DMLT 2nd Year Notes QnA

Haematology and Blood Bank Technology

Short Questions:

1. What are the main components of blood?
   • Red Blood Cells (RBCs): Transport oxygen.
   • White Blood Cells (WBCs): Fight infections.
   • Platelets: Aid in blood clotting.
   • Plasma: Carries nutrients, hormones, and waste.
2. What is the function of platelets in blood?
   Platelets help in blood clot formation to stop bleeding and repair damaged vessels.
3. What is the difference between anemia and leukemia?
   • Anemia: A condition with reduced RBC count or hemoglobin, leading to fatigue and weakness.
   • Leukemia: A cancer of blood-forming tissues, causing an abnormal increase in WBCs.
4. Define complete blood count (CBC).
   CBC is a blood test that measures the levels of RBCs, WBCs, hemoglobin, hematocrit, and platelets to assess overall health.
5. What is crossmatching in blood transfusion?
   Crossmatching ensures compatibility between donor and recipient blood by mixing a small amount of both to check for reactions.
6. Describe the process of blood typing.
   Blood typing determines a person’s blood group (A, B, AB, or O) and Rh factor (positive or negative) using antiserum to detect antigen-antibody reactions.
7. What is thrombocytopenia?
   Thrombocytopenia is a condition with an abnormally low platelet count, increasing the risk of bleeding.
8. What are the types of anemia?
   • Iron-deficiency anemia
   • Vitamin B12 or folate deficiency anemia
   • Hemolytic anemia
   • Aplastic anemia
   • Sickle cell anemia
9. How is bone marrow examined?
   Bone marrow examination involves aspiration or biopsy, where a sample is collected from the hipbone and analyzed for abnormalities.
10. What is the role of WBCs in immunity?
    WBCs protect the body by identifying and destroying pathogens, producing antibodies, and regulating the immune response.

Long Questions:

1. Explain the composition of blood and the function of each component.
   • RBCs: Contain hemoglobin for oxygen transport.
   • WBCs: Defend against infections and include neutrophils, lymphocytes, monocytes, eosinophils, and basophils.
   • Platelets: Facilitate clotting.
   • Plasma: Transports nutrients, hormones, enzymes, and waste products.
2. Describe the steps involved in blood donation and storage.
   • Donation: Screening, venipuncture, and collection in sterile bags.
   • Storage:
     • RBCs: Stored at 2-6°C for up to 42 days.
     • Platelets: Stored at 20-24°C with continuous agitation for 5-7 days.
     • Plasma: Frozen within hours and stored at -18°C or lower.
3. Discuss the pathophysiology of anemia and its diagnostic approach.
   • Pathophysiology: Reduced RBC production, increased destruction, or blood loss leads to decreased oxygen delivery to tissues.
   • Diagnostics: CBC, peripheral blood smear, reticulocyte count, and tests for iron, vitamin B12, and folate levels.
4. Explain the principles of blood typing and its clinical significance.
   Blood typing identifies antigens on RBCs using specific antibodies. This prevents hemolytic reactions in transfusions and ensures maternal-fetal compatibility.
5. Discuss the types of leukemia and their diagnostic features.
   • Acute Lymphoblastic Leukemia (ALL): Immature lymphocytes, common in children.
   • Acute Myeloid Leukemia (AML): Immature myeloid cells.
   • Chronic Lymphocytic Leukemia (CLL): Mature lymphocytes, common in adults.
   • Chronic Myeloid Leukemia (CML): Mature myeloid cells.
     Diagnostics: CBC, bone marrow biopsy, and cytogenetic analysis.
6. Describe the methods of crossmatching blood for transfusions.
   • Major Crossmatch: Tests donor RBCs against recipient plasma.
   • Minor Crossmatch: Tests donor plasma against recipient RBCs.
   • Compatibility ensures safe transfusion and prevents hemolytic reactions.
7. Explain the techniques used in a complete blood count (CBC).
   • Automated analyzers measure RBCs, WBCs, platelets, hemoglobin, and hematocrit.
   • Peripheral blood smear analysis provides details on cell morphology.
8. Discuss the causes, symptoms, and treatment of thrombocytopenia.
   • Causes: Bone marrow disorders, infections, medications, or autoimmune diseases.
   • Symptoms: Bruising, bleeding gums, prolonged bleeding, and petechiae.
   • Treatment: Platelet transfusions, corticosteroids, or treatment of underlying causes.
9. Describe the role of the bone marrow in haematopoiesis.
   Bone marrow produces blood cells through:
   • Erythropoiesis: RBC production.
   • Leukopoiesis: WBC production.
   • Thrombopoiesis: Platelet production.
     Bone marrow stem cells differentiate into all blood cell types.
10. Explain the use of blood components in transfusion therapy.
    • RBCs: For anemia or blood loss.
    • Platelets: For thrombocytopenia or clotting disorders.
    • Plasma: For coagulation factor deficiencies.
    • Cryoprecipitate: For fibrinogen replacement.

