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IMH612S-IMMUNOHAEMATOLOGY - JAN 2020 |
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NAMIBIA UNIVERSITY
OF SCIENCE AND TECHNOLOGY
FACULTY OF HEALTH AND APPLIED SCIENCES
DEPARTMENT OF HEALTH SCIENCES
QUALIFICATION : BACHELOR OF MEDICAL LABORATORY SCIENCES
QUALIFICATION CODE: O8BMLS
LEVEL: 6
COURSE CODE: IMH612S
COURSE NAME: IMMUNOHAEMATOLOGY
SESSION: JANUARY 2020
DURATION: 3 HOURS
PAPER: THEORY
MARKS:100
SUPPLEMENTARY/SECOND OPPORTUNITY EXAMINATION PAPER
EXAMINER(S)
EDWIG HAUWANGA
MODERATOR:
MR MAURICE NYAMBUYA
INSTRUCTIONS
1. Answer ALL the questions.
2. Write clearly and neatly.
3. Number the answers clearly.
THIS QUESTION PAPER CONSISTS OF 6 PAGES (including this front page)
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Immunohaematology IMH621S
Second Opportunity
SECTION A (31 MARKS)
[15]
QUESTION 1
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 Blood group antigens on the red cells occur as the following molecules except:
(1)
(A) Lipid
(B) Proteins
(C) Glycoproteins
(D) Glycolipids
1.2 The process of identifying red cell antigens by agglutinating them with anti-sera is known as.. (1)
(A) Antibody screening
(B) Antibody identification
(C) Phenotyping
(D) ABO Typing
1.3 Which of the following best describes the expression of blood group inheritance?
(A) Dominant
(B) Recessive
(C) Codominant
(D) Recessive
1.4 Identify the immunodominant sugar for the H antigen.
(1)
(A) D galactose
(B) L-fructose
(C) L-Fructosyltransferase
(D) N-acetylgalactoseamine
1.5 The enzyme D-galactosamine tansfers a sugar for which antigen:
(1)
(A) A antigen
(B) B antigen
(C) O antigen
(D) H antigen
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Immunohaematology IMH621S
Second Opportunity
1.6 ABO discrepancy characterized by a population of agglutinated cells and another of (1)
agglutinated cells is known as...
(A) Weak subtypes
(B) Mixed Field
(C) Weak subtypes
(D) Immunocompromised
patient
1.7 Using the following ABO typing results, what conclusion can be drawn from these results?
(1)
Forward Typing
Anti-A
4+
Anti-B
4+
Reverse Typing
Aicells
1+
B cells
0
(A) Expected results for O
(B) Expected results for AB
(C) Discrepant results, of weak A
(D) Discrepant results of B
1.8 A father who is Rir and a mother that is R2r can produce the following off springs except:
(1)
(A) DcE/DcE
(B) DcE/ce
(C) DCe/Dce
(D) ce/ce
1.9 D antigens are weakened when inherited in trans with a............ ?
(A) d
(B) e
(C)D
(D) c
1.10 A 23-year-old female patient tested A negative. She has never had children and her
(1)
transfusion history is unknown. Which unites would you issue considering a low blood
bank stock?
(A) A negative
(B) A positive
(C) O positive
(D) O negative
1.11 Identify most frequent Kell phenotype?
(A) K+k-
(B) K+k+
(C) K-k+
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Immunohaematology IMH621S
Second Opportunity
(D) Kp (a+b-)
1.12 The duffy phenotype Fy (a-b-) is resistant to which malaria parasite?
(1)
(A) P. Falcipurum
(B) P.Vivax
(C) P.Ovale
(D) P.Malariae
1.13 Identify the antigens that are destroyed by enzymes
(A) Le
(B)E
(C) Fy?
(D)s
1.14 Identify the anticoagulant used in samples for DAT
(A) Citrate
(B) EDTA
(C) Gel separator
(D) No anticoagulant, use a dry tube
1.15 The following are all uses of DAT except.
(A) Identification of antibodies
(B) Investigations of haemolytic anaemias
(C) Investigations of Haemolytic Disease of the New-born
(D) Investigations of transfusion reactions
QUESTION 2
[12]
2.1 For the following Blood Group systems, suggest main antigens, antibody class and clinical (12)
significance.
