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CDL Past MCQ/BAQ

Total questions: 98

Worksheet time: 3570secs

Name
Class
Date
1.

A 19-year-old anxious girl presents with numbness and carpal spasm. Arterial blood gas shows low HCO₃⁻ and low pCO₂. What is the most likely acid–base imbalance?

a)

Respiratory acidosis

b)

Respiratory alkalosis

c)

Metabolic acidosis

d)

Metabolic alkalosis

2.

A 50-year-old patient has macrocytic red blood cells. What is the most likely cause?

a)

Iron deficiency anaemia

b)

Alcohol use

c)

Thalassaemia

d)

[Other cause]

3.

A 30-year-old woman presents with 6 months of progressive loss of appetite, cough, night sweats, and weight loss. Chest X-ray shows a right upper lobe cavity. Biopsy shows necrosis, and microscopy reveals acid-fast bacilli (AFB) within epithelioid cells. What is the origin of the epithelioid cells?

a)

Macrophage

b)

Lymphocyte

c)

Fibroblast

d)

[Other]

4.

A patient presents with bloody diarrhoea. Laboratory culture shows a non-sorbitol fermenter and H₂S-negative organism. What is the most likely causative agent?

a)

Enterohemorrhagic Escherichia coli

b)

Shigella

c)

Enterotoxigenic Escherichia coli

d)

Enteroinvasive Escherichia coli

5.

A blood bag is received from another blood bank. Which test must be repeated after receiving it?

a)

Hepatitis B surface antibody (HepB Ab)

b)

Reverse ABO grouping

c)

Forward ABO grouping

d)

Antibody screening

6.

A 25-year-old woman presents with congestive heart failure. She has a history of intermittent hypertensive attacks triggered by emotional stress. Examination reveals a right abdominal mass. CT confirms a retroperitoneal mass. Twenty-four-hour urinary metanephrines and vanillylmandelic acid are elevated. Surgery is performed after medical therapy. What is the most likely diagnosis?

a)

Liposarcoma

b)

Neuroblastoma

c)

Phaeochromocytoma

d)

Renal cell carcinoma

7.

A 22-year-old nurse working in a paediatric ward develops headache, runny nose, and remains afebrile. She recovers after 3 days. What is the most likely causative organism?

a)

Rhinovirus

b)

Coronavirus

c)

Influenza virus

d)

Paramyxovirus

8.

A 50-year-old man with a 30-year history of heavy smoking presents with chronic cough and wheezing. Examination shows hyperventilation and increased chest diameter. FEV₁/FVC ratio is reduced. During admission, he develops a pneumothorax. What is the most likely cause?

a)

Asthma

b)

Emphysema

c)

Bronchiectasis

d)

Chronic bronchitis

9.

A 3-year-old girl presents with generalised oedema. Laboratory results show marked albuminuria, hypoalbuminaemia, and hyperlipidaemia. She has had similar episodes previously, which responded to steroid therapy. What is the most likely diagnosis?

a)

Focal segmental glomerulosclerosis

b)

Post-streptococcal glomerulonephritis

c)

Minimal change disease

d)

Membranous glomerulonephritis

10.

A 25-year-old Kadazan–Dusun man is found to be anaemic during a blood donation campaign. He is asymptomatic, active in sports, and has no significant medical history. Investigations: • Haematocrit: 0.36 • Haemoglobin: 104 g/L • RBC: 5.8 × 10¹²/L • WBC: 8.0 × 10⁹/L • Platelets: 369 × 10⁹/L • MCV: 62 fL (80–100) • MCH: 18 pg (27–33) • MCHC: 29% (32–36) Peripheral blood film: hypochromic, microcytic red cells, mild anisocytosis, occasional target cells, no basophilic stippling. What is the most likely diagnosis?

a)

Thalassaemia carrier

b)

Sports anaemia

c)

Iron deficiency anaemia

d)

Sideroblastic anaemia

11.