Clinical Pathology

Short Questions:

1. What is the purpose of a complete blood count (CBC)?
   CBC assesses overall health by measuring red blood cells (RBCs), white blood cells (WBCs), hemoglobin, hematocrit, and platelets. It helps diagnose conditions like anemia, infections, and blood disorders.
2. Define liver function tests (LFTs).
   LFTs measure enzymes, proteins, and bilirubin levels to evaluate liver health and detect diseases like hepatitis or liver cirrhosis.
3. What are the common tests for kidney function?
   • Blood Urea Nitrogen (BUN)
   • Creatinine levels
   • Glomerular Filtration Rate (GFR)
   • Urinalysis (protein, albumin, or blood in urine)
4. What is the significance of a urinalysis?
   Urinalysis detects abnormalities in urine, such as infections, kidney diseases, or metabolic disorders like diabetes.
5. What is a Gram stain used for?
   Gram stain identifies and differentiates bacteria based on their cell wall structure, aiding in the diagnosis of bacterial infections.
6. Describe the purpose of a culture and sensitivity test.
   This test identifies pathogens causing infections and determines their antibiotic susceptibility, guiding effective treatment.
7. What is the role of urine microscopy in diagnosis?
   Urine microscopy detects cellular and non-cellular components like RBCs, WBCs, crystals, and bacteria, aiding in diagnosing urinary and kidney disorders.
8. What is an abnormal finding in a routine urinalysis?
   • Presence of glucose (glycosuria)
   • Protein (proteinuria)
   • Blood (hematuria)
   • Ketones (ketonuria)
   • Bacteria or pus cells
9. What is the normal range for hemoglobin in adults?
   • Men: 13.8–17.2 g/dL
   • Women: 12.1–15.1 g/dL
10. How is kidney disease diagnosed?
    Kidney disease is diagnosed through blood tests (creatinine, GFR), urinalysis, imaging studies (ultrasound, CT scan), and sometimes kidney biopsy.

Long Questions:

1. Discuss the importance of liver function tests in diagnosing hepatic diseases.
   LFTs provide insights into liver health by measuring:
   • ALT and AST: Elevated in liver injury.
   • Alkaline Phosphatase (ALP): Increased in bile duct obstruction.
   • Bilirubin: Indicates jaundice or liver dysfunction.
   • Albumin: Reflects liver’s synthetic function.
   • Prothrombin Time (PT): Indicates coagulation issues due to liver dysfunction.
2. Describe the procedure for a complete blood count (CBC) and its clinical significance.
   • Procedure: Blood is drawn into EDTA tubes and analyzed by automated hematology analyzers.
   • Significance:
     • Detects anemia, infections, and leukemia.
     • Evaluates RBC, WBC, platelet counts, and hemoglobin levels.
     • Identifies abnormal cell morphologies in blood smears.
3. Explain the role of urinalysis in the diagnosis of diabetes.
   Urinalysis detects glucose (glycosuria) and ketones (ketonuria) in urine, which are indicative of uncontrolled diabetes. It also monitors for complications like diabetic nephropathy.
4. Discuss the principle and significance of Gram staining in microbiology.
   • Principle: Differentiates bacteria based on cell wall properties.
   • Significance:
     • Gram-positive bacteria retain crystal violet and appear purple.
     • Gram-negative bacteria appear pink after counterstaining.
       Used to guide antibiotic therapy and diagnose bacterial infections.
5. Explain how blood cultures are used to identify pathogens.
   • Procedure: Blood is collected aseptically and incubated in culture bottles.
   • Significance:
     • Identifies bacterial or fungal bloodstream infections.
     • Determines antibiotic susceptibility for effective treatment.
6. Describe the microscopic examination of urine and what abnormalities are commonly detected.
   • Procedure: Urine is centrifuged, and the sediment examined under a microscope.
   • Abnormalities:
     • RBCs (hematuria): Indicates trauma or kidney disease.
     • WBCs (pyuria): Indicates infection.
     • Casts: Suggest renal dysfunction.
     • Crystals: Indicate kidney stones.
7. Discuss the clinical significance of kidney function tests (KFTs).
   KFTs evaluate kidney health and detect:
   • Acute or chronic kidney disease.
   • Dehydration or electrolyte imbalances.
   • Complications of diabetes or hypertension.
     Parameters: BUN, creatinine, GFR, and urine albumin.
8. Explain the diagnostic approach for urinary tract infections (UTIs) using clinical pathology techniques.
   • Urinalysis: Detects WBCs, RBCs, bacteria, and nitrites.
   • Urine Culture: Identifies causative organisms and antibiotic sensitivity.
   • Microscopy: Confirms infection via presence of pus cells or bacteria.
9. Describe the role of microbiological tests in identifying infectious diseases.
   • Culture and Sensitivity: Identifies pathogens and guides antibiotic therapy.
   • Serology: Detects antibodies or antigens (e.g., ELISA for HIV, hepatitis).
   • PCR: Amplifies pathogen DNA for precise identification.
   • Staining Techniques: Detects bacteria (Gram, Ziehl-Neelsen).
10. Explain how electrolyte imbalances are detected in clinical pathology.
    • Tests: Serum sodium, potassium, chloride, and bicarbonate levels.
    • Significance:
      • Hyponatremia: Low sodium.
      • Hyperkalemia: High potassium.
      • Hypocalcemia: Low calcium.
        Electrolyte panels help diagnose dehydration, kidney failure, or endocrine disorders.

