BS-section A MQS study PDF

BS-section A 60-MQC study: 15-MQC: Question 1 What is NOT a cause of anaemia?: a. Splenomegaly b. shortened RBC life span c. Mutations in haemoglobin d. Blood loss Lack of EPO production. Correct Answer: Splenomegaly Reason: Splenomegaly can exacerbate anaemia but is not a di...

BS-section A 60-MQC study: 15-MQC: Question 1 What is NOT a cause of anaemia?: a. Splenomegaly b. shortened RBC life span c. Mutations in haemoglobin d. Blood loss Lack of EPO production. Correct Answer: Splenomegaly Reason: Splenomegaly can exacerbate anaemia but is not a direct cause. The other options, such as shortened RBC lifespan, mutations in haemoglobin, blood loss, and lack of EPO production, are direct causes of anaemia. Question 2 What does Pyruvate Kinase Deficiency lead to? a. Reduced Haemoglobin synthesis b. Reduced DNA synthesis c. Reduced ATP formation d. Reduced EPO synthesis e. Reduced 2-3 DPG synthesis Correct Answer: Reduced ATP formation Reason: Pyruvate kinase deficiency disrupts glycolysis, leading to insufficient ATP production in red blood cells. Question 3 What type of anaemia is pernicious anaemia linked to?: a. Sickle cell anaemia b. Alpha thalassemia c. Pyruvate kinase deficiency  d. Vitamin B12 deficiency e. Glucose-6-phosphate dehydrogenase deficiency. Correct Answer: Vitamin B12 deficiency Reason: Pernicious anaemia is caused by impaired absorption of vitamin B12 due to intrinsic factor deficiency. Question 4 What is Thalassaemia?: a. is an inherited blood disorder that is caused by a structural defect of the haemoglobin chains. b. alpha will only be picked up during the haemoglobin production switch postpartum. c. beta leads to the over production of beta chains d. is an inherited autosomal recessive disease. e. is caused by mutations in genes located on Chromosomes 12 and 13. Correct Answer: is an inherited autosomal recessive disease. Reason: Thalassaemia is an autosomal recessive disorder caused by mutations in haemoglobin chain genes, usually on chromosomes 11 and 16. Question 5 The direct Coombs test looks at: a. quantitative IgG levels in the plasma. b. total number of lymphocytes in whole blood. c. quantitative IgM levels in the plasma d. total antibodies present in the serum. e. antibodies present on the red blood cell surface. Correct Answer: antibodies present on the red blood cell surface. Reason: The direct Coombs test identifies antibodies bound to red blood cell surfaces, typically in autoimmune haemolytic anaemia.  Question 6 Acute leukaemia is best described as a disease which has the following characteristics: a. slow progression, and is harder to treat, >30% blasts in the bone marrow b. fast progression, easier to treat, >30% blasts in the bone marrow c. slow progression, easier to treat, >20% blasts in the bone marrow d. fast progression, easier to treat, >20% blasts in the bone marrow e. slow progression, harder to treat, >20% blasts in the bone marrow. Correct Answer: fast progression, easier to treat, >20% blasts in the bone marrow Reason: Acute leukaemia progresses rapidly, and its diagnostic criterion includes ≥20% blasts in the bone marrow. Question 7 Regarding blood film observations: a. Hypochromic cells are red cells with an increased central area of pallor. b. Anisocytosis denotes shape changes of red blood cells. c. Poikilocytosis denotes changes to the size of the red blood cells. d. Microcytic cells are red blood cells larger than normal. e. Schistocytes denotes the presence of red blood cell shaped as teardrops. Correct Answer: Hypochromic cells are red cells with an increased central area of pallor. Reason: Hypochromic cells are a hallmark of iron-deficiency anaemia, showing reduced haemoglobin and increased pallor. Question 8 Which of the following is NOT regarded as Personal Protective Equipment (PPE) in a laboratory?: a. Waterproof trousers. b. Laboratory coat c. Eye protection. d. Gloves.  