A 40-year-old woman presents with weight loss, increased appetite, and diplopia. Examination reveals tachycardia, tremor, and bilateral corneal ulceration. TSH is suppressed (0.1 uU/mL). Radioiodine scan shows increased diffuse uptake in the thyroid. What is the most likely diagnosis?

a)

Toxic multinodular goitre

b)

Autoimmune thyroiditis

c)

Graves’ disease

d)

Solitary toxic adenoma

12.

A 69-year-old diabetic woman presents with dysuria and haematuria. Urine dipstick shows leucocytes (++++) and erythrocytes (++). Midstream urine sample is sent for culture. Which is the most suitable agar for this culture?

a)

Nutrient agar

b)

Blood agar

c)

MacConkey agar

d)

Hektoen enteric agar

13.

A 26-year-old woman presents with left-sided abdominal pain. Examination reveals enlargement of the left ovary. Left oophorectomy is performed. Histology shows a cystic tumour lined by stratified squamous epithelium with sebaceous glands, hair shafts, and other skin adnexal structures. What is the most likely diagnosis?

a)

Struma ovarii

b)

Brenner tumour

c)

Mature ovarian teratoma

d)

Germ cell tumour

14.

A 28-year-old man presents with symptomatic anaemia and gum bleeding. FBC: • Hb: 7 g/dL • RBC: 2.8 × 10¹²/L • WBC: 78 × 10⁹/L • Platelets: 17 × 10⁹/L Peripheral blood film: 60% blast cells, some with Auer rods. Which investigation is most specific for confirming the diagnosis?

a)

Morphology of trephine biopsy

b)

Morphology of bone marrow aspirate

c)

Cytogenetic study of bone marrow aspirate

d)

Immunophenotyping of bone marrow aspirate

15.

A 40-year-old man presents with a solitary, non-tender nodule on the left side of his neck and hoarseness of voice. Thyroid function tests are normal. Excisional biopsy shows malignant cells forming branching structures with fibrovascular stalks, orphan Annie eye nuclei, psammoma bodies, and inclusion bodies. What is the most likely diagnosis?

a)

Papillary carcinoma of the thyroid

b)

Follicular carcinoma of the thyroid

c)

Medullary carcinoma of the thyroid

d)

Anaplastic carcinoma of the thyroid

16.

Which organism is the most common cause of catheter-associated urinary tract infections worldwide?

a)

Klebsiella spp.

b)

Salmonella spp.

c)

Escherichia coli

d)

Proteus vulgaris

17.

Which of the following is associated with nephrotic syndrome?

a)

Proteinuria > 3 g/24 hours

b)

Presence of epithelial cell casts in urine

c)

Lipiduria and hypercholesterolaemia

d)

Haematuria > 10 RBCs/high-power field

18.

A 28-year-old man presents with lethargy, dyspnoea, sore throat for several weeks, and gum bleeding for a few days. FBC: Hb 17 g/dL, RBC 2 × 10¹²/L, leukocytosis, platelets 25 × 10⁹/L. Peripheral blood film: 28% blast cells, some with Auer rods. Which investigation is most specific for determining prognosis?

a)

Cytochemical staining

b)

Cytogenetic analysis

c)

Immunophenotyping

19.

A 42-year-old woman presents with sudden-onset abdominal pain radiating to the back. She denies alcohol or drug use. Examination reveals guarding and rigidity. Laboratory tests show raised serum amylase and hypocalcaemia. What is the most likely diagnosis?

a)

Acute pancreatitis

b)

Acute cholecystitis

c)

Acute viral hepatitis

20.

A 2-year-old child presents with fever, vesicular lesions on the hands and soles, and ulcers on the lower lip mucosa. What is the most likely causative organism?

a)

Varicella zoster virus

b)

Measles virus

c)

Rubella virus

d)

Enterovirus 71

21.

A pedigree shows: • Generation I: Mother affected, father unaffected. • Generation II: Four siblings (M, F, M, F) all affected. • Generation III: o Children of first sibling (M): all unaffected. o Second sibling (F): no children. o Children of third sibling (M): all unaffected. o Children of fourth sibling (F): all affected. What is the most likely mode of inheritance?

a)

Mitochondrial

b)

X-linked recessive

c)

X-linked dominant

d)

Autosomal recessive

22.

