Sample/practice exam 2014, questions PDF

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Mock Progress Test: Blood Sciences (5LMS0007)

Name (print): ……………………………………………………………………. Student Serial Number: ……………………………………………............……

INSTRUCTIONS    

Please write your Name and Student Registration Number clearly on this paper. This paper consists of twenty questions, twelve in section A and eight in section B. Answer all the questions in section A using the provided MRQ bubble sheet Answer all the questions in section B in a short answer format on the test paper using a pen only.

Guidance for section A: Each question consists of five statements labelled a), b), c), d) and e). Indicate whether each statement is TRUE (T) or FALSE (F) by filling in the appropriate circle on the ANSWER SHEET provided. Use an HB pencil to mark your answers. For example, if you think part a of question 1 is true and part b is false then fill in the answer sheet as illustrated below; Q1 a.

T

F

b.

T

F

You must choose ONE option only. If you fill in both circles for one you will receive no marks for that part of the question. A correct choice receives +1 mark, an incorrect choice receives ‘minus 0.5’ mark and no choice receives 0 mark. Please be sure to hand in the MRQ and test paper at the end. The duration of this Progress Test is 90 minutes

Section A carries 60% of the marks Section B carries 40% of the marks

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Please note the following sections only show samples of the types of questions to expect for the final progress test: Section A: MRQs (in the final test will contain twelve questions) 1. The full blood count is the most commonly requested test in a haematology laboratory. The test measures numbers of each blood cell type and various properties of both red blood cells and platelets. a) The anticoagulant used for the full blood count is EDTA as this chelates calcium ions. b) One parameter which is useful for differentiating anaemia types is the MCV; this represents the Mean Cell Volume and is calculated using the equation haematocrit/haemoglobin. c) The hematocrit is the proportion of red blood cells in a total blood volume and is affected by red blood cell count and red cell size. d) Manual methods are sometimes required to generate the full blood count parameters, the haemocytometer is used to generate a haemoglobin result. e) An additional parameter linked to red blood cells is the reticulocyte which is an immature red blood cell. This indicates the response of the kidney to anaemia.

2. The synthesis of blood cells is termed haemopoiesis, this process is supported by the bone marrow stroma and haemopoietic growth factors. a) The bone marrow stroma contains many cell types for example macrophages to support stem cell renewal & efficient maturation of precursor cells. b) Haemopoietic growth factors; aid the proliferation of hemopoietic progenitor cells, support efficient differentiation and maturation of haemopoietic cells, and can enhance apoptosis. c) Erythropoietin is a hormone synthesised in the bone marrow and is responsible for stimulating early precursor cells in the haemopoietic spaces to produce more red blood cells. d) Red blood cells, platelets and lymphocytes are examples of cell types derived from the common myeloid progenitor cell. e) The bone marrow contains sinuses which are vascular pools of blood lined with endothelial cells to allow mature blood cells to enter the circulation.

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3. Thrombin: a) b) c) d) e)

is also known as factor II. activates platelets. activates cofactors FVIII and X. cleaves fibrinogen to allow fibrin to form polymers. triggers the intrinsic pathway in vivo by activating FXI.

4. Haemoglobinopathies includes disorders of haemoglobin where there is abnormal or reduced synthesis of a globin chain. a) Alpha thalassaemia results from reduced synthesis of the alpha globin chain. b) HbH disease is caused by the deletion of three alpha genes. c) In sickle cell anaemia the beta globin chain is affected resulting in the polymerisation of the haemoglobin molecule in deoxygenated conditions. d) Cellulose acetate electrophoresis is used in the diagnosis of many haemoglobinopathies, This separates different forms of haemoglobins based on their overall charge. e) Microcytic red blood cells are a specific morphological finding of thalassaemia.

5. Fatty acid biosynthesis: a) uses acetyl CoA as the starting material b) takes place in the mitochondria on the fatty acid synthase complex which is a dimer c) requires NADPH as a cofactor to provide reducing power d) yields the sixteen carbon saturated fatty acid palmitate e) is upregulated in diabetes

Section A: /60

Section B: Short Answer Questions (in the final test this section will contain eight questions)

1. Name the group of stains used for blood smears and explain how the key components of this highlights the cellular components of blood. (5 marks)

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2. What does the abbreviation G6PD denote? Explain the significance of a deficiency in this enzyme and how the fluorescent spot test can identify a G6PD deficient patient. (5 marks)

3. Platelets are required in the formation of a blood clot. Name and explain the three stages involved in the platelet response to endothelial damage (6 marks)

4. What does PT stand for? Give two reasons for a prolonged PT and briefly explain why this prolongs the clotting time. (5 marks)

5. In which pathway does acyl carrier protein feature and what is its role? (Precise details of the pathway are not required.) (4 marks)

Section B:

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