e. Plastic spillage protection aprons Correct Answer: Waterproof trousers. Reason: Waterproof trousers are not typically considered PPE in a laboratory setting, unlike lab coats, gloves, and eye protection. Question 9 Blood samples in Eppendorf tubes can be disposed of in the: a. plastic containers on the bench with lids on. b. biohazard bags with lids on. c. black waste bags by the handwashing sink. d. white buckets containing microsol with lids on. e. sink containing microsol as an open sample (no lid). Correct Answer: biohazard bags with lids on. Reason: Blood samples must be disposed of in biohazard bags to ensure safe and compliant waste management. Question 10 The pre-analytical phase involves: a. analyser maintenance. b. patient identity checks on the sample and details compared to the request form. c. ensuring the samples are stored appropriately. d. samples being loaded on the analyser e. checking control data is within the stated range. Correct Answer: patient identity checks on the sample and details compared to the request form. Reason: The pre-analytical phase includes verifying patient identity and ensuring proper labelling and handling before analysis. Question 11 The starting material for fatty acid synthesis is: a. pyruvate b. acetyl CoA c. Citrate d. phosphatidate e. glycerol Correct Answer: acetyl CoA Reason: Fatty acid synthesis begins with acetyl CoA, which is converted to malonyl CoA in the first committed step. Question 12 Which of the following is a cofactor for phosphoglyceride biosynthesis?: a. NADP+ b. UTP c. CTP d. NADH e. GTP Correct Answer: CTP Reason: CTP is a cofactor in the activation of phosphatidate during phosphoglyceride synthesis. Question 13 In red blood cell metabolism: a. the iron ion needs to be in its reduced form to carry oxygen b. NADH restores glutathione c. fatty acids can provide energy d. the citric acid cycle provides NADH e. NADPH mops up superoxide Correct Answer: the iron ion needs to be in its reduced form to carry oxygen. Reason: The ferrous (Fe²⁺) form of iron binds oxygen in haemoglobin. Other processes like NADPH involvement are related to oxidative stress, not oxygen carriage. Question 14 Tay Sachs disease is caused by: a. a defect in lipid degradation b. a disorder of amino acid biosynthesis c. a lack of essential fatty acids d. a deficiency in the G6PD enzyme e. a defect in the urea cycle Correct Answer: a defect in lipid degradation Reason: Tay-Sachs results from a deficiency of hexosaminidase A, leading to impaired degradation of GM2 gangliosides. Question 15 Proteins are labelled for degradation by the: a. addition of ubiquinone to the C terminus of the amino acid chain b. addition of ubiquitin to the N terminus of the amino acid chain c. addition of ubiquitin by an isopeptide bond d. addition of ubiquitin to the C terminus of the amino acid chain e. addition of ubiquinone by an isopeptide bond Correct Answer: addition of ubiquitin by an isopeptide bond. Reason: Ubiquitin tags proteins for proteasomal degradation via isopeptide bond formation. 30-MQC: Questions Anaemia and Haemoglobinopathies 1. What does the reticulocyte count indicate in a blood test? a) White blood cell activity b) Bone marrow function and red blood cell production c) Platelet count d) Presence of haemoglobin mutations 2. What is the most common cause of microcytic hypochromic anaemia? a) Vitamin B12 deficiency b) Folate deficiency c) Iron deficiency d) Chronic kidney disease 2. Which of the following is NOT typically associated with iron-deficiency anaemia? a) Low serum ferritin b) High transferrin saturation c) High TIBC d) Low serum iron 3. What laboratory parameter is commonly elevated in iron-deficiency anaemia? a) Serum ferritin b) Total iron-binding capacity (TIBC) c) Mean corpuscular volume (MCV) d) Haemoglobin concentration 4. Which of the following red blood cell indices is used to classify anaemia as microcytic, normocytic, or macrocytic? a) MCH b) MCV c) RDW d) MCHC  5. What condition is associated with a defect in the beta-globin gene? a) Alpha-thalassaemia b) Beta-thalassaemia c) Sickle cell anaemia d) G6PD deficiency 6. What is the hallmark feature of megaloblastic anaemia on a blood