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HAM621S - HAEMATOLOGY 2B - 1ST OPP - NOVEMBER 2024 |
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J)
nAmlBIA UnlVERSITY
OF SCIEnCE Ano TECHnOLOGY
FACULTY OF HEALTH, APPLIED SCIENCES AND NATURAL RESOURCES
DEPARTMENT OF CLINICAL HEALTH SCIENCES
QUALIFICATION : BACHELOR OF MEDICAL LABORATORY SCIENCES
QUALIFICATION CODE: 08BMLS
LEVEL: 6
COURSE CODE: HAM6215
COURSE NAME: HAEMATOLOGY 28
SESSION:
NOVEMBER 2024
PAPER:
THEORY
DURATION:
3 HOURS
MARKS:
100
EXAMINER(S)
MODERATOR:
FIRST OPPORTUNITY EXAMINATION PAPER
Ms EDWIG SHINGENGE
Ms BELINDA ROSELIN RTSAUSES
INSTRUCTIONS
1. Answer ALL the questions.
2. Write clearly and neatly.
3. Number the answers clearly.
4. Non-programmable calculators allowed.
THIS QUESTION PAPER CONSISTS OF 7 PAGES (Including this front page)
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QUESTION 1
[10]
Evaluate the statements in each numbered section and select the most appropriate answer or phrase from the
given possibilities. Write the appropriate letter next to the number of the statement/phrase.
1.1 A White Cell Count of 19.8 x 109/e is within the normal range for which individual listed below?
(1)
A) 5-year-old
B) 5-day old infant
C) 25-year-old male
D) 60-year-old female
/
1.2 Which of the following findings is NOT a characteristic feature of myelodysplastic syndromes?
(1)
A) Dimorphic macrocytes/normocytes
B) Hypo lobulated neutrophils
C) Dimorphic microcyte/normocyte picture
D) Giant platelets
1.3 Identify an example of epigenetics:
(1)
A) Histone modification
B) Translocation
C) Inversion
D) Deletion
1.4 Secondary granules start to appear at which stage of the neutrophil maturation?
(1)
A) Blast
B) Band Cell
C) Myelocyte
D) Metamyelocyte
1.5 Which chromosome abnormality occurs in AML with RUNXl-RUNXlTl?
(1)
A) t(8;21)
B) t(9;22)
C) t(15;17)
D) t(1;19)
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1.6 A 27-year-old woman presents with acute bleeding to the emergency department and is found to have a (1)
white count of 32.7 x 109L with pancytopenia: haematocrit 25%, platelet count 30 x 109 /L, and absolute
neutrophil count 0.8 x 109 /L. She has a combination of 93% blasts and abnormal promyelocytes in her peripheral
blood; some of these cells contain stacked Auer rods. What form of leukaemia does she most likely have?
A) Acute myeloid with t(lS;l 7)
B) Chronic myeloid leukemia
C) Acute monoblastic leukemia
D) Acute myeloid with t(8;21)
1.7 Forward light scatter is a result of:
(1)
A) Cellular size
B) Internal components
C) Dilution of sample
D) Intensity of laser light
1.8 Which of the following is used to restrict the data analysis to one population?
(1)
A) Compensation
B) Linear amplification
C) Gating
D) Logarithmic amplification
1.9 The French American British (FAB) classification of Acute Myeloblastic Leukaemia (AML) is based on?
(1)
A) Cytogenetic abnormalities
B) Morphology and cytochemistry of blasts
C) lmmunophenotyping of blasts
D) Molecular genetic abnormalities
1.10 Blood donors are normally bled to save lives of patients. However, there are some conditions that
(1)
required to be bled save their own lives. Which of the following condition will this form of treatment apply
to:
A) Myelofibrosis
B) Essential Thrombocythemia
C) Acute Myeloid Leukaemia
D) Polycythaemia Vera
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QUESTION 2
[14]
2.1 For each of the following Myelodysplastic Syndrome (MDS) categories, suggest criteria that warranties a (14)
definite diagnosis:
2.1.1 MDS with low blasts and isolated Sq deletion (MDS-Sq.
(2)
2.1.2 MDS with low blasts and SF3B1 mutation (MDS-SF3B1.
(2)
2.1.3 MDS with biallelic TP53 inactivation.
(2)
2.1.4 MDS with low blasts (MDS-LB).
(2)
2.1.5 MDS with low blasts and ring sideroblasts (MDS-LB-RS).
(2)
2.1.6 MDS, hypoplastic (MDS-h).
(2)
2.1.7 MOS with increased blasts.
(2)
QUESTION 3
[22]
Neutrophils are primary white blood cells involved in the body's function to fight pathogens. Answer the
following questions concerning these cells:
3.1 Use the following table to differentiate between primary and secondary granules (duplicate table onto
(10)
answer sheet).
3.1.1 Also Called:
3.1.2 Stage of
appearance
3.1.3 Colour
3.1.4 Two examples
of content
Primary Granules
Secondary Granules
3.2 By means of a sketch, predict the white cell histogram in the following conditions.
(5)
3.2.1 Normal conditions
3.2.2 Infection
3.2.3 Chronic Myeloid Leukaemia
3.2.4 Acute Myeloid Leukaemia
3.3 Briefly discuss Gaucher's disease which is a benign disorder of the monocyte?
(5)
3.4 By means of the absolute count, define eosinophilia.
(2)
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QUESTION 4
[19]
4.1 Outline the FAB classification for acute myeloid leukaemia.
(8)
4.2 The following questions are based on the subtypes you identified in question 4.1:
4.2.1 Which subtype is often associated with people living with down syndrome?
(1)
4.2.2 Which subtype will be negatived with Myeloperoxidase stain:
(1)
4.2.3 Which subtype has the tendency to infiltrate gums.
(1)
4.2.4 Which subtype will yield a positive Periodic Acid Schiff result.
(1)
4.2.5 Which subtype is often associated with Disseminated lntravascular Coagulation.
(1)
4.3 Briefly describe what is meant by bone marrow cellularity and demonstrate the percentages that define
(4)
hypo and hypercellularity.
4.4 Identify at least 2 tests performed on bone marrow samples for the diagnosis of leukaemia.
(2)
QUESTION 5
[ 35 MAR_KSJ_
[18]
5.1 What are the preliminary actions towards a patient sample with decreased platelet count.
(4 )
5.2 The following morphologies are all associated with falsely low platelet counts. Identify the morphologies
(6)
and suggest how they result in low platelet counts: (Print in colour)(Table on next page)
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Marks
A)
RBC Morphology
B)
Morphology & Causes
C)
5.3 The increase in red blood cells is termed as polycythaemia. Discuss the three forms of polycythaemia.
(6)
5.4 What is the importance of using Perl's Prussian Blue in Myelodysplastic Syndromes?
(2)
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QUESTION 6
[17)
The following are flow cytometry results from two patients.
6.1 Interpret the results for each patient.
(7)
6.2 Based on the immunophenotype results, predict the type of leukaemia that each patient could be suffering
from and explain your answer.
(4)
6.3 The CD34 marker is known as an aberrant marker, what does this mean?
(2)
6.4 What is the importance of the CD45 marker?
(2)
6.5 Briefly explain the principle of immunophenotyping.
(2)
THE END [100 MARKS TOTAL]
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