Immunology and Serology

Short Questions:

1. What is the difference between innate and adaptive immunity?
   • Innate Immunity: The first line of defense; non-specific, rapid, and does not involve memory (e.g., skin, phagocytes).
   • Adaptive Immunity: Specific, slower to respond, and involves memory cells for long-term protection (e.g., T-cells, B-cells).
2. Define antibodies.
   Antibodies are proteins produced by B-cells (plasma cells) that bind specifically to antigens, neutralizing them or marking them for destruction.
3. Name the five major classes of immunoglobulins.
   • IgG
   • IgA
   • IgM
   • IgE
   • IgD
4. What is the function of T-cells in immunity?
   T-cells help in cell-mediated immunity:
   • Helper T-cells (CD4): Activate other immune cells.
   • Cytotoxic T-cells (CD8): Destroy infected or cancerous cells.
5. What does an ELISA test detect?
   ELISA detects antigens or antibodies in a sample, commonly used for diagnosing infections like HIV and hepatitis.
6. What is the purpose of a Western blot test?
   Western blot confirms the presence of specific proteins (e.g., antibodies or antigens) and is often used to verify ELISA results.
7. What is the role of B-cells in immunity?
   B-cells produce antibodies as part of the humoral immune response and form memory cells for faster future responses.
8. How do vaccines work in stimulating immunity?
   Vaccines introduce antigens (weakened, inactivated, or part of pathogens) to stimulate the adaptive immune system to produce memory cells.
9. Define antigen-antibody interaction.
   This is the specific binding of an antibody to its corresponding antigen, leading to immune responses like neutralization or opsonization.
10. What is a serological test used for?
    Serological tests detect antibodies or antigens in blood to diagnose infections, autoimmune diseases, or immune status.

Long Questions:

1. Discuss the components of the immune system and their functions.
   • Innate Immunity:
     • Physical barriers (skin, mucous membranes).
     • Cells: Phagocytes (macrophages, neutrophils), natural killer cells.
     • Soluble factors: Complement proteins, cytokines.
   • Adaptive Immunity:
     • Humoral: B-cells and antibodies.
     • Cellular: T-cells (helper and cytotoxic).
2. Explain how the body’s immune response works against infections.
   • Innate Immunity: Recognizes pathogens through pattern recognition receptors (PRRs). Phagocytes engulf pathogens, and cytokines recruit more immune cells.
   • Adaptive Immunity: Antigen-presenting cells (APCs) activate T-cells, which help B-cells produce specific antibodies and kill infected cells.
3. Describe the different types of antibodies and their roles.
   • IgG: Provides long-term immunity; crosses the placenta.
   • IgA: Found in mucosal areas; prevents pathogen entry.
   • IgM: First antibody produced; effective in forming antigen-antibody complexes.
   • IgE: Involved in allergic reactions and defense against parasites.
   • IgD: Functions as a receptor on immature B-cells.
4. Discuss the principle and application of ELISA in diagnosing diseases.
   • Principle: Uses enzyme-labeled antibodies to detect antigens or antibodies. A color change indicates the presence of the target molecule.
   • Applications: Diagnosing infections (HIV, hepatitis), autoimmune disorders, and allergies.
5. Explain the role of T-cells in the immune response.
   • Helper T-cells (CD4): Activate B-cells and other immune cells.
   • Cytotoxic T-cells (CD8): Kill infected or cancerous cells.
   • Regulatory T-cells: Maintain immune tolerance and prevent autoimmune diseases.
6. Describe the process of antigen-antibody reaction.
   • Steps:
     • Antibody binds specifically to its antigen.
     • Forms complexes that neutralize pathogens or mark them for destruction.
   • Outcomes: Neutralization, opsonization, agglutination, or complement activation.
7. Discuss the significance of serological tests in diagnosing infections.
   • Purpose: Detect antibodies or antigens in blood to diagnose infections.
   • Examples:
     • Rapid tests for HIV or hepatitis.
     • Widal test for typhoid fever.
     • RPR for syphilis.
8. Explain how vaccines stimulate adaptive immunity.
   • Vaccines introduce antigens, mimicking infection without causing disease.
   • Activate B-cells and T-cells to produce memory cells.
   • Provides long-term immunity against specific pathogens.
9. Describe the steps involved in performing a Western blot test.
   • Steps:
     1. Proteins are separated by electrophoresis.
     2. Transferred onto a membrane.
     3. Incubated with specific antibodies.
     4. Detected using enzyme-linked or fluorescent labels.
   • Application: Confirmatory test for HIV and other diseases.
10. Discuss the different types of immune responses (humoral, cellular).
    • Humoral Immunity:
      • Mediated by B-cells and antibodies.
      • Defends against extracellular pathogens.
    • Cellular Immunity:
      • Mediated by T-cells.
      • Defends against intracellular pathogens like viruses and cancer cells.

