There are FIVE questions from which you are required to answ…
There are FIVE questions from which you are required to answer THREE; additional answers will not be marked. There are 3 answer boxes below this box. Each answer box MUST be used to answer one of the questions you select. Please also remember to tell us which question you are answering. See the example below: ‘This is my answer to Question 1…’ Questions are as followed: Question 1 (Answer all parts of the question): a) Discuss the steps built into the pre-transfusion process to ensure the process is as safe as possible and to avoid the administration of an incorrect blood component (60%) b) What types of adverse reactions or adverse events may be seen, and which haemovigilance schemes are in place to monitor these? (40%) Question 2 (Answer all parts of the question) a) Explain how the red blood cell membrane is organised to allow reversible deformation (20%) b) Compare and contrast the pathophysiology of Hereditary Spherocytosis and G6PD Deficiency (include in your answer examples of typical laboratory findings for patients with these conditions) (80%) Question 3 Sarah, a 16-year-old girl of African origin was seen in the emergency department for severe abdominal pain, fever and nausea. She had a history of recurrent fevers throughout childhood which was accompanied by pains in the limbs. The patient received a transfusion of 2 units of red cells 7 days ago when her Hb was 70g/L. Her mother states she had recently been to a mountainous area for a period of time. Family history revealed that her mother had a history of anaemia when she was young. On examination she appeared very pale and her skin and conjunctivae were slightly yellow. a) Considering the clinical and laboratory findings (see below), make a differential diagnosis for this patient, discussing how you have excluded other possibilities. (40%) b) Discuss the probable underlying pathologic mechanisms that might cause the abnormal RBC morphology. (60%) Question 4 Discuss the laboratory approach to the investigation of a bleeding patient (100%) Question 5 (Answer all parts of the question) Compare and contrast the clinical significance of antibodies in the ABO blood group system to those of the other clinically significant blood group systems (Rh, Duffy, Kidd etc). (100%)
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