A 40-year-old man presents with fatigue, gum bleeding, sore throat for 3 days, and multiple bruises on the limbs. Examination reveals no hepatosplenomegaly. FBC: Hb low, platelets low, WBC high, and one more cell line decreased. Peripheral blood film: Auer rods present. Which investigation is most specific for prognosis?

a)

Cytochemical staining

b)

Cytogenetic analysis

c)

Immunophenotyping

23.

A 20-year-old woman presents with progressive bilateral central vision loss. Detailed family history and pedigree analysis are performed. Which inheritance pattern most likely explains this case?

a)

Autosomal recessive

b)

Autosomal dominant

c)

Mitochondrial

d)

X-linked recessive

e)

X-linked dominant

24.

Which statements regarding parasites are correct?

a)

Pinworm can be diagnosed using the scotch tape test

b)

Eosinophilia suggests helminth infection

c)

Stool samples for ova should be frozen

25.

Which statements about Hepatitis B serology are correct?

a)

HBsAg negative, Anti-HBs positive, Anti-HBc negative — indicates vaccination

b)

HBsAg negative, Anti-HBs negative, Anti-HBc positive — indicates recovery

c)

HBsAg positive, Anti-HBc IgG positive, HBeAg negative — acute infection

d)

HBsAg positive, Anti-HBc IgM positive, HBeAg negative — chronic infection with high transmissibility

e)

HBsAg positive, Anti-HBc IgM positive, HBeAg positive — acute infection with high transmissibility

26.

Which of the following are causes of immunoassay interference?

a)

Electrolyte interference

b)

Haemolysed sample

c)

High-dose hook effect

d)

Cross-reactivity

e)

Endogenous antibodies

27.

Which findings are consistent with Cushing’s disease due to adrenal adenoma?

a)

Increased serum ACTH

b)

Increased urinary cortisol

c)

Decreased serum cortisol at midnight

d)

Suppressed cortisol with low-dose dexamethasone test

e)

Suppressed cortisol with high-dose dexamethasone test

28.

Which are causes of hypercalcaemia?

a)

Conn’s syndrome

b)

Thiazide diuretics

c)

Multiple myeloma

d)

Vitamin D deficiency

e)

Squamous cell carcinoma of the lung

29.

Which statements regarding carcinoembryonic antigen (CEA) are correct?

a)

Raised in diverticulitis

b)

Increased in pregnancy

c)

Useful for screening colorectal cancer

30.

Anaemia of chronic disease is associated with:

a)

Low serum iron

b)

Low total iron-binding capacity (TIBC)

c)

High ferritin

d)

High transferrin

31.

Which findings may be present in a patient with disseminated intravascular coagulation (DIC)?

a)

High platelet count

b)

High D-dimer

c)

Prolonged PT

d)

Prolonged APTT

e)

Positive fibrin degradation products (FDP)

32.

Which statements about Plasmodium knowlesi infection are correct?

a)

Severe infection can cause pulmonary oedema

b)

Infection is carried by female Aedes aegypti mosquitoes

c)

Associated with blackwater fever

d)

Can recur after initial treatment

33.

Which statements regarding molecular genetics are correct?

a)

Fusion gene in leukaemia can be detected by PCR

b)

Fusion gene in leukaemia can be detected by FISH

c)

Nucleotide deletion in cystic fibrosis can be diagnosed by FISH

d)

Nucleotide deletion in cystic fibrosis can be diagnosed by Southern hybridisation with long DNA probe

e)

Trinucleotide repeat in Huntington’s disease can be detected by PCR

34.

Information required for histopathological staging includes:

a)

Tumour architecture

b)

Nuclear pleomorphism of tumour cells

c)

Vascular invasion by tumour cells

d)

Lymph node metastases

e)

Involvement of surgical margins with tumour cells

35.

Pheochromocytoma:

a)

Is associated with oat-cell carcinoma of the lung

b)

Causes hyperpigmentation of the skin

c)

Shows increased resting plasma catecholamine levels

d)

Presents with hypertension

e)

Arises in the adrenal medulla

36.

