chem path test1

Katie is a 35 year old woman with ulcerative colitis presented with diarrhoea and passing blood with her stools. Her HB level was 8.5 g/dl and there was moderate microcytosis and hypochromia. Her plasma iron and ferritin studies revealed:
Plasma
Iron 4 µmol/l
Transferrin 1.5 g/l
% saturation 11.89
Ferritin 33 µg/l

1.1 Comment on the diagnosis of Katie. [7]

Indicate treatment for Katie. [1]

2. The following sets of results were from a 65 year –old woman admitted to the coronary care unit because of chest pain. The ECG and plasma enzyme studies did not reveal a myocardial infarct:
Plasma:
Na 139 mmol/l
K 3.9 mmol/l
Cl 103 mmol/l
HCO3- 25 mmol/l
Urea 6.1 mmol/l
Creat 105 µmol/l

Ca 2.22 mmol/l
PO4 0.86 mmol/l
Mg 0.60 mmol/l
Alb 35 g/l

2.1 Comment on the patient’s results. [10]

Discuss the homeostasis of magnesium. [4]



3. Sharan is a Technologist – in - charge of a private lab. She reports to the lab manager, Tembe who in turn reports to the Pathologist Prof Mokoena. There are 3 qualified Med techs viz. Susan, Prinivan and Dorothy who reports to the QC officer Kinon, Senior med Tech Faizel and senior med Tech Sne’ respectively. Kinon, Faizel and Sne’ reports to Parvathy who is the 2IC. Prinivan’s subordinate is the student med Tech Jabu while the Technician Harry reports to Dorothy. The Technician handles all Peter’s day –to –day matters. Peter is a General assistant. Draw an organogram for this private lab, showing names and titles. [13]

Gives reasons/ explanation of the following:
Patients are bled in a quiet and pleasant area.
“Shute” or vacuum system for specimens.
Urgent specimens are distinguished in the lab
Treatment of Stat samples in a private lab.
Most work is done in the first shift.
Transcription errors are not allowed.[Give an example of an error of this type]
Laboratory staff are always rotated.
Most labs have a 3 way interface system
The two-way traffic in public hospitals has huge benefits.
Card board boxes are not stacked at lab exits.
[10]

Multiple choices. Show working / explanation and give the correct answer.

Calculate the coefficient of variation for a set of data where the mean = 89 mmol/l and the 2 standard deviations = 14.
7.8
7.9
15.7
15.8

A CSF specimen is sent to the lab @ 9 pm for glucose analysis. The specimen is cloudy and appears to contain red blood cells. Which of the following statements is true?
Glucose testing cannot be performed on the specimen
Specimen should be centrifuged and the glucose test run immediately.
Specimen can be refrigerated as received and the glucose run the next day.
Specimen can be frozen as received and the glucose run the next day.

Xanthrochromasia of cerebrospinal fluid may be due to increased levels of which of the following?
Chloride
Protein
Glucose
Magnesium

With the development of fetal lung maturity, which of the following phospholipid concentrations in amniotic fluid significantly and consistently increases?
Sphingomyelin
Phosphatidyl ethanolamine
Phosphatidyl inositol
Phosphatidyl choline

Which of the following is characteristic of an exudates effusion?
Leukocyte count greater than 1000 /µl
Cloudy appearance
Protein concentration less than 3.0 g/dl
Absence of fibrinogen

How many millilitres of concentrated H2SO4 ( sp gravity = 1.84g/ml; assay =97%) are required to prepare 10 L of a 0.1 N H2SO4
1.84
9.20
27.5
54.4

How many grams of NaOH are required to prepare 2500 ml of a 4 M solution?
40
100
160
400





Because of a malfunction, a spectrophotometer is able to show only the percent transmittance (%T) readings on the digital display. Convert 68.0%T to its corresponding absorbance.
0.109
0.168
0.320
0.495

How many grams of a NaOH are required to prepare 500ml of a 0.02N solution?
0.4
0.8
4.0
8.0

How much CaSO4 should be weighed out to prepare one litre of a 0.5 M solution of Ca SO4?
a. 6.8g
b. 0.68g
c. 6800g
d. 68 g
[10 x2 = 20]

6. A lumbar puncture is performed for suspected meningitis.

6.1 Explain the significance of the globulin test in CSF. [2]

6.2 Give the significance of a raised glucose level in CSF. [3]

7. Describe the interfering factors that may give false results in the occult blood test.
[3]

8. With the aid of a diagram show a LSAR chromatography plate indicating a possible
negative and a positive lung maturity. Show calculations of LSAR patterns. [7]