FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
DECEMBER 2016
POSSESSION USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE
EXAMINATION HALL.
IMMUNO-HEMATOLOGY TRANSFUSION MEDICINE
PAPER III
IHTM/D/16/15/III
Time 3 hours
Max. Marks 100
Important instructions:
• Attempt all questions in order.
• Each question carries 10 marks.
• Read the question carefully and answer to the point neatly and legibly.
• Do not leave any blank pages between two answers.
• Indicate the question number correctly for the answer in the margin space.
• Answer all the parts of a single question together.
• Start the answer to a question on a fresh page or leave adequate space between two answers.
• Draw table/diagrams/flowcharts wherever appropriate.
Write short notes on:

1. Discuss the investigations and management in a 56 year old male who is
bleeding following a CABG. He has received streptokinase, Abciximab (Gp IIb
IIIa inhibitor) and Clopidogrel.
10
2. An 18 year old boy with severe haemophilia A is detected to have inhibitors of
2 Bethesda Units. Mention:
Short term management in a bleed.
Long term management.
6+4
3. A 30 year old lady who is 34 weeks pregnant and has a platelet count of 40 x
109/L with large platelets. How will you investiage and manage this patient?
5+5
4. A 42 year old male with acute promyelocytic leukemia with seizures and
bleeding gums.
Outline the approach to this patient.
What blood products would you recommend based on your findings?
5+5
5. A 25 year old lady has post partum hemorrhage and massive blood loss
Investigations and transfusion support.
Use of recombinant activated FVIIa (Novoseven) in this situation.
6+4
6. Preterm neonate delivered at 32 weeks of gestation. Most suitable blood
component reasons thereof since he is requiring top up for:
Platelets
Red cells
4+6
7. Enumerate pathogen reduction strategies in blood and blood products.
10
8. You have been asked to develop a program for Thalassaemia management in
your town.
Outline the feasibility of a screening program.
Enumerate the facility development for investigations and management.
4+6
9. Cord blood banking.
Processing and storage for a public cord blood bank.
5+5
10. You have been asked to develop blood storage centres at 3 of your satellite
hospitals which offer all medical and surgical subspecialities.
Evaluate the need and outline facility management.
Blood stock management.
4+6