HAM621S - HAEMATOLOGY 2B - 2ND OPP - JANUARY 2025


HAM621S - HAEMATOLOGY 2B - 2ND OPP - JANUARY 2025



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'f
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: HAM621S
COURSE NAME: HAEMATOLOGY 28
SESSION:
JANUARY 2025
PAPER:
THEORY
DURATION:
3 HOURS
MARKS:
100
EXAMINER(S)
MODERATOR:
SECOND OPPORTUNITY/SUPPLEMENTARY EXAMINATION PAPER
Ms EDWIG SHINGENGE
Ms BELINDA ROSELINE TSAUSES
INSTRUCTIONS
1. Answer ALL the questions.
2. Write clearly and neatly.
3. Number the answers clearly.
4. Non-programmable calculator allowed
THIS QUESTION PAPER CONSISTS OF 6 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 What is the sequence for the maturation pools of granulocyte production?
(1)
A) Maturation, proliferation, storage, functional (or marginated) pool
B) Proliferation, maturation, storage, functional (or marginated) pool
C) Storage, maturation, proliferation, functional (or marginated) pool
D) Functional (or marginated) pool, storage, proliferation, maturation
1.2 Which granulocytic cell has a kidney-shaped nucleus with clumped chromatin and small, (l)
pink, secondary granules with a few primary dark granules?
A) Band
B) Myelocyte
C) Promyelocyte
D) Metamyelocyte
1.3 Primary granules also known as azurophilic granules contain:
(1)
A) Myeloperoxidase
B) Lactoferrin
C) Iron
D) Collagenase
1.4 A neutrophil precursor with 10-18um in diameter, with round or oval nucleus, no nucleoli, (l)
prominent primary granules and a few secondary granules bests describes:
A) Blast
B) Band cells
C) Myelocyte
D) Metamyelocyte
1.5 Which cytokine is responsible for the maintenance of the haemopoietic stem cell tissue? (l)
A) G-CSF
B) SCF
C) IL-1
D) IL-2
1.6 . Marrow stem cells are capable of which of the following?
(1)
A) Differentiating into any cellular line
B) Producing antibodies
C) Stimulating the hemostasis system
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D) Initiating the complement system
1.7 Which cellular components are represented by the M:E ratio?
(1)
A) Myeloid:Eosinophils
B) Myeloid:Erythroid
C) Megakaryocytes:Erythroid
D) Monoblasts:Eosinophils
1.8 Identify the number of blasts in bone marrow necessary to diagnose acute myeloid (1)
leukaemia according to WHO criteria.
A) 30%
B) 10%
C) 15%
D) 20%
1.9 What is the most frequent cause of a heterophile (Monospot) negative mononucleosis-like (1)
syndrome?
A) HIV
B) CMV
C) Hepatitis C
D) Toxoplasma gondii
1.10 Identify the following cell
(1)
A) Monocyte
B) Myelocyte
C) Band Cell
D) Metamyelocyte
3

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QUESTION 2
[22]
2.1 Briefly discuss three ways in which qualitative neutrophilic disorders can affect the function (6)
of the neutrophils.
2.2 Identify the benign conditions of the white cells represented by the following morphologies: (5)
(Print in colour)
Morphology
Disorder
2.3 Neutrophils react to bacterial infections not only by increasing in numbers but change of
morphology as well. Identify the morphological changes found in a reactive neutrophil.
(3)
2.4 Discuss any four characteristics of a macrophage.
(4)
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2.5 Outline the haematological findings in HIV patients.
(4)
~ECTION B: SHC>Rt & LONG QUESTIONS
[22]
QUESTION 3
3.1 Malignant transformation occurs because of the accumulation of genetic mutations in
(B)
cellular genes. With examples, discuss how mutated proto-oncogenes and tumour suppressor
genes result in the development of cancer.
3.2 Briefly describe what epigenetics is and give three examples.
(5 )
3.3 Discuss the most common full blood count results ih leukaemia. (1/2 mark per answer)
(5 )
3.4 What are the benefits of using cytogenetics and molecular testing in the diagnosis of
(4 )
haematological malignancies.
QUESTION 4
[21]
4.1 Although blast lineage identification requires flow cytometry, there are some
morphological differences between a lymphoblast and myeloblast. Tabulate these
(6)
differences. (1/2 mark per answer)
4.2 Classify the six major categories of Acute Myeloid Leukaemia as classified by WHO.
(6)
4.3 Discuss the role of tyrosine kinase in the development of myeloproliferative disorders and
how this is mitigated during treatment.
(6)
4.4 Patients with promyelocytic leukaemia often present with disseminated intravascular
coagulation. Briefly explain the underlying cause of Disseminated lntravascular
(3)
Coagulation in these patients.
5

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QUESTION 5
Here we have a 26-year-old woman that is complaining of headaches and dizziness, she also
noticed that her menstrual bleeding has become heavy. Her laboratory results were as follows:
RBe: 3.2x10 12, wee 17x10 9, Platelets 823x109, HB 9.9g/dl. Below are her bone marrow and
peripheral blood smear morphologies. (Print in colour).
Peripheral Blood Smear
Bone Marrow Smear
5.1 Analyse and discuss the laboratory results.
(6)
5.2 What is the most likely diagnosis and underlying cause? Explain your answer.
(4)
5.3 Suggest further tests and expected results to confirm the diagnosis.
(3)
QUESTION 6
[12]
6.1 Myelodysplastic syndromes are characterised by dysplastic changes in morphology and
function of myeloid cells. Outline the myelodysplastic morphological changes that occur in (12)
the red cell lineage (dyserythropoeisis), granulocytes (dysgranulopoiesis) and platelet
lineage (dysmegakaryopoiesis) in both the bone marrow and peripheral blood.
(at least 2 points per category)
THE END [100 MARKS TOTAL]
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