Taking blood proximal to an intravenous dextrose/saline infusion site can cause:

a)

Increased triglycerides

b)

Increased sodium

c)

Increased potassium

d)

Increased albumin

e)

Reduced glucose

37.

Causes of hypocalcaemia include:

a)

Multiple myeloma

b)

Chronic renal failure

c)

Hypoparathyroidism

d)

Acute pancreatitis

e)

Pheochromocytoma

38.

Which test is correctly matched with its collection tube?

a)

Full blood count: EDTA tube

b)

Erythrocyte sedimentation rate: Sodium citrate tube

c)

Direct ABO grouping: Plain tube

d)

Haemostatic screening: Sodium citrate tube

e)

Peripheral blood film: Heparin tube

39.

Likely viral agents for gastroenteritis in a 9-month-old boy:

a)

Astrovirus

b)

Adenovirus

c)

Enterovirus 71

d)

Norovirus

e)

Rotavirus A

40.

Haemophilia A and von Willebrand disease can be differentiated by:

a)

Bleeding time (BT)

b)

Platelet aggregation test

c)

Thrombin time (TT)

d)

Activated partial thromboplastin time (APTT)

e)

Prothrombin time (PT)

41.

‘Group, screen and hold’ procedure in blood banking:

a)

Is indicated for cases with high certainty for transfusion

b)

Is practised when irregular red cell antibodies are found

c)

Avoids artificial shortage of blood stock

d)

Includes cross-matching

e)

Allows blood to be issued quickly when needed

42.

Plasmodium falciparum:

a)

Malaria patient may present with blackwater fever

b)

Is identified by thin blood film with Leishman stain

c)

Is associated with recurrent relapses after treatment

d)

Infection is typically associated with thrombocytopenia

e)

Is transmitted by female Anopheles mosquitoes

43.

Characteristic features of Conn’s syndrome include:

a)

Polyuria

b)

Glycosuria

c)

Hand tremor

d)

Hypertension

e)

Hypokalaemia

44.

Expected laboratory findings in untreated chronic iron deficiency anaemia:

a)

Thrombocytosis

b)

Increased reticulocyte count

c)

Increased MCV

d)

Reduced serum ferritin

e)

Increased TIBC

45.

Morphological classification of anaemia is based on:

a)

Reticulocyte count

b)

Red cell distribution width (RDW)

c)

Mean corpuscular volume (MCV)

d)

Mean corpuscular haemoglobin (MCH)

e)

Mean corpuscular haemoglobin concentration (MCHC)

46.

Microbial infections detectable in a Pap smear:

a)

Giardia lamblia

b)

Candida albicans

c)

Toxoplasma gondii

d)

Trichomonas vaginalis

e)

Herpes simplex virus

47.

Regarding nosocomial infections:

a)

Rotavirus can cause gastroenteritis in adults

b)

Respiratory syncytial virus commonly causes bronchiolitis in paediatric wards

c)

Bacteroides fragilis is often isolated in peritonitis after bowel surgery

d)

Pseudomonas aeruginosa is the most common cause of ventilator-associated pneumonia

e)

Methicillin-resistant Staphylococcus aureus is an important pathogen in open wound infections

48.

Routine blood screening includes:

a)

ABO group

b)

Rh group

c)

Cytomegalovirus (CMV) testing

d)

HIV testing

e)

Blood culture

49.

Western blot results for muscular dystrophy interpretation — which are correct?

a)

Sample P has longer dystrophin protein

b)

Sample Q has normal length dystrophin

c)

Sample R has no dystrophin protein

d)

Sample P has reduced amount of dystrophin

e)

Sample Q has normal dystrophin

50.

FNAC is useful in diagnosing:

a)

Lymphoma

b)

Squamous cell carcinoma of the cervix (via Pap smear)

51.

Recognised adverse effects of blood transfusion include:

a)

Sepsis

b)

Haemolysis

c)

Hypercalcaemia

d)

Hypothermia

e)

Reduced oxygen–haemoglobin affinity

52.

