EXAMINATION FOR MEMBERSHIP

PAPER 1
Monday, 4th July 2005

Please note

This paper consists of six questions, each of equal value but only five
questions are to be attempted.

Question 1 is compulsory

Please write answers to each question on a separate page and write the
question number on the top right hand corner of the page.

The time allocated for the examination is three hours.

Please use a black pen and make your answers legible.

MI.2005

Question 1 is compulsory.

1. Describe the processes for CO2 production and removal from the body.
Describe the causes of high and low pCO2.
2. Suggest possible causes and discuss further investigations in a 42-yearold man who had a ferritin measurement of 1020 g/L (Reference interval
20 - 300 g/L).

3. Critically discuss sample collection and methods used for the

measurement of urinary albumin for the early detection of renal damage in
diabetes mellitus.

4. Discuss mechanisms for obtaining light of a limited wavelength range. Use

examples where possible.

5. Critically discuss the role of the laboratory in assessing vitamin B12 status.

6. Outline the steps in receiving samples into a pathology laboratory.

Comment on problems that may arise during these processes.

EXAMINATION FOR MEMBERSHIP

PAPER 2

PART A

Wednesday, 6th July 2005

Please note

Paper 2 consists of two parts, A and B.

The time allocated to paper 2 is three hours.

All questions in paper 2 are of equal value.

Part A of Paper 2 is compulsory.

Part A is divided into two sections. Answers to both sections should be

written in the one examination booklet labelled PART A.

Please write answers to each question or part-questions on a separate

page and write the question number on the top right hand corner of the
page.

Please use a black pen and make your answers legible.

MIIa.2005
Part A
Questions 1 and 2 are compulsory.

1.

2.

a)

Define "limit of quantitation".

b)

What is the approximate molar concentration of hydrogen ions

at pH 7.4 and 7.0.

c)

You are asked to prepare 50 mL of a 100 mmol/L solution of

potassium dihydrogen phosphate. How much anhydrous
KH2PO4 (MW 136) is required? What amount would be required
if KH2PO4.3H2O is used?.

d)

Write a reaction used for glucose measurement.

e)

Why is tissue transglutaminase measured.

f)

List 2 causes of a low plasma cholinesterase.

g)

Define osmolality and osmolarity.

h)

List pre-analytical factors in ionised calcium measurement.

i)

List four causes of artefactual hyperkalaemia.

j)

How is an overnight dexamethasone suppression test

performed.

Write brief notes on:

a) Uncertainty of measurement.
b) Clinical use of free light chain measurement.
c) CA 125
d) The reaction used for measurement of AST activity. Comment on the
function of each component of the reagents.
e) The oxygen electrode.

EXAMINATION FOR MEMBERSHIP

PAPER 2

PART B

Wednesday, 6th July 2005

Please note

Part B consists of four questions, each of equal value, but only three
questions are to be attempted.

Please write answers to each question on a separate page and write the
question number on the top right hand corner of the page.

The time allocated for Paper 2 is three hours. All questions in Paper 2 are
of equal value.

Please use a black pen and make your answers legible.

MIIb.2005

Part B

3. The following may interfere with analyses. Outline the nature and
mechanism of the interference (with examples) and suggest how the
interference may be overcome:
(a) lipaemia
(b) haemolysis
(c) bilirubin
(d) heterophile antibodies
(e) protein

4. Describe four biochemistry assays that are routinely performed on CSF.

Include in your answer the diagnostic usefulness of the assays and the
principal of the assays.

5. Describe the common Westgard Rules used in routine chemistry

laboratories. Indicate which types of errors are best detected by the
various rules. Indicate how the choice of rules and other factors influence
optimal assay control.

6. Discuss the biochemical tests used in the assessment of testosterone

status in males and females.

EXAMINATION FOR FELLOWSHIP

PAPER 2
Wednesday, 6th July 2005

Please note

This paper consists of six questions, each of equal value but only four
questions are to be attempted.

Question 1 is compulsory.

Please write answers to each question on a separate page and write the
question number at the top of the page.

The time allocated for the examination is three hours.

Please use a black pen and make your answers legible.

F.2.2005

Question 1 is compulsory.

1. Describe the metabolism of ethanol and discuss how excess ethanol

consumption may affect a patients pathology results in the short and long
term.

2. Outline the investigation of an adult patient complaining of severe thirst.

3. The following may interfere with analyses. Outline the nature and
mechanism of the interference (with examples) and suggest how the
interference may be overcome:
(a) Lipaemia
(b) Haemolysis
(c) Bilirubin
(d) Heterophile antibodies
(e) Protein

4. Your laboratory is considering the implementation of an integrated

chemistry and immunoassay systems. Comment on the advantages and
disadvantages of such systems and outline the process of installation.