Microbiology and Parasitology

Short Questions:

1. What are the key differences between bacteria and viruses?
   • Bacteria: Single-celled organisms that can survive independently, have a cell wall, and can reproduce by binary fission.
   • Viruses: Non-living entities that require a host cell for replication, lack cellular structures, and consist only of genetic material (DNA or RNA) surrounded by a protein coat.
2. Name two types of fungi and their diseases.
   • Candida (Fungus): Causes candidiasis (e.g., oral thrush, vaginal yeast infections).
   • Aspergillus (Fungus): Causes aspergillosis (lung infections, especially in immunocompromised patients).
3. What is the role of the microbiota in human health?
   Microbiota refers to the community of microorganisms (bacteria, fungi, viruses) living on and in the human body. They aid in digestion, protect against pathogenic microbes, contribute to immune system development, and synthesize vitamins.
4. Describe the structure of a typical bacterial cell.
   A typical bacterial cell has a cell wall, cell membrane, cytoplasm, ribosomes, and genetic material (DNA) located in the nucleoid region. Some bacteria have flagella for movement and pili for attachment.
5. What are the types of protozoa that can cause diseases in humans?
   • Plasmodium: Causes malaria.
   • Entamoeba histolytica: Causes amoebic dysentery.
   • Trypanosoma: Causes sleeping sickness.
   • Giardia lamblia: Causes giardiasis.
6. What is the mode of transmission of malaria?
   Malaria is transmitted to humans through the bite of infected female Anopheles mosquitoes, which carry the Plasmodium parasite.
7. What is the significance of a Gram stain in microbiology?
   The Gram stain is a laboratory technique used to classify bacteria into two groups: Gram-positive (purple stain) and Gram-negative (pink stain). It helps in identifying bacterial species and determining appropriate antibiotics.
8. How are parasitic diseases transmitted to humans?
   Parasitic diseases can be transmitted via several routes:
   • Vector-borne (e.g., malaria via mosquitoes).
   • Foodborne (e.g., tapeworms from undercooked meat).
   • Waterborne (e.g., giardiasis from contaminated water).
   • Direct contact (e.g., scabies from skin-to-skin contact).
9. What are the main types of helminths?
   Helminths (parasitic worms) are classified into three main types:
   • Nematodes (roundworms): e.g., Ascaris (ascariasis), Enterobius (pinworm).
   • Cestodes (tapeworms): e.g., Taenia (tapeworm infection).
   • Trematodes (flukes): e.g., Schistosoma (schistosomiasis).
10. How can fungal infections be treated?
    Fungal infections are typically treated with antifungal medications such as:
    • Azoles (e.g., fluconazole, itraconazole).
    • Polyenes (e.g., amphotericin B).
    • Echinocandins (e.g., caspofungin).

Long Questions:

1. Discuss the differences between Gram-positive and Gram-negative bacteria and their clinical significance.
   • Gram-positive bacteria: Have a thick peptidoglycan layer, which retains the crystal violet stain, making them appear purple. They are generally more susceptible to antibiotics like penicillin.
   • Gram-negative bacteria: Have a thinner peptidoglycan layer and an outer lipid membrane, making them appear pink after staining. They are often more resistant to antibiotics and are associated with more complex infections (e.g., Escherichia coli, Pseudomonas).
2. Describe the life cycle of Plasmodium and its role in causing malaria.
   • The Plasmodium life cycle involves two hosts: the mosquito (Anopheles) and humans. Infected mosquitoes inject sporozoites into the bloodstream, which travel to the liver and mature into merozoites. These merozoites infect red blood cells, causing symptoms like fever and chills. Some merozoites develop into gametocytes, which are taken up by mosquitoes, continuing the cycle.
3. Explain the structure and replication of viruses.
   • Viruses consist of a protein coat (capsid) and genetic material (either DNA or RNA).
   • Replication:
     • The virus attaches to a host cell and injects its genetic material.
     • It uses the host’s machinery to replicate its genome and produce new viral proteins.
     • New virus particles assemble and are released, often destroying the host cell.
4. Discuss the significance of microbiological culture and sensitivity tests.
   Culture tests identify the specific microorganism causing an infection by growing it in a lab setting. Sensitivity tests determine which antibiotics are effective in treating the infection, helping clinicians choose the right treatment.
5. Explain the different forms of parasitic transmission (e.g., vector-borne, waterborne, foodborne).
   • Vector-borne: Parasitic diseases transmitted by insect vectors, e.g., malaria by Anopheles mosquitoes.
   • Waterborne: Parasites transmitted through contaminated water, e.g., Giardia causing giardiasis.
   • Foodborne: Parasites transmitted through undercooked food, e.g., tapeworms from beef or pork.
6. Describe the impact of fungal infections in immunocompromised individuals.
   In immunocompromised individuals (e.g., HIV patients, cancer patients), fungal infections like Candida and Aspergillus can be severe, leading to life-threatening conditions such as systemic infections, pneumonia, or bloodstream infections.
7. Explain the clinical features and diagnosis of tuberculosis.
   Clinical features of tuberculosis include a persistent cough, chest pain, weight loss, night sweats, and hemoptysis. Diagnosis is done through a combination of chest X-rays, sputum smear microscopy, and culture tests to identify Mycobacterium tuberculosis.
8. Discuss the role of microbiology in diagnosing and treating infections.
   Microbiology helps identify the causative organism (bacteria, viruses, fungi, or parasites) using laboratory techniques like culture, PCR, and microscopy. This guides the selection of appropriate antibiotics or antivirals and helps prevent the spread of infections.
9. Explain the pathogenic mechanisms of protozoan diseases.
   Protozoa cause disease through various mechanisms, including:
   • Invasion of tissues (e.g., Plasmodium infecting red blood cells).
   • Toxin production (e.g., Entamoeba histolytica causing ulceration in the intestines).
   • Immune evasion by altering surface proteins.
10. Discuss the treatment options for parasitic infections.
    Treatment varies depending on the parasite but often includes:

• Antimalarial drugs for Plasmodium (e.g., chloroquine, artemisinin).
• Antihelminthic drugs (e.g., mebendazole for roundworms, praziquantel for schistosomiasis).
• Antiprotozoal drugs (e.g., metronidazole for giardiasis, lumefantrine for malaria).

Medical Laboratory Management

Short Questions:

1. What are the major sections of a medical laboratory?
   • Hematology: Studies blood and blood-forming tissues.
   • Clinical Chemistry: Analyzes blood, urine, and other body fluids for chemical substances.
   • Microbiology: Identifies pathogens causing diseases (bacteria, viruses, fungi).
   • Immunology/Serology: Tests immune system responses and antigen-antibody interactions.
   • Blood Bank (Transfusion Medicine): Manages blood typing, crossmatching, and blood product transfusions.
   • Pathology: Examines tissues for disease diagnosis (histopathology).
   • Molecular Biology/Genetics: Analyzes DNA, RNA, and genetic material for disease diagnosis.
2. What is the purpose of quality control in a medical laboratory?
   Quality control ensures that laboratory results are accurate, reliable, and consistent. It involves using standardized materials, equipment calibration, and regular checks to minimize errors in tests and diagnoses.
3. Define laboratory accreditation.
   Laboratory accreditation is the formal recognition by an authorized body (e.g., NABL, ISO 15189) that a laboratory meets specific standards for quality and competence, ensuring the reliability and validity of its test results.
4. How is inventory managed in a laboratory?
   Inventory management in a laboratory involves tracking and controlling supplies, reagents, and equipment to ensure they are available when needed, within expiration dates, and stored appropriately. It includes ordering, receiving, storing, and maintaining stock levels.
5. What are standard operating procedures (SOPs)?
   SOPs are detailed, written instructions that describe how laboratory procedures should be performed to ensure consistency, safety, accuracy, and compliance with regulations.
6. What is the role of the laboratory manager?
   The laboratory manager oversees the daily operations of the lab, ensuring efficient functioning, adherence to quality control measures, staff management, inventory management, compliance with regulations, and maintaining safety standards.
7. Explain the concept of external quality assessment (EQA).
   EQA is a process where laboratories participate in proficiency testing by submitting samples to external agencies for analysis. The results are compared to ensure the laboratory is producing accurate and reliable results, and to identify areas for improvement.
8. What are biosafety measures in the laboratory?
   Biosafety measures in the lab include protocols for handling, storing, and disposing of hazardous materials (e.g., biological specimens, chemicals), personal protective equipment (PPE), waste management, and ensuring containment of infectious agents to prevent exposure to lab workers and the environment.
9. Why is continuous training important for laboratory staff?
   Continuous training ensures that laboratory staff remain up-to-date with the latest techniques, regulations, technologies, and safety protocols, leading to improved skills, enhanced accuracy in results, and compliance with industry standards.
10. What are the regulatory bodies for medical laboratories?

• NABL (National Accreditation Board for Testing and Calibration Laboratories) in India.
• CAP (College of American Pathologists) in the US.
• ISO 15189: International standard for medical laboratories.
• CLIA (Clinical Laboratory Improvement Amendments) in the US.
• FDA (Food and Drug Administration): Regulates laboratory equipment and testing kits.

Long Questions:

1. Discuss the components of a medical laboratory’s organizational structure.
   A medical laboratory’s organizational structure typically includes:
   • Laboratory Director/Pathologist: Oversees all operations.
   • Laboratory Manager: Manages day-to-day activities, staff, and resources.
   • Technical Supervisors: Specialize in specific sections (e.g., hematology, microbiology).
   • Medical Technologists/Technicians: Conduct tests and analyses.
   • Quality Control/Assurance Personnel: Ensure that procedures and results meet standards.
   • Support Staff: Handle administrative, cleaning, and logistical tasks.
2. Explain the importance of quality control and assurance in ensuring reliable laboratory results.
   Quality control (QC) and quality assurance (QA) are crucial for ensuring that lab results are accurate, reproducible, and timely. QC involves the use of control samples and equipment calibration to detect errors. QA involves systemic checks and audits to ensure laboratory processes meet regulatory standards, thereby ensuring that test results are reliable for clinical decision-making.
3. Describe the steps involved in laboratory accreditation.
   The accreditation process generally includes:
   • Application: The laboratory submits a formal request to an accrediting body.
   • Document Review: The laboratory’s policies, procedures, and documentation are evaluated.
   • On-site Inspection: Auditors assess the laboratory’s practices, equipment, and staff competency.
   • Compliance Verification: The laboratory must meet the required standards for quality, safety, and technical competence.
   • Accreditation Decision: If the laboratory meets the standards, it is granted accreditation.
4. Discuss the regulatory requirements for medical laboratories and how they ensure safety and compliance.
   Regulatory bodies establish standards to ensure laboratories provide safe and reliable testing services. These regulations cover areas such as personnel qualifications, equipment maintenance, quality control practices, safety protocols, and laboratory facilities. Compliance ensures that labs can provide accurate results, maintain patient safety, and protect the health of laboratory staff.
5. Explain the role of the laboratory manager in the day-to-day operations of the laboratory.
   The laboratory manager is responsible for overseeing laboratory operations, ensuring that staff follow SOPs, managing resources, maintaining equipment, ensuring compliance with regulations, conducting regular quality checks, troubleshooting issues, and reporting to higher management or accrediting bodies.
6. Describe how inventory management is crucial in a medical laboratory.
   Effective inventory management ensures that the laboratory has the necessary reagents, chemicals, and equipment available when needed. Proper inventory tracking prevents shortages, expiration of supplies, and unnecessary overstocking, ensuring continuous operation and reducing costs.
7. Discuss the safety protocols that must be followed to maintain a safe laboratory environment.
   Safety protocols include:
   • Personal Protective Equipment (PPE): Gloves, masks, gowns, and safety goggles.
   • Chemical Handling: Safe storage and disposal of hazardous chemicals.
   • Biological Safety: Proper handling of infectious materials and disposal of biohazardous waste.
   • Equipment Safety: Regular maintenance and calibration of laboratory instruments.
   • Emergency Procedures: Protocols for fire, chemical spills, and exposure incidents.
8. Explain how training and development programs are structured for laboratory staff.
   Training programs include initial onboarding (e.g., safety training, equipment use), periodic workshops on new technologies, continuous education on best practices, and specialized training in areas like quality control, regulatory compliance, and advanced techniques. Development programs focus on improving professional skills and ensuring staff remain competent and confident in their roles.
9. Discuss the process of implementing standard operating procedures (SOPs) in the laboratory.
   Implementing SOPs involves:
   • Development: Writing clear, detailed procedures for each laboratory task.
   • Training: Educating staff on how to follow SOPs properly.
   • Monitoring: Regular assessments to ensure compliance and identify areas for improvement.
   • Review and Updates: Periodic revisions to keep SOPs relevant to current standards and technologies.
10. Explain the role of the laboratory in patient care and diagnosis from a management perspective.
    From a management perspective, the laboratory plays a critical role in patient care by providing accurate, timely, and reliable test results that are essential for diagnosing diseases, monitoring treatment progress, and guiding clinical decisions. Proper management ensures that laboratory services are efficient, cost-effective, and compliant with healthcare standards, ultimately supporting optimal patient outcomes.

22/12/24

Advance Biochemistry

1. Which single test is appropriate to monitor thyroid function?

The TSH (Thyroid Stimulating Hormone) test is the most reliable and widely used single test to monitor thyroid function.

• Explanation:
  • TSH is a hormone secreted by the pituitary gland that stimulates the thyroid gland to produce thyroid hormones (T3 and T4).
  • In hypothyroidism (underactive thyroid), TSH levels increase because the body tries to stimulate the thyroid gland to produce more hormones.
  • In hyperthyroidism (overactive thyroid), TSH levels decrease because the thyroid gland is overproducing hormones, and the pituitary reduces TSH output.
• Normal Range:
  • 0.4–4.0 mIU/L (milli-international units per liter).
• Advantages:
  • Accurate, cost-effective, and requires a single blood sample.
  • Often used as the first-line test for screening thyroid disorders.

2. What do you mean by good cholesterol?

Good cholesterol refers to HDL (High-Density Lipoprotein) cholesterol.

• Explanation:
  • HDL removes excess cholesterol from the bloodstream and arterial walls, transporting it back to the liver for processing or excretion.
  • This process reduces plaque buildup in the arteries, lowering the risk of atherosclerosis and cardiovascular diseases.
• Normal HDL Levels:
  • Low (at risk): <40 mg/dL (men), <50 mg/dL (women).
  • Normal: 40–60 mg/dL.
  • Optimal (protective): >60 mg/dL.
• Factors that improve HDL levels:
  • Regular exercise.
  • A diet rich in healthy fats (e.g., omega-3 fatty acids).
  • Avoiding smoking and maintaining a healthy weight.

3. Name the enzyme to be estimated to diagnose chronic alcoholism.

The enzyme Gamma-Glutamyl Transferase (GGT) is used to diagnose chronic alcoholism.

• Explanation:
  • GGT is an enzyme found in the liver, bile ducts, and kidneys.
  • Chronic alcohol consumption increases GGT levels due to liver damage or inflammation.
  • Elevated GGT levels are commonly observed in conditions like alcoholic liver disease and fatty liver.
• Normal Range:
  • Male: 7–50 U/L.
  • Female: 5–40 U/L.