Artefactual results when blood is taken proximal to an IV infusion:

a)

Increased sodium (normal saline)

b)

Reduced glucose

c)

Increased albumin

d)

Reduced oxygen–haemoglobin affinity

e)

Increased LDH

53.

Causes of hypokalaemia include:

a)

Diarrhoea

b)

Renal failure

c)

Conn’s syndrome

d)

Phaeochromocytoma

e)

Iatrogenic causes

54.

Cushing’s disease caused by adrenal adenoma — possible findings:

a)

Increased ACTH

b)

Increased morning serum cortisol

c)

Decreased evening serum cortisol

d)

Suppression with low-dose dexamethasone

e)

Suppression with high-dose dexamethasone

55.

Dengue fever — correct statements:

a)

Caused by a flavivirus

b)

Incubation period is 2–3 weeks

c)

Spread by Aedes albopictus

d)

Transmitted vertically

e)

Best confirmed by dengue-specific IgG

56.

Special stains and their uses:

a)

Mucicarmine — parasite detection

b)

Ziehl–Neelsen — acid-fast bacilli (AFB)

c)

Von Kossa — fungal detection

d)

Oil Red O — fat detection

e)

Congo red — amyloid detection

57.

Components of a full blood count (FBC):

a)

Haematocrit

b)

Haemoglobin

c)

Reticulocyte count

d)

Differential count

e)

Platelet count

58.

Regarding molecular genetics:

a)

Fusion gene in leukaemia detected by PCR

b)

Fusion gene in leukaemia detected by FISH

c)

Nucleotide deletion in cystic fibrosis detected by FISH

d)

Nucleotide deletion in cystic fibrosis detected by Southern hybridisation with long DNA probe

e)

Trinucleotide repeat in Huntington’s disease detected by PCR

59.

Which test and collection tube pairing is correct?

a)

LFT — heparin

b)

TFT — sodium fluoride

c)

FBC — EDTA

d)

Coagulation profile — sodium citrate

e)

Renal profile — plain tube

60.

Which statement regarding laboratory error is correct?

a)

Delay in transport causes low glucose in results

b)

Sodium citrate tube is used for STAT samples

c)

High lipid levels cause pseudohyponatraemia

d)

There is an age-related reference range for sodium

e)

Haemolysis causes pseudohyperkalaemia

61.

Blood taking proximal to a Dextrose/NS infusion site can cause high levels of:

a)

Glucose

b)

Triglycerides

c)

Lipid

d)

Sodium

e)

Chloride

62.

Which of the following must be screened for in blood transfusion?

a)

Cytomegalovirus antibody

b)

HIV

c)

ABO blood group

d)

Rh blood group

63.

Which of the following are anaemia-related investigations?

a)

Ferritin

b)

Renal profile

c)

FOBT

d)

Lipid profile

64.

Which statements are correct?

a)

Sutures indicate surgical orientation

b)

10% alcohol fixation is used

c)

Macroscopic features can be omitted from the report

d)

Congo red stain is used for amyloid

e)

Examination of margins is useful for staging

65.

Immunohistochemistry is used for which purposes?

a)

Identifying the cell of origin in metastatic carcinoma

b)

Prognostication of breast carcinoma

c)

Identifying fungal bodies in granulomatous lesions

d)

Classifying types of lymphoma

e)

Estimating the amount of fibrosis in tissue

66.

Causes of hypercalcaemia include:

a)

Conn’s syndrome

b)

Chronic renal failure

c)

Multiple myeloma

d)

Vitamin D deficiency

e)

Squamous cell carcinoma of the lung

67.

FNAC helps in diagnosis of:

a)

Follicular adenoma of thyroid

b)

Tuberculous lymphadenopathy

c)

Lymphoma

d)

Ovarian cyst

e)

Squamous cell carcinoma of the cervix

68.

Alpha-fetoprotein (AFP):

a)

Produced by the fetal gut

b)

Tumour marker for choriocarcinoma

c)

Increased in pregnancy

d)

Tumour marker for testicular cancer

e)

Tumour marker for hepatocellular carcinoma

69.