film? a) Hypersegmented neutrophils b) Target cells c) Schistocytes d) Hypochromic microcytes 7. What is the typical laboratory finding in pernicious anaemia? a) Microcytic red blood cells b) Macrocytic red blood cells c) Hypochromic red blood cells d) Elevated reticulocyte count 8. What is the primary defect in sickle cell anaemia? a) Decreased production of haemoglobin b) Mutation in beta-globin leading to HbS formation c) Deficiency in G6PD enzyme d) Reduced ATP synthesis in red blood cells 9. What test is commonly used to detect sickle cell disease? a) Osmotic fragility test b) Haemoglobin electrophoresis c) Direct Coombs test d) Bone marrow biopsy 10. Which enzyme is deficient in hereditary haemolytic anaemia caused by pyruvate kinase deficiency? a) Glucose-6-phosphate dehydrogenase b) Hexokinase c) Pyruvate kinase d) Phosphofructokinase 11. What is a characteristic finding in the blood film of a patient with lead poisoning? a) Hypersegmented neutrophils b) Target cells c) Basophilic stippling d) Schistocytes Haemolysis and Blood Disorders 13. Which pathway is impaired in glucose-6-phosphate dehydrogenase (G6PD) deficiency? a) Glycolysis b) Pentose phosphate pathway c) TCA cycle d) Fatty acid oxidation 14. What triggers haemolysis in G6PD deficiency? a) Viral infections b) Exposure to oxidative stress, such as certain drugs or foods c) Dehydration d) Deficiency of folic acid 15. What is the function of haptoglobin in the blood? a) Transports oxygen in red blood cells b) Binds free haemoglobin in the plasma c) Facilitates iron absorption in the intestine d) Stimulates the production of white blood cells  16. Which of the following laboratory findings is consistent with haemolysis? a) Elevated serum haptoglobin b) Low lactate dehydrogenase (LDH) c) Elevated unconjugated bilirubin d) Normal reticulocyte count 17. What is the key laboratory test to confirm hereditary spherocytosis? a) Peripheral blood smear b) Coombs test c) Osmotic fragility test d) Bone marrow biopsy 18. Which blood disorder is associated with an increased risk of thrombotic events? a) Haemophilia A b) Polycythaemia vera c) Von Willebrand disease d) Aplastic anaemia 19. What is the most likely cause of elevated haemoglobin and haematocrit in a patient with polycythaemia vera? a) EPO deficiency b) JAK2 mutation c) Vitamin B12 deficiency d) Bone marrow suppression Coagulation and Laboratory Techniques 20. What is the main clinical feature of von Willebrand disease? a) Haemarthrosis b) Mucosal bleeding c) Thrombosis d) Reticulocytosis 21. Which vitamin is crucial for the synthesis of clotting factors II, VII, IX, and X? a) Vitamin B12 b) Vitamin C c) Vitamin K d) Vitamin D 22. Which anticoagulant is commonly used in blood collection tubes for a complete blood count (CBC)? a) Sodium citrate b) EDTA  c) Heparin d) Sodium fluoride 23. What is a key diagnostic feature of disseminated intravascular coagulation (DIC)? a) Normal platelet count b) Prolonged PT and APTT, and low fibrinogen c) Increased clotting factor activity d) Decreased d-dimer levels 24. What stain is most commonly used to assess blood films in the laboratory? a) Gram stain b) Giemsa stain c) Wright stain d) PAS stain Clinical Cases and Miscellaneous 25. Which type of anaemia is commonly seen in chronic kidney disease? a) Microcytic anaemia b) Normocytic normochromic anaemia c) Macrocytic anaemia d) Hypochromic anaemia 26. What does the direct Coombs test detect? a) Antibodies present on the red blood cell surface b) Total antibodies in the serum c) Quantitative IgG levels in the plasma d) Total lymphocyte count in whole blood 27. Which of the following is NOT regarded as Personal Protective Equipment (PPE) in a laboratory? a) Waterproof trousers b) Laboratory coat c) Eye protection d) Gloves 28. Blood samples in Eppendorf tubes can be disposed in the: a) Plastic containers on the bench with lids on b) Biohazard bags with lids on c) Black waste bags by the handwashing sink d) Sink containing microsol as an open sample (no lid) 29. The pre-analytical phase of the patient sample journey