Med Lab Revision

7/31/2019 Med Lab Revision

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Medical Laboratory Sciences

II

2 hour Examination

Section A Short question answers

Section B 1 hour essay question

Choice of 1 out of 3


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What Have we Learnt?

BloodGrouping

Haemolyticdisease ofthe newborn

Bloodproducts

Bloodconservation

Introduction

LiverFunction

Kidney, Heart& Thyroidfunction

PaediatricBiochemistry

Genetics

Urinary TractInfection

SexuallyTransmittedDisease

Enterics

GeneralBacteriology

Virology

Blood Bank Biochemistry Microbiology


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Blood Bank Blood Grouping

ABO System What is it?

Why is it particularly important?

Typing Forward and reverse groupings

RhD

Cross matching

Coombs test


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Blood Bank HDN

Clinical scenario

Routine serology

Screening/Prophylaxis Maternal/paternal/foetal

Significant alloantibodies

Management of HDN Prophylaxis RAADP

Liley chart


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Blood Bank Blood Products

Whole Blood

Fresh Frozen Plasma (FFP) Indications for use Preparation

Red Cells in SAGM Indications for use What is it?

Platelets Indications for use Preparation and administration

Cyroprecipitate, Serum immunoglobulins,Albumin


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Blood Bank Conservation

SHOT

Shortages

Short term, acute, long term

NBS Plan for Management Green, Amber, Red phase

Autologous transfusion PAD, ANH, CellSalvage

Management of Hb levels

Emergency blood management group


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Example Questions:

1. Haemolytic disease of the newborn (HDN) is caused bytransplacental passage of maternal alloantibodies directedagainst foetal red cell antigens.

a) What is meant by the term alloantibody?

An antibody produced by one individual that reacts with allontigens

of another individual of the same species.(1 mark)

b) Which class of antibody usually facilitate HDN reactions due totheir ability to cross the placenta: IgG, IgA or IgM?

IgG(1 mark)

c) Why is it particularly important to identify Rhesus D (RhD)negative, pregnant women prior to their giving birth?

(5 marks)

d) Other than anti-RhD, name 3 other significant alloantibodiesassociated with HDN

(3 marks)


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Example Questions:

2. Conservation of blood donated through theBritish Blood Transfusion Service is ofincreasing importance. Briefly outline someof the possible scenarios that may contributeto short term shortages, acute shortages and

prolonged shortages.

In July 2004, the Department of Health issueda plan for the management of bloodshortages in the UK, integrated using a trafficlight system. Outline what is meant by thetraffic light system and provide a criticalanalysis of some of the new measuresintroduced to help conserve blood usage.


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Example Questions:

2. Conservation of blood donated through theBritish Blood Transfusion Service is ofincreasing importance. Briefly outline someof the possible scenarios that may contributeto short term shortages, acute shortages and

prolonged shortages.

In July 2004, the Department of Health issueda plan for the management of bloodshortages in the UK, integrated using a trafficlight system. Outline what is meant by thetraffic light system and provide a criticalanalysis of some of the new measuresintroduced to help conserve blood usage.


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Biochemistry Introduction

Specimen collection Different preservatives

Sample integrity Haemolysed, icteric, lipaemic

Transport conditions


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Biochemistry Liver Function

Normal functions of the liver Normal structure of the liver

LFT Bilirubin, Albumin, ALP, ALT, AST, GGT, LDH

Clinical interpretation


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BiochemistryKidney, Heart &Thyroid Renal Function

Normal function renal function eGFR, CCT, Urea, Creatinine, Sodium, Potasium,

Proteinuria, Microalbumin urine test, Urine osmolarity,Transferrin saturation, Stone screen

Cardiac Function Myoglobin, LDH, AST, CK (-MM, -MB, -MM), Troponin (-

T, -I), hsCRP, NT-proBNP

Thyroid Function Normal thyroid function Hyperthyroid vs hypothyroid FT3, FT4, TSH, anti-TPO, anti-TSH Receptor


