Nokea
A 4-year-old child with acute lymphoblastic leukemia is receiving high-dose methotrexate during interim maintenance. He receives ondansetron and арретitant during his stay, which control his nausea and vomiting well. These medications work by inhibiting signaling in which part of the brain?
- A. Vestibular system
- B. Cerebral cortex
- C. Hypothalamus
- D. Vomiting center
Correct Answer: E
Rationale: I apologize, but it seems like the correct answer (E) is missing from the choices provided in the question. If you could kindly provide the correct answer, I would be more than happy to provide a detailed explanation for why that answer is correct and summarize why the other choices are incorrect.
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Which of the following is false regarding heparin?
- A. Subcutaneous injection of heparin is avoided because of hematomas formation.
- B. Heparin is usually stored in the mast cells.
- C. Heparin binds to plasma anti thrombin III and inhibits activated thrombin.
- D. Protamine sulfate can be used to counteract heparin overdose.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Subcutaneous injection of heparin is avoided due to the risk of hematoma formation at the injection site.
2. This statement is false because heparin is commonly administered subcutaneously for prophylaxis of thromboembolic events.
3. The preferred route for heparin administration is subcutaneous or intravenous.
4. Therefore, choice A is the false statement.
Summary:
- Choice A is incorrect as heparin is commonly given subcutaneously.
- Choice B is incorrect as heparin is not stored in mast cells but in specialized granules in mast cells.
- Choice C is correct as heparin binds to plasma antithrombin III to inhibit thrombin.
- Choice D is correct as protamine sulfate can reverse heparin's anticoagulant effects in case of overdose.
NADPH is a product of the hexose monophosphate pathway (HMP) in the red blood cell. The NADPH is used for the
- A. Synthesis of fatty acids
- B. Reduction of glutathione
- C. Formation of ATP
- D. Removal of oxygen radicals
Correct Answer: B
Rationale: The correct answer is B: Reduction of glutathione. In the hexose monophosphate pathway (HMP), NADPH is generated, which serves as a reducing agent. This NADPH is crucial for reducing oxidized glutathione back to its reduced form, maintaining cellular antioxidant defense. This process helps to protect cells from oxidative damage and maintain redox balance.
Now, let's summarize why the other choices are incorrect:
A: Synthesis of fatty acids - NADPH is indeed involved in fatty acid synthesis, but in the context of red blood cells, the primary role of NADPH is in reducing glutathione.
C: Formation of ATP - NADPH is not directly involved in ATP synthesis. ATP is primarily produced through processes like glycolysis and oxidative phosphorylation.
D: Removal of oxygen radicals - While NADPH indirectly contributes to the removal of oxygen radicals through its role in reducing glutathione, it is not the primary function of NAD
Which of the following is the most suitable anti malarial drug for pregnant women?
- A. Atovaquone and proguanil
- B. Quinine and doxycycline
- C. Quinine and clindamycin
- D. Primaquine
Correct Answer: C
Rationale: The correct answer is C: Quinine and clindamycin. Quinine is considered safe for use in pregnancy to treat malaria, as it has been used for many years without significant adverse effects. Clindamycin is also safe for use in pregnancy and can be used in combination with quinine to treat malaria. Atovaquone and proguanil (choice A) are not recommended for use in pregnancy due to limited safety data. Quinine and doxycycline (choice B) is not suitable for pregnant women as doxycycline is contraindicated during pregnancy. Primaquine (choice D) is not recommended for use during pregnancy as it can cause harm to the fetus.
Busulfan therapy lead to all except:
- A. hyperpigmentation
- B. pulm .Fibrosis
- C. optic neuritis
- D. BM suppression
Correct Answer: C
Rationale: The correct answer is C: optic neuritis. Busulfan therapy is known to cause adverse effects such as hyperpigmentation, pulmonary fibrosis, and bone marrow suppression due to its cytotoxic effects. However, optic neuritis is not a reported side effect of busulfan therapy. Optic neuritis is more commonly associated with other medications or conditions affecting the optic nerve. Therefore, the absence of optic neuritis as a known side effect of busulfan therapy makes choice C the correct answer.
A 10-year-old patient with aplastic anemia, who is blood type B negative, is receiving a red blood cell transfusion. About 10 minutes after the transfusion starts, the patient develops anxiety and lower back pain. The transfusion continues for another 5 minutes until it is stopped when he develops a temperature of 40 °C with chills and rigors. A transfusion reaction work-up is most likely to reveal what findings?
- A. Spherocytes on peripheral blood smear
- B. Gram-negative Bacillus on gram stain of remaining RBC unit
- C. Chest x-ray with bilateral pulmonary infiltrates that are new compared to an x-ray done last week
- D. DAT positive for C3
Correct Answer: D
Rationale: The correct answer is D: DAT positive for C3. This finding suggests complement-mediated hemolysis, which is consistent with a transfusion reaction known as transfusion-related acute lung injury (TRALI). TRALI presents with respiratory distress, fever, and chills due to immune complexes activating the complement system. A: Spherocytes indicate hemolysis, which is not specific to TRALI. B: Gram-negative Bacillus suggests bacterial contamination, leading to sepsis, not TRALI. C: Bilateral pulmonary infiltrates are seen in transfusion-associated circulatory overload (TACO), not TRALI.