Leptospirosis:

a)

Microorganism shed from renal tubules

b)

Gram-positive bacilli

c)

Spread via animal urine

d)

Microscopic agglutination test (MAT) is diagnostic

e)

Incubation period is 7–10 days

70.

Anaemia in chronic renal failure:

a)

Responds well to folic acid

b)

Greatly improved by dialysis

c)

Normochromic normocytic

d)

Associated with reduced erythropoietin

e)

Most common in polycystic kidney disease

71.

Recognised adverse effects of blood transfusion include:

a)

Sepsis

b)

Haemolysis

c)

Hypothermia

d)

Hypercalcaemia

e)

Reduced oxygen–haemoglobin affinity

72.

Molecular diagnosis:

a)

Fusion gene in leukaemia detected by PCR

b)

Fusion gene in leukaemia detected by FISH

c)

Three-nucleotide deletion in cystic fibrosis detected by FISH

d)

Three-nucleotide deletion in cystic fibrosis detected by Southern hybridisation with DNA probe

e)

Trinucleotide repeat expansion in Huntington’s disease detected by PCR

73.

A patient has bloody diarrhoea. Stool culture shows a non–sorbitol-fermenting, H₂S-negative organism.
What is the most likely causative agent?

a)

  • Enterohemorrhagic Escherichia coli

b)

  • Shigella

c)

  • Enterotoxigenic Escherichia coli

d)

  • Enteroinvasive Escherichia coli

74.

Restriction Fragment Length Polymorphism (RFLP) uses restriction enzymes to detect DNA mutations.
Which property of restriction enzymes is most important for this purpose?

a)

  • Low cost

b)

  • High specificity

c)

  • Ease of handling

d)

  • Easy availability

75.

A patient taking NSAIDs for joint pain develops mid-sternal pain. OGDS shows punctate haemorrhages on the gastric mucosa. Biopsy: mucosal erosion without ulceration.
What is the most likely diagnosis?

a)

  • Acute gastritis

b)

  • Chronic gastritis

c)

  • Chronic active gastritis

d)

  • Peptic ulcer disease

76.

Following acute blood loss, what change is expected in haemoglobin and haematocrit?

a)

  • Both increase

b)

  • Both decrease

c)

  • Hb decrease, Hct decrease

d)

  • Hb normal, Hct decrease

77.

No granuloma is seen on histology.
Which organism is least likely?

a)

  • Mycobacterium tuberculosis

b)

  • Mycobacterium avium

c)

  • Mycobacterium leprae

78.

In a breast cancer patient post-mastectomy, which should be tested before initiating targeted therapy with trastuzumab (Herceptin)?

a)

  • HER2 receptor status

b)

  • Oestrogen receptor status

c)

  • Progesterone receptor status

d)

  • BRCA1 mutation

79.

Neoplastic tumours include:

a)

Tubular adenoma

b)

Villous adenoma

c)

Hyperplastic polyp

d)

Peutz–Jeghers polyp

e)

Inflammatory polyp

80.

Cystic fibrosis can be detected by:

a)

FISH

b)

Southern hybridisation using oligonucleotide probe

c)

Southern hybridisation using long probe

d)

PCR followed by Southern with long probe

e)

PCR

81.

Langhans giant cells:

a)

Act as antigen-presenting cells of skin

b)

Seen in tuberculosis

c)

Nuclei scattered around cytoplasm

d)

Central clear area surrounded by peripheral nuclei

82.

Immunophenotype of B-cell acute lymphoblastic leukaemia:

a)

CD7

b)

CD19

c)

CD33

d)

CD34

e)

CD79α

83.

Nosocomial infections:

a)

Most common is UTI

b)

Considered UTI if ≥10⁴ organisms/ml urine

c)

Common cause of UTI — E. coli

d)

Common cause of mortality

e)

Occurs >48 hours after hospital admission

84.

Pre-analytical errors include:

a)

Prolonged tourniquet application

b)

Milking puncture site for blood

c)

Taking sample from IV drip site

d)

Shaking sample bottle vigorously

85.

