p) NAMIBIA UNIVERSITY OF SCIENCE AND TECHNOLOGY

Faculty of Health and Applied Sciences

Department of Health Sciences

QUALIFICATION: BACHELOR OF MEDICAL LABORATORY SCIENCES &

BACHELOR OF BIOMEDICAL SCIENCES

QUALIFICATION CODE: O8BMLS & 50BBMS LEVEL: 7

COURSE CODE: HAM711S & COURSE: HAEMATOLOGY 3

HAM310S

DATE: JUNE 2018 SESSION:

DURATION: 3 HOURS MARKS: 115

FIRST OPPORTUNITY EXAMINATION

EXAMINER(S) | Dr Martin Gonzo MODERATOR: | Dr Aaron Maramba

INSTRUCTIONS

1. Answer all questions.

2. Please write neatly and legibly.

3. Donot use the left side margin of the exam paper. This must be allowed for the

examiner.

4. No books, notes and other additional aids are allowed.

5. _ Mark all answers clearly with their respective question numbers.

Permissible material

Non programmable calculator is allowed.

THIS QUESTION PAPER CONSISTS OF 6 PAGES (Including this front page)

SECTION A [15]

MULTIPLE CHOICE QUESTIONS

QUESTION 1 [15]

Answer ALL questions. Each correct answer is worth ONE mark.

1.1. A patient has a congenital non-spherocytic haemolytic anaemia. After exposure to anti-malarial

drugs the patient experiences a severe haemolytic episode. This episode is characterized by red

cell inclusions caused by haemoglobin denaturation. Which of the following conditions is MOST

consistent with these findings? (1)

a) Vitamin B12 deficiency

b) G6PD deficiency

c) Thalassemia major

d) Pyruvate kinase deficiency

e) Paroxysmal nocturnal haemoglobinuria

1.2. The following results were obtained on an electronic particle counter:

WBC: ++++

RBC: 2.01 x 106/uL (2.01 x 10412/L)

Hgb: 7.7 g/dL (77 g/L

Hct: 28.2

MCV: 141 um3 (141 fL

MCH: 38.5 pg

MCHC: 23.3%

What step should be taken before reporting the results? (1)

a) Clean the apertures

b) Warm the specimen

c) Dilute the specimen

d) Replace the lysing agent

e) Top up the basolyse reagent

1.3. The most common cause of error when using automated cell counters is: (1) a) Contamination of the diluent

b) Inadequate mixing of the sample prior to testing

c) Variation in voltage of the current supply

d) Acalibrating error

e) Contamination of the lysing reagent

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1.4. The presence of excessive rouleaux formation on a blood smear is often accompanied by an

increased: (1)

a) Nucleated red cells

b) Reticulocyte count

c) Erythrocyte count

d) ESR e) HCT

1.5. Which of the following technical factors will cause a decreased erythrocyte sedimentation

rate (1)

a) Gross haemolysis

b) Small fibrin clots in the sample

c) Increased room temperature

d) Tilting of the tube

e) Exposing the tube to sunlight

1.6. With this blood picture below, an additional test indicated is: (1)

a) Alkali desaturation

b) Alkaline phosphate stain

c) HAMSs test

d) Protein electrophoresis

e) Hgb electrophoresis

1.7. The acceptable range for haemoglobin values on a control sample is 13 with + 0.4 or —0.4. A

haemoglobin determination is performed five times in succession on the same control sample.

The results are: 12; 12.3; 12; 12.2; 12.1.

These results are: (1) a) Both accurate and precise

b) Precise but not accurate

c) Accurate but not precise

d) Neither accurate nor precise

e) Drifting

1.8. In malaria, the form of plasmodia that is transmitted from mosquito to human is the (1)

a) Sporozoite

b) Gametocyte

c) Merozoite

d) Hypnozoite

e) Schizoint

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1.9. Each of the following statements concerning Malaria is correct except (1)

a) The female anopheles mosquito is the vector

b) Early infection, sporozoites enter hepatocytes

c) Release of merozoites from red blood cells cause fever and chills

d) The principal site of gametocyte formation is the human gastrointestinal tract

e) The male anopheles mosquito is not a vector

1.10. A patient with malaria will complain of (1)

a) Headache

b) Fever and headache

c) Chills and fever

d) Chills and fever and joint pain and headache

e) Malaise

1.11. After development of malaria in the liver, the liver cells burst, and release a great number of

new parasites, called ............ into the blood stream. (1)

a) Merozoites

b) Gametocyte

c) Ring forms

d) Hypnozoite

e) Schizoints

1.12. A 27-year-old female is seen in the ante-natal clinic with a main complaint of overwhelming

tiredness and fatigue. Routine blood tests indicate the following results:

RBC 3.3.x 1072/L

Hgb 6.08 g/dL

Het 21.9%

MCV 66.1 fL

MCHC 29.6 g/dl

RDW 23%

This patient’s anaemia would be classified morphologically as: (1)

a) Macrocytic, normochromic

b) Microcytic, hypochromic

c) Normocytic, normochromic

d) Microcytic, normochromic

e) Haemolytic

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1.13. Evidence of active red cell production may be indicative on a blood smear by: (1)

a) Nucleated RBCs and polychromasia

b) Hypochromia, macrocytes and nucleated RBCs

c) Nucleated RBCs, polychromasia and Hypochromia

d) Cabot rings, Howell-jolly bodies and basophilic stippling

e) Target cells

1.14. What laboratory test is used to monitor oral anticoagulant therapy? (1)

a) Activated partial thromboplastin time

b) D-Dimer test

c) Prothrombin time

d) Bleeding time

e) Factor VIII assay

1.15. Which option would cause a dimorphic red cell curve with TTT RDW? (1)

a) Aplastic anaemia

b) Thalassaemia trait

c) Transfused iron deficiency

d) Pernicious anaemia

e) Cold haemagglutinin disease

SECTION B[25]

QUESTION 2 [25]

2.1. EDTA is the most commonly used anticoagulant in evacuated tubes. Explain the action of EDTA

which prevents blood from clotting (2)

2.2. What do you understand by Pseudo-thrombocytopenia? (3)

2.3. Describe the pathophysiology of the sickle cell anaemia? (15)

2.4. Describe a target cell and give three diseases where target cells are most likely found. (5)

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SECTION C [75]

QUESTION 3 (75)

3.1.

3.2.

3.3.

What do you understand by the term Neonatal anaemia? In your answer discuss the

causes of anaemia in the neonate. (25)

Critically appraise the management of haematological malignancies under the following

subheadings:

a. Blood product support

b. Psychological support

c. Pain management

d. Chemotherapy and treatment of infection (25)

The main function of platelets is the formation of mechanical plugs during haemostatic

response. Describe the major platelet functions. (25)

THE END

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