4. Which protein is excreted in normal urine?

Tamm-Horsfall protein (uromodulin) is excreted in normal urine.

• Explanation:
  • It is a glycoprotein produced by the epithelial cells of the loop of Henle in the kidneys.
  • It serves protective functions, such as preventing bacterial adhesion to the urinary tract and inhibiting kidney stone formation.
• Excretion Levels: Small amounts (10–20 mg per day) are excreted under normal conditions.

5. What happens to the specific gravity of urine in chronic renal failure?

In chronic renal failure, the specific gravity of urine becomes fixed around 1.010.

• Explanation:
  • Specific gravity reflects the concentration of solutes in urine.
  • In chronic renal failure, the kidneys lose their ability to concentrate or dilute urine due to nephron damage.
  • As a result, urine osmolality becomes similar to plasma osmolality (isosthenuria).

6. What is the Creatinine Clearance Test?

The Creatinine Clearance Test measures the rate at which creatinine is cleared from the blood by the kidneys, assessing their filtration efficiency.

• Explanation:
  • Creatinine is a waste product of muscle metabolism, excreted entirely by the kidneys.
  • The test involves collecting a 24-hour urine sample and a blood sample.
• Calculation:Creatinine Clearance (mL/min)=Urine creatinine (mg/dL) × Urine volume (mL/min)Serum creatinine (mg/dL)\text{Creatinine Clearance (mL/min)} = \frac{\text{Urine creatinine (mg/dL) × Urine volume (mL/min)}}{\text{Serum creatinine (mg/dL)}}Creatinine Clearance (mL/min)=Serum creatinine (mg/dL)Urine creatinine (mg/dL) × Urine volume (mL/min)​
• Normal Range:
  • Males: 90–140 mL/min.
  • Females: 80–125 mL/min.

Hematology and Blood Banking

1. What is the classification of antibodies?

Antibodies (immunoglobulins) are classified into five major types based on their structure and function:

1. IgG:
   • Most abundant antibody in the blood and extracellular fluid.
   • Provides long-term immunity after infection or vaccination.
   • Crosses the placenta to protect the fetus.
2. IgA:
   • Found in mucosal secretions (e.g., saliva, tears, and breast milk).
   • Protects mucosal surfaces from infection.
3. IgM:
   • First antibody produced during an immune response.
   • Effective in forming antigen-antibody complexes.
4. IgE:
   • Involved in allergic reactions and defense against parasitic infections.
5. IgD:
   • Functions as a receptor on immature B-cells.
   • Role in initiating B-cell activation.

2. How will you discard an HIV-positive blood bag?

Disposing of an HIV-positive blood bag requires strict adherence to biohazard protocols:

• Steps:
  1. Label the bag as biohazard.
  2. Place it in a designated biohazard container.
  3. Incinerate the bag in a high-temperature biohazard disposal facility.
  4. Use personal protective equipment (PPE) during handling to prevent accidental exposure.
  5. Follow institutional and national biomedical waste disposal guidelines.

3. Explain the composition of blood.

Blood is a complex fluid comprising:

1. Plasma (55%):
   • Water (90%), electrolytes, nutrients, hormones, and plasma proteins (albumin, globulin, fibrinogen).
2. Formed Elements (45%):
   • Red Blood Cells (RBCs): Carry oxygen using hemoglobin.
   • White Blood Cells (WBCs): Defend against infections (neutrophils, lymphocytes, monocytes, eosinophils, basophils).
   • Platelets: Help in blood clotting.

4. What is Hemoglobin? Note down the value of Hemoglobin.

Hemoglobin is a protein in RBCs responsible for oxygen transport.

• Structure: Composed of globin (protein chains) and heme (iron-containing groups).
• Normal Values:
  • Males: 13.8–17.2 g/dL.
  • Females: 12.1–15.1 g/dL.
  • Children: 11–16 g/dL.

5. Discuss hemoglobin estimation by cyanmethemoglobin method.

• Principle: Hemoglobin reacts with potassium cyanide and potassium ferricyanide to form a stable cyanmethemoglobin compound, measured spectrophotometrically.
• Procedure:
  1. Add blood to Drabkin’s reagent.
  2. Allow it to stand for 10 minutes for reaction.
  3. Measure absorbance at 540 nm.

6. How will you perform the test for reticulocyte?

• Procedure:
  1. Mix blood with a supravital dye (e.g., new methylene blue).
  2. Incubate for 15 minutes.
  3. Make a blood smear and examine under a microscope.
  4. Count reticulocytes as a percentage of total RBCs.
• Normal Range: 0.5–2.5% of RBCs.

Clinical Pathology

1. What is the process of Urine Analysis?

Urine analysis (urinalysis) is performed to detect abnormalities in urine that reflect systemic diseases or urinary tract disorders. It includes three main components:

1. Physical Examination:
   • Color: Indicates hydration or pathological conditions (e.g., red in hematuria).
   • Clarity: Clear, turbid, or cloudy.
   • Specific Gravity: Assesses urine concentration (normal: 1.005–1.030).
2. Chemical Examination:
   • Reagent Strips: Test for pH, glucose, protein, ketones, blood, bilirubin, and nitrites.
3. Microscopic Examination:
   • Identifies RBCs, WBCs, epithelial cells, bacteria, casts, and crystals.

