Nokea
A patient presents with fatigue, weakness, and jaundice. Laboratory tests reveal hemolytic anemia, elevated LDH, decreased haptoglobin, and presence of schistocytes on peripheral blood smear. Which of the following conditions is most likely to cause these findings?
- A. Hereditary spherocytosis
- B. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
- C. Autoimmune hemolytic anemia (AIHA)
- D. Thalassemia
Correct Answer: B
Rationale: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive disorder that leads to hemolytic anemia in response to oxidative stress. The patient's presentation of fatigue, weakness, and jaundice along with laboratory findings of hemolytic anemia (evidenced by schistocytes), elevated LDH, and decreased haptoglobin are all characteristic of G6PD deficiency. The oxidative stress causes red blood cell destruction, resulting in the release of LDH and bilirubin, leading to jaundice. Decreased haptoglobin is seen due to its consumption in binding free hemoglobin released from the lysed red blood cells. Additionally, the presence of schistocytes on a peripheral blood smear is indicative of red blood cell fragmentation, a common finding in hemolytic anemias including G6PD deficiency
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Based on the Right to Privacy and Confidentiality under the Patient's Bill of Rights, the patient has the right to demand on the following, but NOT _______ pertaining to his care as confidential.
- A. Information
- B. Records
- C. Communication
- D. Financial status
Correct Answer: D
Rationale: The patient has the right to demand that information, records, and communications pertaining to their care be kept confidential under the Right to Privacy and Confidentiality as outlined in the Patient's Bill of Rights. However, financial status is generally not considered part of the confidential medical information and may not fall under the same level of protection as personal health information. Therefore, the patient cannot demand that their financial status be treated as confidential under this particular right.
A patient presents with knee pain and instability following a twisting injury during sports activity. MRI reveals a tear involving the anterior cruciate ligament (ACL). Which surgical procedure is commonly performed to reconstruct the ACL?
- A. Arthroscopic meniscectomy
- B. Medial patellofemoral ligament (MPFL) reconstruction
- C. Anterior cruciate ligament (ACL) reconstruction
- D. Lateral collateral ligament (LCL) repair
Correct Answer: C
Rationale: Anterior cruciate ligament (ACL) reconstruction is a common surgical procedure performed to repair a torn ACL. This procedure involves replacing the damaged ACL with a graft, often using a portion of the patient's own patellar tendon, hamstring tendon, or an allograft (donor tissue). ACL reconstruction is typically indicated for patients with ACL tears that result in knee instability and functional limitations, especially in active individuals who participate in sports or activities requiring pivoting and cutting movements. Arthroscopic surgery is commonly used to perform ACL reconstruction, allowing for smaller incisions and faster recovery compared to traditional open surgeries. Post-operative rehabilitation and physical therapy are crucial components of the recovery process following ACL reconstruction surgery to optimize outcomes and return to pre-injury activity levels.
A patient presents with well-demarcated, hypopigmented macules with fine scaling, affecting the trunk and proximal extremities. The patient reports a history of sun exposure and outdoor activities. Which of the following conditions is most likely responsible for this presentation?
- A. Tinea versicolor
- B. Vitiligo
- C. Pityriasis rosea
- D. Seborrheic keratosis
Correct Answer: A
Rationale: The presentation described in the question is characteristic of tinea versicolor, a fungal skin infection caused by Malassezia furfur. The hypopigmented macules with fine scaling are often seen on the trunk and proximal extremities, particularly in areas that are more prone to sebum production. Patients with tinea versicolor may have a history of sun exposure and outdoor activities as the organism responsible for the infection thrives in warm, humid environments. Treatment typically involves the use of topical antifungal agents such as ketoconazole or selenium sulfide.
A patient with cystic fibrosis (CF) presents with recurrent pulmonary exacerbations characterized by increased sputum production, cough, and fever. Which of the following treatments is most effective for addressing the underlying pathophysiology of CF and preventing disease progression?
- A. Inhaled corticosteroids
- B. Mucolytic agents (e.g., dornase alfa)
- C. Antibiotic therapy for respiratory infections
- D. Lung transplantation
Correct Answer: B
Rationale: The most effective treatment for addressing the underlying pathophysiology of cystic fibrosis (CF) and preventing disease progression is the use of mucolytic agents, such as dornase alfa. CF is a genetic disorder that leads to the production of thick, sticky mucus in the respiratory tract. This mucus buildup can obstruct airways, lead to recurrent infections, and contribute to pulmonary exacerbations. Mucolytic agents work by reducing the viscosity of the mucus, making it easier to clear from the airways. This helps to improve lung function, reduce the frequency of exacerbations, and slow down disease progression in CF patients. Inhaled corticosteroids may be used for managing airway inflammation, but they do not target the underlying mucus production in CF. Antibiotic therapy is important for treating respiratory infections in CF patients, but it does not address the primary
Attention deficit, Hyperactivity, disorder (ADHD) is characterized by NOT one of the following?
- A. Mental retardation
- B. Inattentiveness
- C. Over activity
- D. Impulsiveness
Correct Answer: A
Rationale: Attention deficit hyperactivity disorder (ADHD) is characterized by inattentiveness, overactivity, and impulsiveness. Individuals with ADHD may have difficulty paying attention, completing tasks, sitting still, or controlling their impulses. Mental retardation (now referred to as intellectual disability) is a separate condition characterized by limitations in intellectual functioning and adaptive behaviors. While individuals with ADHD may experience difficulties in school or work due to their symptoms, ADHD itself does not indicate mental retardation.