involves: a) Analyser maintenance  b) Patient identity checks on the sample and details compared to the request form c) Ensuring the samples are stored appropriately d) Checking control data is within the stated range 30. The starting material for fatty acid synthesis is: a) Pyruvate b) Acetyl CoA c) Citrate d) Glycerol Answer Key 1. b 2. c 3. b 4. b 5. b 6. b 7. a 8. b 9. b 10. b 11. c 12. c 13. b 14. b 15. b 16. c 17. c 18. b 19. b 20. b 21. c 22. b 23. b 24. b 25. b 26. a 27. a  28. b 29. b 30. b More 15-MGC : Questions Haematological Malignancies 1. Which of the following is a key characteristic of acute myeloid leukaemia (AML)? 2. a) Lymphoblast proliferation in bone marrow 3. b) Rapid progression with >20% myeloblasts in the bone marrow 4. c) Increased plasma cells in the peripheral blood 5. d) Chromosome 9;22 translocation 6. What is the defining genetic abnormality in chronic myeloid leukaemia (CML)? a) JAK2 mutation b) BCR-ABL fusion gene (Philadelphia chromosome) c) MYC overexpression d) P53 deletion 7. In multiple myeloma, what type of abnormal protein is often detected in the urine? a) Haemoglobin b) Bence-Jones protein c) Albumin d) Transferrin 8. Hodgkin lymphoma is characterized by the presence of which specific cell type? a) Reed-Sternberg cells b) Plasma cells c) Lymphoblasts d) Reticulocytes 9. Which cell lineage is primarily affected in chronic lymphocytic leukaemia (CLL)? a) T lymphocytes b) B lymphocytes c) Monocytes d) Erythrocytes Immunohaematology 6. What blood group antigen is most likely to cause severe haemolytic disease of the newborn (HDN)? a) ABO antigens b) Rh (D) antigen c) Kell antigen d) Duffy antigen 7. In crossmatching blood for transfusion, which test detects recipient antibodies against donor red cells? a) Direct antiglobulin test (DAT) b) Indirect antiglobulin test (IAT) c) Osmotic fragility test d) Reticulocyte count 8. What is the main role of immunoglobulin IgG in blood transfusion reactions? a) Binds to complement b) Neutralizes antigens on pathogens c) Coats red blood cells for removal by macrophages d) Activates platelet aggregation Coagulation Disorders 9. In haemophilia A, which clotting factor is deficient? a) Factor VIII b) Factor IX c) Factor XI d) Von Willebrand factor 10. A prolonged activated partial thromboplastin time (APTT) with a normal prothrombin time (PT) is most likely associated with: a) Liver disease b) Factor VIII deficiency c) Vitamin K deficiency d) DIC Laboratory Techniques 11. Which parameter in a complete blood count (CBC) provides information about red blood cell size variability? a) Mean corpuscular volume (MCV) b) Red cell distribution width (RDW) c) Mean corpuscular haemoglobin (MCH) d) Haematocrit 12. What is the purpose of flow cytometry in haematology? a) Identification of cell morphology b) Detection of cell surface markers c) Measurement of haemoglobin levels d) Analysis of coagulation factors 13. What laboratory method is used to assess clot retraction? a) Thromboelastography (TEG) b) Prothrombin time (PT) c) Platelet aggregation studies d) Activated clotting time (ACT) Blood Disorders and Red Cell Morphology 14. In which condition are Heinz bodies typically seen? a) Iron-deficiency anaemia b) G6PD deficiency c) Sickle cell anaemia d) Vitamin B12 deficiency 15. What is the most likely cause of a blood smear showing schistocytes (fragmented red blood cells)?  a) Iron-deficiency anaemia b) Disseminated intravascular coagulation (DIC) c) Hereditary spherocytosis d) Megaloblastic anaemia Answer Key 1. b) Rapid progression with >20% myeloblasts in the bone marrow 2. b) BCR-ABL fusion gene (Philadelphia chromosome) 3. b) Bence-Jones protein 4. a) Reed-Sternberg cells 5. b) B lymphocytes 6. b) Rh (D) antigen 7. b) Indirect antiglobulin test (IAT) 8. c) Coats red blood cells for removal by macrophages 9. a) Factor VIII 10. b) Factor VIII deficiency 11. b) Red cell distribution width (RDW) 12. b) Detection of cell surface markers 13. a) Thromboelastography (TEG) 14. b) G6PD deficiency 15. b) Disseminated intravascular coagulation (DIC)