5. For the following sets of serum lipid results, indicate the abnormalities in
lipoprotein concentrations, possible causes for the pattern and other
investigations that may be indicated.
A: total cholesterol 5 mmol/L; triglycerides 4 mmol/L; HDLC 0.7 mmol/L
B: total cholesterol 12 mmol/L; triglycerides 2 mmol/L; HDLC 1.0 mmol/L
C: total cholesterol 12 mmol/L; triglycerides 36 mmol/L; HDLC 0.5 mmol/L

6. Describe the common Westgard Rules used in routine chemistry

laboratories. Indicate which types of errors are best detected by the
various rules. Indicate how the choice of rules and other influence optimal
assay control.

EXAMINATION FOR FELLOWSHIP

PAPER 3
Friday, 8th July 2005

Please note

This paper consists of six questions, each of equal value but only four
questions are to be attempted.

Question 1 is compulsory.

Please write answers to each question on a separate page and write the
question number at the top of the page.

The time allocated for the examination is three hours.

Please use a black pen and make your answers legible.

F.3.2005
Question 1 is compulsory.
1. Explain the concepts of Measurement Uncertainty and indicate how this
should be implemented in a laboratory.

2. Outline the role of the natriuretic peptides (BNP and/or NT-proBNP) in

assessment of shortness of breath and in acute coronary syndrome.

3. Outline your responses to the following telephone enquiries:

a) A doctor asks how GFR can be estimated in an adult patient.
b) A patient enquires how to prepare for an oral glucose tolerance test.
c) A GP asks about possible causes of persistently low serum vitamin D
concentration in a patient on vitamin D therapy.

4. Describe the laboratory methodology applicable to the diagnosis of a

monoclonal gammopathy. Comment on the techniques and their
performance.

5. Describe the forms of hCG, which may be present in serum and the
characteristics required of an hCG assay. Discuss assay standardisation
and interferences.

6. Compare and contrast the available serum tests for the diagnosis of
pancreatitis. Discuss other biochemical tests results that may be changed
in association with pancreatitis.

EXAMINATION FOR FELLOWSHIP

(Endocrine slanted)

PAPER 2
Wednesday, 6th July 2005

Please note

This paper consists of six questions, each of equal value but only four
questions are to be attempted.

Question 1 is compulsory.

Please write answers to each question on a separate page and write the
question number at the top of the page.

The time allocated for the examination is three hours.

Please use a black pen and make your answers legible.

F.2.2005

Question 1 is compulsory.

1. Discuss the clinical presentation, causes and diagnosis of hypopituitarism.

2. Outline the investigation of an adult patient complaining of severe thirst.

3. The following may interfere with analyses. Outline the nature and
mechanism of the interference (with examples) and suggest how the
interference may be overcome:
(f) Lipaemia
(g) Haemolysis
(h) Bilirubin
(i) Heterophile antibodies
(j) Protein

4. Your laboratory is considering the implementation of an integrated

chemistry and immunoassay systems. Comment on the advantages and
disadvantages of such systems and outline the process of installation.

5. Outline the methods used for measuring the concentration of free

hormones and the clinical and technical advantages and disadvantages
over total hormone determinations. Use examples where possible.

6. Describe the common Westgard Rules used in routine chemistry

laboratories. Indicate which types of errors are best detected by the
various rules. Indicate how the choice of rules and other factors influence
optimal assay control.

EXAMINATION FOR FELLOWSHIP

(Endocrine slanted)

PAPER 3
Friday, 8th July 2005

Please note

This paper consists of six questions, each of equal value but only four
questions are to be attempted.

Question 1 is compulsory.

Please write answers to each question on a separate page and write the
question number at the top of the page.

The time allocated for the examination is three hours.

Please use a black pen and make your answers legible.

F.3.2005

Question 1 is compulsory.
1. Explain the concepts of Measurement Uncertainty and indicate how this
should be implemented in a laboratory.

2. Outline the role of the natriuretic peptides (BNP and/or NT-proBNP) in

assessment of shortness of breath and in acute coronary syndrome.

3. Outline your responses to the following telephone enquiries:

d) A doctor asks how GFR can be estimated in an adult patient.
e) A patient enquires how to prepare for an oral glucose tolerance test.
f) A GP asks about possible causes of persistently low serum vitamin D
concentration in a patient on vitamin D therapy.

4. Describe the laboratory methodology applicable to the diagnosis of a

monoclonal gammopathy. Comment on the techniques and their
performance.

5. Describe the forms of hCG, which may be present in serum and the
characteristics required of an hCG assay. Discuss assay standardisation
and interferences.

6. Discuss the biochemical tests used in the assessment of testosterone

status in males and females.