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IMH621S - IMMUNOHAEMATOLOGY - 2ND OPP - JAN 2023 |
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nAmlBIA un1VERSITY
OFSCl.EnCEAnD..TECHnOLOGY
FACULTYOF HEALTH, APPLIED SCIENCESAND NATURAL RESOURCES
DEPARTMENT OF HEALTHSCIENCES
QUALIFICATION: MEDICAL LABORATORY SCIENCES
QUALIFICATION CODE: 08BMLS
COURSE CODE: IMH621S
LEVEL: 6
COURSE NAME: IMMUNOHAEMATOLOGY
SESSION:
JANUARY 2023
PAPER:
THEORY
DURATION:
3 HOURS
MARKS:
100
EXAMINER(S)
SUPPLEMENTARY/SECOND OPPORTUNITY PAPER
Ms EDWIG HAUWANGA
MODERATOR:
Dr MAURICE NYAMBUYA
INSTRUCTIONS
1. Answer ALL the questions.
2. Write clearly and neatly.
3. Number the answers clearly.
THIS QUESTION PAPER CONSISTS OF 5 PAGES (Including this front page)
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lmmunohaematology IMH621S
Second Opportunity
SECTION A (47 MARKS)
[5]
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 Select the term that describes the unique configuration of the antigen that allows recognition (l)
by a corresponding antibody:
(A) lmmunogen
(B) Epitope
(C) Avidity
(D) clone
(1)
1.2 In haemagglutination test, the antigen is?
(A) Secreted by the red cell
(B) In the red cell nucleus
(C) On the red cell membrane
(D) In plasma or serum
1.3 Which of the following best describes the expression of blood group inheritance?
(1)
(A) X-linked Codominant
(B) X-linked Recessive
(C) Autosomal-Codominant
(D) Autosomal Recessive
1.4 What is the immunodominant sugar for the H antigen?
(1)
(A) D galactose
(B) L-fructose
(C) L-Fructosyltransferase
(D) N-acetylgalactoseamine
1.5 Which of the following antibodies can cause Haemolytic disease of the foetus and new-born: (l)
(A) lgA
(B) lgD
(C) lgG
(D) lgM
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lmmunohaematology IMH621S
Second Opportunity
QUESTION 2
[30]
2.1 Define the following terms:
2.1.1 Blood Group System
(2)
2.1.2 lmmunodominant Sugar
(2)
2.1.3 Dosage Effect
(2)
2.1.4 Lectin
(2)
2.1.5 Plasmapheresis
(2)
2.2 Outline the characteristics of ABO antibodies.
(5)
2.3 Bombay blood groups are usually referred to as not having any ABO antigens. Explain this (5)
phenomenon and how it occurs.
2.4 Explain the Fisher-Racetheory of Rh inheritance.
(5)
2.5 Denote the following Weiner notations into Fisher race.
(5)
a) DCE
b) DcE
c) Dee
d) Ce
e) CE
QUESTION 3
3.1 Scrutinize the frequency table for MNS group below and answer the questions that follow:
[12]
S-s-U-
0
Less than 1
3.1.1 What is the most frequent MNS antigen in the black population?
3.1.2 What is the most common frequent antigen in the white population?
(1)
(1)
2
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lmmunohaematology IMH621S
Second Opportunity
3.1.3 Which phenotype is prevalent overall?
3.1.4 List the antibodies that the 5-s-U- is likely to produce?
3.1.5 State whether those antibodies are lgG or lgM.
(1)
(2.5)
(2.5)
3.2 One of the Duffy phenotypes can resist invasion of Malaria parasite. Name the phenotype (4)
and explain this phenomenon.
SECTION B (28 MARKS)
QUESTION 4
4.1 Identify and explain the 2 methods used to produce commercial anti-sera
[14]
(6)
4.2 For each of the following tests, identify the techniques used:
(4)
a) ABO/Rh
b) Direct crossmatch
c) Transfusion transmissible infections testing
4.3 Explain the Direct Antiglobulin Test and its applications in blood transfusion.
(4)
QUESTION 5
5.1 At times patients are advised to get large amounts of blood drawn not for a purpose of
donation but more to treat certain disorders, what is this process called and in which
disorders is it indicated?