2. What is the method of H & E staining?

Hematoxylin and Eosin (H&E) staining is a routine stain in histopathology used to differentiate cellular components in tissues.

1. Principle:
   • Hematoxylin stains nuclei blue (basic dye).
   • Eosin stains cytoplasm and extracellular matrix pink (acidic dye).
2. Method:
   • Fix the tissue in formalin.
   • Dehydrate in graded alcohol.
   • Stain with hematoxylin, rinse in water.
   • Differentiate in acid-alcohol.
   • Counterstain with eosin.
   • Dehydrate, clear in xylene, and mount.

3. Write down the technique of Decalcification.

Decalcification is the process of removing calcium from hard tissues (bones, teeth) to enable sectioning.

1. Methods:
   • Acidic Decalcifiers: e.g., Nitric acid (5–10%), Formic acid (10%).
   • Chelating Agents: e.g., EDTA (binds calcium without damaging tissue).
2. Procedure:
   • Fix tissue.
   • Immerse in decalcifying solution.
   • Test for end-point decalcification (e.g., bending test or chemical test).
   • Rinse, process, and embed.

4. Technique of Mounting

Mounting is the process of placing a coverslip over a stained tissue section to preserve it.

1. Steps:
   • After staining, sections are cleared in xylene.
   • Apply a drop of mounting medium (e.g., DPX) on the tissue section.
   • Gently place the coverslip to avoid bubbles.
   • Allow to dry.

5. Describe Microtome

A microtome is an instrument used to cut extremely thin tissue sections for microscopic examination.

• Types:
  • Rotary microtome (common in histology).
  • Cryostat microtome (for frozen sections).
• Working Principle:
  • A sharp blade slices the tissue embedded in a block (e.g., paraffin or frozen).
  • The section thickness is adjustable (typically 3–5 microns).

6. Explain Cerebrospinal Fluid (CSF)

CSF is a clear fluid that surrounds the brain and spinal cord, providing cushioning and nutrient transport.

1. Composition:
   • Proteins, glucose, electrolytes, and minimal WBCs.
2. Functions:
   • Protects CNS from trauma.
   • Removes waste products.
3. Clinical Examination:
   • Lumbar puncture is used to collect CSF for analysis of infections (e.g., meningitis) or diseases (e.g., multiple sclerosis).

Community Development Activities

1. Scope of Extension Education

Extension education aims to disseminate knowledge and skills to improve rural and urban community living standards.

1. Scope:
   • Agriculture and farming techniques.
   • Health and sanitation.
   • Literacy and skill development.
   • Women empowerment.
2. Methods:
   • Demonstrations, field visits, training sessions.

2. Describe HIV

HIV (Human Immunodeficiency Virus) is a retrovirus that attacks the immune system, specifically CD4+ T cells.

1. Transmission:
   • Blood, semen, vaginal fluids, breast milk.
2. Symptoms:
   • Acute flu-like illness followed by a long asymptomatic phase.
3. Treatment:
   • Antiretroviral therapy (ART).

3. Nature and Scope of Rural and Urban Community Development in India

• Rural Development: Focuses on agricultural productivity, infrastructure, health, and education.
• Urban Development: Targets housing, sanitation, public transportation, and waste management.

4. What is Community Development Program?

A community development program aims to empower local populations to address their social, economic, and cultural needs.

5. Causes of Pollution

• Air Pollution: Emissions from industries, vehicles.
• Water Pollution: Industrial waste, agricultural runoff.
• Soil Pollution: Pesticides, improper waste disposal.

6. Comments on AIDS

AIDS (Acquired Immunodeficiency Syndrome) is the final stage of HIV infection characterized by severe immunosuppression, leading to opportunistic infections.

Advanced Histopathology

1. Mechanism of Clotting and Bleeding Disorder Tests

• Clotting Mechanism:
  1. Vascular spasm.
  2. Platelet plug formation.
  3. Coagulation cascade (intrinsic/extrinsic pathways).
• Tests:
  • PT/INR: Evaluates extrinsic pathway.
  • APTT: Assesses intrinsic pathway.
  • Bleeding Time: Tests platelet function.

2. Tissue Fixation

Fixation preserves tissues by preventing decomposition.

• Fixatives:
  • Formalin (10% neutral buffered).
  • Bouin’s solution.

3. Notes on Barr Body

A Barr body is an inactivated X chromosome in females, visible as a dense spot in the nucleus during interphase.

4. Tissue Processing

• Principle: Prepare tissues for sectioning by dehydration, clearing, and embedding.
• Procedure:
  1. Fixation.
  2. Dehydration in alcohol.
  3. Clearing with xylene.
  4. Embedding in paraffin.

5. Notes on Kaiserling Solution

Kaiserling solution is used for preserving and restoring the natural color of specimens for teaching and demonstration purposes.

6. Concept of Frozen Section

A frozen section involves rapid freezing of tissues for immediate pathological examination, often during surgeries.

1. Procedure:
   • Tissue is frozen using liquid nitrogen.
   • Sections are cut in a cryostat and stained for rapid diagnosis.