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Biochemistry Paediatrics

Terms Neonate, Preterm, Term, Extreme preterm

Why are paediatric cases different Specimen collection

Specimen analysis

Data interpretation

Inherited conditions Phenylketonuria, Niemann-Pick (C & D), Congenital

hypothyroid, Sickle cell, MCADD, Cystic fibrosis

Screening Wilson & Jungner


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Biochemistry Genetics

What is it, Why do it, How do we do it Screening, Counselling, Extraction, PCR, Southern

blotting, Cytogenetics, Genotyping

Inheritance Autosomal dominance, recessive, Penetrance,

Variability

Clinical examples Huntington, Cystic fibrosis, Mitochondrial disorders,

X-linked disorders, Downs, Fragile X,Haemochromatosis. AAT


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Example Questions:

3. Clinical Biochemistry routinely assesses organ function.

a) State 4 tests used to assess renal function(2 marks)

b) Provide a clinical interpretation of an abnormal result foreach of the 4 tests you have named above.(4 marks)

c) State the full name of each of the following analytes used toassess liver function:

(3 marks)

AST, ALT, LDH

d) Free thyroxine is measured as part of the assessment ofwhich organ?

(1 mark)


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Example Questions:

4. A 40 year old male presents to his GP withpalpitations, shaking, lethargy and weight loss.Upon further examination the GP sees signs oftachycardia, moist skin and exophthalmos.Graves disease is suspected and a blood sample

sent to the Pathology department.

Describe the thyroid hypothalamus-pituitary axis,detailing how this is disrupted in the onset ofGraves disease. What tests would be requested

and how would a Biomedical Scientist interpretthese results to differentially diagnose Graves?Briefly outline a possible treatment strategyconsidering long and short term aims for thismans condition?


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Example Questions:

4. A 40 year old male presents to his GP withpalpitations, shaking, lethargy and weight loss.Upon further examination the GP sees signs oftachycardia, moist skin and exophthalmos.Graves disease is suspected and a blood sample

sent to the Pathology department.

Describe the thyroid hypothalamus-pituitary axis,detailing how this is disrupted in the onset ofGraves disease. What tests would be requested

and how would a Biomedical Scientist interpretthese results to differentially diagnose Graves?Briefly outline a possible treatment strategyconsidering long and short term aims for thismans condition?


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Microbiology - STIs

Basic anatomy, male and female

Gonorrhoea, Syphillis, Chlamidia Transmission

Clinical features Pathogenesis

Lab diagnosis: Specimen collection, Culture,Microscopy (light, dark, morphology), Gram stain,Oxidase test, Biomerieux, ELISA, PCR, Sensitivity

testing Treatment/prevention

General basic knowledge Genital herpes, Genital warts, Pubic lice,

Trichomoniasis, Vaginal candidosis


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Microbiology - UTIs

Basic anatomy, male and female Host defence

Symptoms Terminology

Causative organisms Inpatients/outpatients

Specimen collection Critical analysis

Laboratory investigation Microscopy, casts, Flow cytometry, Culture, Chromogenic media.

Kass criteria

Treatment/prevention


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Microbiology and Virolgoy

Apologies, I did not receive thefollowing talks in time to put thispresentation together before going on

leave. You will have to review andsummarise these two lectures foryourselves.

Medical Microbiology: Respiratory &Gastro Infection

Medical Virology


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Example Questions:

5a) Give two reasons why UTIs are more common in femalesthan males.(2 marks)

b) What is the most common cause of UTIs in the public?(1 mark)

c) Discuss how the causative agents of UTIs found in hospitalinpatients are likely to differ from those found in the generalpublic.

(3 marks)

d) Critically analyse the different types of specimen andspecimen collection methods used to investigate suspectedUTI.

(4 marks)


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Example Questions:

6. Discuss the aetiology and clinicalsymptoms of Mycobacterium tuberculosis(TB) infection. Critically discuss thelaboratory investigations that may beconducted by a Biomedical Scientistinvestigating a possible case of TB,including the advantages and

disadvantages of the different tests thatcould be requested. Briefly outlinepossible treatment and preventionstrategies.


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Example Questions:

6. Discuss the aetiology and clinicalsymptoms of Mycobacterium tuberculosis(TB) infection. Critically discuss thelaboratory investigations that may beconducted by a Biomedical Scientistinvestigating a possible case of TB,including the advantages and

disadvantages of the different tests thatcould be requested. Briefly outlinepossible treatment and preventionstrategies.


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