Blood Groups
Kell
Kidd
Lutheran
MNS
Main Antigen
Ab Class
Clinical significance
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Immunohaematology IMH621S
Second Opportunity
QUESTION 3
[4]
3.1 The | blood group system is made up of | antigens found on adult cells and i antigens found
on infant cells. Briefly describe the transition ofi antigens to | antigens from infants to adults.
SECTION B (30 MARKS)
QUESTION 4
[20]
4.1 Briefly describe the following antibody antigen reactions:
4.1.1 Hemagglutination
(2)
4.1.2 Sensitization
(2)
4.1.3 Haemolysis
(2)
4.1.4 Neutralization (agglutination inhibition)
(2)
4.1.5 Precipitation
(2)
4.2 Identify FIVE reasons for temporary deferral and FIVE reasons for permanent deferral in
(10)
donors.
QUESTION 5
[10]
5.1 For each of the following scenarios, suggest the most suitable blood product and the reason
for choice of product.
5.1.1 An anaemic patient with IgA deficiency syndrome.
(2)
5.1.2 A Haemophilic A patient.
(2)
5.1.3 A leukaemia patient on chemotherapy with normal red cell and white cell count and low
(2)
platelets.
5.1.4. A severely burned man that survived a recent fire.
(2)
5.1.5 Motor vehicle accident known patient with a low platelet count currently being treated
(2)
for Idiopathic thrombotic purpura.
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Immunohaematology IMH621S
Second Opportunity
SECTION C (39 MARKS)
QUESTION 6
[20]
6.1 Describe the pathogenesis of the Haemolytic disease of the foetus and New-born.
(10)
6.2 A Rh-negative mother gives birth to a baby with haemolytic disease of the new-born. You
are required carry out the acid elution test to suggest a dose of Rhig for the mother. Explain (10)
how this will be carried out.
QUESTION 7
[19]
7.0 A young man who is O negative came in with a gunshot wound and bleeding profusely. His
antibody screens tested positive at IAT and the following antibody panel was set up.
Antibody Identification Panel 2 (Ficin-Treated)*:
RH
MNS
LU
DIC/E;cle;|ft IMI NYS
+{/+]}/0),0]+]/0
+{+]O0]0]+]0
8+ 14] +
84+] 414
+/O]}4+]4+)/0)/0F0] 4+] +
+/0/O0];+]4+]+4+8+]+4+ 40
O)+]/O];+]+]+ 9+]+]0
O1O};+]+] +] 494+} 4] 4
7 O;/O0;/O0O;+#]}+]+ 9+ ]+ 10
8 0/0
+] ¢]¢ be |e] +
9 O/0;0]/+]+]+ 9+ ]0]+
10 0/0
+] ¢] +
+10
11 +/+] O0]0]+]/0F+4+]4]4
AC
“Initial panel — ficin treated by manufacturer
Lu® | Lu?
+
+
+
+
+
+
+
+
+
+
+
Lewis
2) Le®
+
0
0
0
0
+
0
+
0
+
0
Kell
Duffy
kK
+ O| +
+ Pet | +
+ + 1+
+70]0
+ — +10
+ FO]
+90 | +
+ + |0
+ FO] +
+ + og
oe
ee
Kidd
Ficin
Jl | ake Cc} IAT
+] + § 2+ | &
Pt] + + | 4+
490 +90
70] +440
G+ |] O 9 2+
Fe ft
O} +
+| 0
Fa] +
0+
es
7.1 Identify the antibody.
(2)
7.2 Explain the steps you took to identify the antibody.
(8)
7.3 The blood bank stock is currently running low, especially on O negative units? Explain how
(3)
you would go about issuing compatible units for this patient.
7.4 Explain the principle of DAT and identify at least two of its uses.
(6)
End of paper!