5.2 What is meant by hemovigilance, why is it important and how does appropriate
documentation and record keeping positively contribute to this exercise?
5.3 List at least 6 elements of the quality management system.
[14]
(3)
(5)
(6)
3
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lmmunohaematology IMH6215
Second Opportunity
SECTION C (25 MARKS)
QUESTION 6
[8]
6.1 Haemolytic disease of the foetus and new-born (HDFN) can arise from both ABO, Rh and
other antibodies. Using the following headings outline the differences between ABO and Rh
(4)
HDFN:
ABO
Rh
Severity
Bilirubin levels
DAT result
Treatment
6.2 While performing the Kleihauer-Bekte test, you count 20 foetal cells and 980 maternal cells, (4)
calculate the volume of foetal maternal haemorrhage. Show your workings:
QUESTION 7
Below are results of an antibody panel.
,'°' :lii'ii'.rtt.".r ,, ''M1M5;t:· :fJ; ,,, + littR;11,;'I'•, ,1, \\~·Kell~•· ;~'
,;..
,t,.
-~"ijcid•l":ih',-;;w;, ~.-! ~-· 1~1\\1~.t,i,~·:-;.(.)..,,.r.t'~'tf 9 11'It
F'r' Donor Cell Number D ,c ·e C e cw K, I;. Kp~ Kp" Js"' J," H,
Jk" Jkb Le" le~ M N S- l ~i LU0 lu 0 IS AHG cc
I
2
,,, ',,
3
,
•
,
,',
5
6 ,·",. ,·
0 .-+ Q 0 1t 0
0 + 0 + + i>
() 0 i:: } .. 0 0
0 ..,,1-"0 0 0
'
'+· 0 0
0 +· 0
0 1~0
·+·O iJ
.t 0
114. 0
'o· +, 110 +•
+ 0 -+ ,, 0 ,;,,
~- -~' q
'
:"t_;, 9
0 +0
0++
1"' 0 0
tl 0 .11-i-'
-~ '1' + 0 0
+0
.. 0 , + + {O,_+ 0
-~ ;+ '
00
0
0, 0 +o 0 1,~, ',I,.,. 0
14
+
.'+
"
'T,
0 0 0 + + 0 0 + 0 + 0 + + + + o· 0 + + 0 + 0 + 0 +
i, 0 0 ',·r• ;- ,O' o, +
,;
o· !~ t o· & 0
,.. + ·o 0,
+
b
.f
.,_,.
0 ., +
0
t· .,
0
2+
3+ -~IP-
0 2+
0 f+
3+ NP
0 ., 2+
[17]
7.1 Show your workings on the panel provided (see last page) to identify the possible
(10)
antibody(ies)
(2)
7.2 What are the possible antibodies?
(5)
7.3 What techniques can be used to resolve multiple antibodies?
End of paper!
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Detach and used to answer guestion 7
Student no:.........................................
Rh-Hr
Kell
Duffy
Kidd
Lewis
MNSs
p Lutheran Patient Results
D C E C e Cw K k Kpa Kpb Jsa Jsb Fya Fy Jka JKb Lea Leb M N s s Pl Lua Lub IS AHG Co
b
1 0 +0 0 + 0 + 0 0 + 0 + + 0 0 + 0 + + 0 0 + + 0 +
0 2+
2 + +0 + + 0 0 + 0 + 0 + 0 + 0 + + 0 + + + 0 + 0 +
3+ NP
3 0 0+ + 0 0 0 + 0 + 0 + 0 + + 0 0 + + 0 0 ++ 0 +
0 2+
4 0 ++ 0 0 0 + 0 0 + 0 + + 0 0 + + 0 0 + 0 + + 0 +
0 2+
5 0 00 + + 0 0 + 0 + 0 + + + + 0 0 + + 0 + 0 + 0 +
3+ NP
6 0 0+ + 0 0 + + 0 + 0 + 0 + + 0 0 + 0 + 0 ++ 0 +
0 2+