-old male undergoes lymph node biopsy revealing a mantle zone proliferation of small-to-medium cleaved lymphoid cells. Immunohistochemistry shows nuclear Cyclin D1 positivity and SOX11 positivity. Which chromosomal translocation confirms Mantle Cell Lymphoma?
A.t(11;14)(q13;q32)
B.t(15;17)(q22;q21)
C.t(2;5)(p23;q35)
D.t(9;22)(q34;q11)
Explanation: Mantle Cell Lymphoma (MCL) is universally driven by the t(11;14)(q13;q32) translocation, juxtaposing CCND1 (cyclin D1) to the IGH locus, causing cyclin D1 nuclear overexpression and deregulated G1/S cell cycle transition.
10In Classical Hodgkin Lymphoma (cHL), what is the typical immunophenotypic marker profile of the diagnostic Reed-Sternberg cells?
A.CD3+, CD4+, CD25+, HTLV-1+, CD30-
B.CD30+, CD15+, PAX5 weak+, CD20-, CD45-
C.CD138+, CD56+, CD19-, CD45-, CD30-
D.CD20+, CD45+, EMA+, CD30-, CD15-
Explanation: Diagnostic Reed-Sternberg cells in Classical Hodgkin Lymphoma (cHL) are derived from B cells but lose B-cell lineage markers. They characteristically express CD30 (100%) and CD15 (75-85%), with dim nuclear PAX5, while negative for CD45 and usually negative or weakly variable for CD20.
About the Cert Clin Haematology(SA) Phys Practice Questions
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