Specimens used in cytogenetic testing:

a)

Amniotic fluid

b)

Bone marrow

c)

Chorionic villus

d)

Cerebrospinal fluid

e)

Peripheral blood

86.

Causes of macrocytic anaemia include:

a)

Anaemia of pregnancy

b)

Anaemia of chronic blood loss

c)

Pernicious anaemia

d)

Folate deficiency

e)

Alcoholism

87.

In general, malignant tumours:

a)

  • Are mobile upon palpation

b)

  • Are cystic

c)

  • Have nuclear pleomorphism

d)

  • Invade surrounding tissue

e)

  • Have a well-circumscribed margin

88.

Specimens suitable for cytogenetic testing include:

a)

  • Cerebrospinal fluid (CSF)

b)

  • Buccal swab

c)

  • Urine

d)

  • Peripheral blood

e)

  • Bone marrow

89.

Indirect antihuman globulin test is used for:

a)

  • ABO grouping

b)

  • Rhesus grouping

c)

  • Crossmatching

d)

  • Antibody detection

90.

Blood collection tube pairing:

a)

  • GXM — EDTA

b)

  • Coagulation profile — Sodium heparin

c)

  • Fibrinogen level — Sodium citrate

d)

  • Full blood count — EDTA

e)

  • Renal profile — Plain tube

91.

Causes of falsely elevated MCV include:

a)

  • Hypoglycaemia

b)

  • Marked leucocytosis

c)

  • Prolonged sample storage

d)

  • Haemolysed sample

e)

  • Cold agglutinin

92.

Microbiology specimen handling:

a)

  • Fungal samples can be sent at room temperature

b)

  • Dry swab is suitable for nasal specimen collection

c)

  • CSF should be frozen

d)

  • Wound swab is useful for deep wound exudate

93.

Parasitology specimen handling:

a)

  • DNA for molecular testing can be sent at room temperature

b)

  • Scotch tape test is done early in the morning before bathing

c)

  • Blood for Brugia malayi is taken at night

d)

  • Formalin is used for delayed specimen examination

94.

A 29-year-old woman presents with unintentional weight loss, excessive sweating, heat intolerance, and diarrhoea. Physical examination shows exophthalmos, tachycardia, and diffusely enlarged thyroid with bruit. What is the expected finding on thyroid function test (TFT)?

a)

  • Low TSH, high free T₄

b)

  • High TSH, normal free T₄

c)

  • Low TSH, normal free T₄

d)

  • High TSH, low free T₄

95.

A woman undergoes lumpectomy for a suspected breast mass lesion. The surgeon immediately fixes and sends the sample to the lab. Histopathology examination cannot be performed due to inadequate fixation. What is the appropriate method for fixation?

a)

  • Store the specimen at –20 °C

b)

  • Use alcohol fixation

c)

  • Submerge specimen in 10% formalin

d)

  • Cut tissue into sections >5 cm thick

96.

A 68-year-old man with known myelodysplastic neoplasm receives 2 units of packed red blood cells. He has previously received transfusions without complications. Pre-transfusion Hb was 7 g/dL. Post-transfusion, he develops fatigue, lethargy, mild jaundice, and Hb 5 g/dL. Which investigation confirms the diagnosis?

a)

  • Serum haptoglobin

b)

  • Urine hemosiderin

c)

  • Serum LDH

d)

  • Direct antihuman globulin test

97.

Ah Leong’s sibling has HbH disease (thalassaemia). Ah Leong is asymptomatic with normal Hb but FBC shows hypochromic microcytic red cells. What is the best investigation to confirm thalassaemia trait?

a)

  • Hb electrophoresis

b)

  • Molecular genetic testing for gene deletion

c)

  • Supravital staining for HbH inclusion bodies

98.

A patient working in Gua Musang presents with fever, chills, and other malaria symptoms. RBCs are not enlarged, schizonts occasionally seen. Diagnosis: Plasmodium knowlesi. Which is true?

a)

  • High parasitaemia

b)

  • Hinton and Mulligan’s form

c)

  • Band form

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