Nokea
A 10 years old girl presented with fever and bruises for last 2 weeks. On examination she is pale; however there is no evidence of lymphadenopathy or hepatosplenomegaly. Her Hb is 6g/dl, TLC is 2700 and platelets are 90000. The most appropriate investigation to clinch the diagnosis is:
- A. Bone marrow aspiration
- B. Retics count
- C. Bleeding time
- D. PT and APTT
Correct Answer: A
Rationale: Bone marrow aspiration is essential to rule out conditions like aplastic anemia or leukemia, which could explain the symptoms and lab findings.
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The nurse is teaching a class about breast self-examinations. A client asks if the she should have an annual mammogram. According to the American Cancer Society, how should the nurse respond?
- A. All women over age 30 should have an annual mammogram.
- B. All women over age 40 should have an annual mammogram.
- C. Any woman over age 20 whose mother had breast cancer should have an annual mammogram.
- D. Any woman who feels she is at risk for breast cancer should have an annual mammogram.
Correct Answer: B
Rationale: According to the American Cancer Society, they recommend that all women aged 40 to 44 should have the choice to start annual mammograms if they wish to do so. For women aged 45 to 54, it is recommended to have an annual mammogram. For women aged 55 and older, they can switch to mammograms every two years or continue with annual screenings. Mammograms are an important screening tool for detecting breast cancer early, especially in women over the age of 40 when the risk of developing breast cancer increases.
A school nurse is conducting vision and hearing testing on fifth-grade children. Which level of prevention is the nurse demonstrating?
- A. Primary
- B. Secondary
- C. Tertiary
- D. Health promotion
Correct Answer: B
Rationale: The school nurse conducting vision and hearing testing on fifth-grade children is demonstrating the secondary level of prevention. Secondary prevention involves identifying and treating health conditions early to prevent their progression. In this scenario, the nurse's aim is to detect any existing vision or hearing problems in the children at an early stage so that appropriate interventions can be initiated to prevent further impairment or complications. This aligns with the goals of secondary prevention, which focuses on early detection, prompt intervention, and minimizing the impact of a health condition.
the Anti Streptolycin o titer (ASOT) is positive with :
- A. tonsillitis
- B. glomerulonephritis
- C. RF
- D. all the above
Correct Answer: D
Rationale: The Anti Streptolysin O titer (ASOT) is a test used to detect antibodies produced by the body in response to a recent streptococcal infection. A positive ASOT result can be seen in various conditions such as tonsillitis, glomerulonephritis, and Rheumatic fever (RF), which are all associated with streptococcal infections. Therefore, the correct answer is D, as all of these conditions can lead to a positive ASOT result.
In embryonic period, formation of all of the following occur by the given time EXCEPT
- A. 8 days - blastocyst formation
- B. 6 weeks - ectoderm formation
- C. 8 weeks - crown-rump length about 3 cm
- D. 10 weeks - endoderm formation
Correct Answer: D
Rationale: Endoderm formation occurs much earlier than 10 weeks in the embryonic period.
Children with ALL who carry poor outcome include all the following EXCEPT
- A. age younger than 1 year and older than 10 year
- B. T-cell immunophenotype
- C. hyperdiploidy chromosomal abnormality
- D. initial leukocyte count of > 50,000
Correct Answer: C
Rationale: Hyperdiploidy is generally associated with a favorable prognosis in ALL, unlike other listed factors.