FINAL EXAMINATION

AUGUST 2016 SEMESTER

COURSE : CLINICAL HAEMATOLOGY

COURSE CODE : MLS 3174
DURATION : 3 HOURS
FACULTY : ENGINEERING AND LIFE SCIENCES
DEPARTMENT : HEALTH SCIENCES
PROGRAMME : BACHELOR IN MEDICAL LABORATORY SCIENCE – HS402
LECTURER : MR MOHD JAAMIA QAADIR BIN MOHD BADRIN

INSTRUCTIONS TO CANDIDATES

This question paper consists of three (3) sections:

Section A - 20 questions (objective questions)

Section B - 4 questions (short answer questions)
Section C - 3 questions (essay questions)

Answer all questions in Section A and B, and only two questions in Section C.

All answer of:

Section A must be answered in OMR objective paper provided

Section B and C must be written in the answer booklet provided.
The answer for each question must start on a new page.

Candidates are NOT ALLOWED to bring any unauthorized items into the exam hall except
with the permission of the invigilator.

Do Not Open the Question Paper Until Instructed

This Question Paper Consists of Eight (8) Printed Pages

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SECTION A: OBJECTIVE QUESTIONS (20 MARKS)

CHOOSE ONE BEST STATEMENT TO ANSWER THE QUESTIONS

1. The variety of shapes in erythrocytes is called

(A) pleocytosis
(B) anisocytosis
(C) poikilocytosis
(D) pleochrocytosis

2. Fifty-five percent (45%) of the human blood is composed of

(A) plasma
(B) platelets
(C) leukocytes
(D) erythrocytes

3. Anemia is classified based on

(A) etiology and morphology

(B) morphology and initiation
(C) etiology and transportation
(D) morphology and transportation

4. Which of the following is an example for intrinsic factor in red cells destruction?

(A) platelet
(B) antibody
(C) macrophage
(D) hemoglobin

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5. Which ability of a red blood cell is lost in sickle cell disease?

(A) fluidity
(B) elasticity
(C) permeability
(D) transformability

6. Which of the following is an example of cell membrane defect?

(A) hereditary elliptosis

(B) hemoglobin C defect
(C) ferritin deficiency effect
(D) pyruvate kinase deficiency

7. Which of the following appears as a hypochromic microcytic anemia?

(A) thalassemia
(B) aplastic anemia
(C) hemolytic anemia
(D) megaloblastic anemia


8. Microcytic anemia can be described as

(A) low mean cell volume

(B) high mean cell volume
(C) low mean cell hemoglobin
(D) high mean cell hemoglobin

9. Thalassemia is a disease that can cause

(A) aplastic anemia

(B) microcytic anemia
(C) macrocytic anemia
(D) megaloblastic anemia

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10. Which of the following is FALSE about hemolytic anemia?

(A) It can only be inherited.

(B) It can be caused sickle cell disease.
(C) It can be caused hereditary spherocytosis.
(D) It can be caused by pyruvate kinase deficiency.

11. Symptoms that may appear in patients with hemolytic anemia are

(A) pallor, styes, pale urine

(B) jaundice, styes, dark urine
(C) pallor, malaise, dark urine
(D) jaundice, malaise, pale urine


12. Which of the following cells is highly elevated bacterial infection?

(A) platelets
(B) neutrophils
(C) eosinophils
(D) lymphocytes

13. Which of the following belongs in megaloblastic anemia?

(A) iron deficiency

(B) G6PD deficiency
(C) vitamin B12 deficiency
(D) pyruvate kinase deficiency

14. Which of the following bursts the red blood cells faster in osmotic fragility testing?

(A) sickle cell anemia

(B) hereditary spherocytosis
(C) acquired hemolytic anemia
(D) hemolytic disease of the newborn

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15. Which of the following is used to stain reticulocytes?

(A) supravital stain

(B) fluorochrome stain
(C) Romanowsky stain
(D) cytochemical stain

16. Reticulocyte count in megaloblastic anemia is

(A) normal
(B) increase
(C) decrease
(D) fluctuate


17. Which of the following describes alpha thalassemia?

(A) insertion disorder

(B) alpha and beta globin chain affected
(C) comes from maternal chromosome origin
(D) severity depends on numbers of affected allele

18. Which of the following describes beta thalassemia?

(A) point mutation disorder

(B) beta globin chain affected
(C) loss of alpha and beta globin chain
(D) severity depends on numbers of affected allele

19. Which of the following describes the mechanisms of hemostasis?

I. fibrinoplasia
II. blood coagulation
III. vascular constriction
IV. platelet plug formation

(A) I, II and III

(B) I, II and IV
(C) II, III and IV
(D) I, II, III and IV

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20. Hemophilia can be described as

I. got two types A and B

II. A type is mainly in males
III. B type is mainly in female
IV. a sex linked recessive disorder

(A) I, II and III

(B) I, II and IV
(C) I, III and IV
(D) I, II, III and IV

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SECTION B: SHORT ANSWER QUESTIONS (40 MARKS)

ANSWER ALL QUESTIONS

1. Summarize aplastic anemia. (10 Marks)

2. Describe the nutritional iron deficiency anemia. (10 Marks)

3. Describe the characteristics of haemoglobin E and haemoglobin S. (10 Marks)

4. Explain haemophilia A in general. (10 Marks)

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SECTION C: ESSAY QUESTIONS (40 MARKS)

ANSWER TWO (2) QUESTIONS ONLY

Question1

A 48-year-old female presented to the emergency department with severe headaches, dyspnea on
exertion, and petechiae on the lower extremities. A CBC (complete blood count) was drawn that
showed the following: WBC=56 x103/µL (abnormal), Hgb=9.0 g/dL (abnormal), Hct=23
(abnormal), MCV=97 fl, plt=15 x109/µL (abnormal), ANC=0.7x103/µL (abnormal). A bone
marrow biopsy was performed and showed 90 percent lymphoid blasts. Give and explain your
diagnosis.
(20 Marks)

Question 2

An orbital infection in a female patient aged 48 years comes with a hemoglobin level 8.3g/dL
(abnormal), white cells count 15.3 x 109/L (abnormal), blasts cells 96% (bone marrow biopsy),
neutrophils count 1% (abnormal) and platelets count 30 x 109/L (abnormal). Give and explain
your diagnosis.
(20 Marks)

Question 3

Adriana is a 7-year-old who lives with her parents in a suburban community. Her parents brought
Adriana to the United States from their homeland in Greece when she was 1 year old. At the age
of 3, Adriana was in the 10th percentile for height and weight, pale, and her hemoglobin was 5.8
g/dL. Haemoglobin electrophoresis gave elevated level of haemoglobins A2 and F. Over the
course of the next 4 years, Adriana was hospitalized every 1–2 months so she could be
transfused with packed red blood cells. During a routine follow-up visit at the hematology clinic,
Adriana’s laboratory results gave hemoglobin: 10 mg/dL and total serum iron: 150 g/L. Give and
explain your diagnosis.
(20 Marks)

END OF QUESTION PAPER

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