ATI Hematologic System Test

ATI Hematologic System Test Related

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A 40 year old patient is presented with unilateral palpebral edema and ipsilateral lymphadenopathy. He later develops megaesophagus and megacolon as complications. Which of the following vector is responsible for this parasitic infection?

  • A. Glossina morsitans
  • B. Ixodes scapularis
  • C. Rhodnius prolixus
  • D. Simulium damnosum
Correct Answer: C

Rationale: The correct answer is C: Rhodnius prolixus. This parasite is responsible for causing Chagas disease. The initial symptoms of unilateral palpebral edema and ipsilateral lymphadenopathy are characteristic of the acute phase of Chagas disease. The development of megaesophagus and megacolon are complications seen in the chronic phase. Rhodnius prolixus is a vector for Trypanosoma cruzi, the parasite that causes Chagas disease. Glossina morsitans is the vector for African trypanosomiasis (sleeping sickness), Ixodes scapularis is the vector for Lyme disease, and Simulium damnosum is the vector for onchocerciasis (river blindness), making them incorrect choices for this particular parasitic infection.

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Which of the following requires IL-2 and IL-4 in the conversion of unilineage progenitor cell into mature circulating cell?

  • A. Neutrophil
  • B. Eosinophil
  • C. Basophil
  • D. B lymphocyte
Correct Answer: D

Rationale: The correct answer is D: B lymphocyte. IL-2 and IL-4 are essential for the differentiation of B lymphocytes from unilineage progenitor cells into mature circulating cells. IL-2 is crucial for B cell proliferation and survival, while IL-4 is required for B cell activation and class switching. Neutrophils do not require IL-2 and IL-4 for differentiation. Eosinophils are primarily influenced by IL-5. Basophils are influenced by IL-3 and IL-5. Therefore, B lymphocytes are the only cell type among the choices that specifically requires IL-2 and IL-4 for their maturation.

Splenectomy is curative in:

  • A. G6PD def.
  • B. ITP
  • C. thalassemia
  • D. hereditary spherocytosis
Correct Answer: D

Rationale: Rationale: Splenectomy is curative in hereditary spherocytosis because it removes the site of red blood cell destruction. The spleen is responsible for filtering out abnormal or damaged red blood cells in this condition. Removing the spleen stops the destruction of spherocytes, leading to an improvement in anemia.

Summary of other choices:
A: G6PD def. - Splenectomy does not address the underlying enzyme deficiency causing hemolysis.
B: ITP - Splenectomy is used in refractory cases of ITP, but not considered curative.
C: Thalassemia - Splenectomy can be used to manage complications in thalassemia but does not cure the underlying genetic defect.

The typical Reed-Sternberg cells are either infrequent or absent. Instead, lymphocytic and histiocytic cells or 'popcorn cells' are seen within a background of inflammatory cells, which are predominantly benign lymphocytes. Which type of Hodgkin's lymphoma best suit the description?

  • A. Nodular sclerosis
  • B. Mixed cellularity
  • C. Lymphocyte depleted
  • D. Lymphocyte predominance
Correct Answer: D

Rationale: Rationale for Choice D (Lymphocyte predominance):
1. Reed-Sternberg cells are infrequent or absent in lymphocyte predominance Hodgkin's lymphoma.
2. 'Popcorn cells' are seen in lymphocyte predominance Hodgkin's lymphoma.
3. Predominance of benign lymphocytes in the background is characteristic of lymphocyte predominance Hodgkin's lymphoma.

Summary of other choices:
A: Nodular sclerosis - Characterized by collagen bands dividing lymph node into nodules, not 'popcorn cells'.
B: Mixed cellularity - Reed-Sternberg cells present, not 'popcorn cells'.
C: Lymphocyte depleted - Few to no lymphocytes seen, not benign lymphocytes as described in the question.

A client is having a bone marrow aspiration and biopsy. What action by the nurse takes priority?

  • A. Administer pain medication first.
  • B. Ensure that valid consent is in the medical record.
  • C. Have the client shower in the morning.
  • D. Premedicate the client with sedatives.
Correct Answer: B

Rationale: The correct answer is B: Ensure that valid consent is in the medical record. This is the priority because obtaining informed consent is essential before any invasive procedure like a bone marrow aspiration and biopsy. It ensures that the client understands the procedure, risks, benefits, and alternatives. Administering pain medication (A), having the client shower (C), and premedicating with sedatives (D) are important aspects of care but obtaining valid consent is crucial for legal and ethical reasons before proceeding with the procedure.

Which of the following alters the function of thrombin from a procoagulant protein to one that downregulates the formation of fibrinogen?

  • A. Protein C
  • B. Protein S
  • C. Antithrombin
  • D. Thrombomodulin
Correct Answer: D

Rationale: Thrombomodulin alters thrombin's function by binding to it and activating protein C. Activated protein C then inhibits factors Va and VIIIa, which are essential for the formation of fibrinogen. Protein C (choice A) also inhibits coagulation, but it doesn't directly alter thrombin's function. Protein S (choice B) enhances protein C's activity but doesn't directly affect thrombin. Antithrombin (choice C) inhibits thrombin and other coagulation factors, but it doesn't specifically alter thrombin's function to downregulate fibrinogen formation.

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