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A patient is presented with fever, vomiting, hypotension and facial edema after his business trip back from Africa. Viral hemorrhagic fever is suspected in this patient. Which of the following family does the suspected virus belong to?
- A. Filovirus
- B. Togavirus
- C. Adenovirus
- D. Bunyavirus
Correct Answer: A
Rationale: The correct answer is A: Filovirus. Filoviruses, such as Ebola and Marburg viruses, are known to cause viral hemorrhagic fevers and are commonly found in Africa. The symptoms presented by the patient align with those of filovirus infections. Togavirus (choice B) and Bunyavirus (choice D) are not typically associated with viral hemorrhagic fevers. Adenovirus (choice C) can cause respiratory and gastrointestinal infections but is not known to cause viral hemorrhagic fevers.
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An oncology nurse is caring for a patient with multiple myeloma who is experiencing bone destruction. When reviewing the patient's most recent blood tests, the nurse should anticipate what imbalance?
- A. Hypercalcemia
- B. Hyperproteinemia
- C. Elevated serum viscosity
- D. Elevated RBC count
Correct Answer: A
Rationale: The correct answer is A: Hypercalcemia. In multiple myeloma, bone destruction releases calcium into the bloodstream, leading to hypercalcemia. This can result in symptoms like excessive thirst, fatigue, confusion, and kidney issues. Hyperproteinemia (B) is not typically associated with multiple myeloma. Elevated serum viscosity (C) is more related to conditions like Waldenström macroglobulinemia, not multiple myeloma. Elevated RBC count (D) is not a common finding in multiple myeloma and is more suggestive of polycythemia vera.
After seven days of treatment with sulfonamides, a patient's hemoglobin had decreased from 14.7 gm/100ml to 10gm/100ml. The most likely cause of hemolysis in this patient is
- A. Sickle cell disease
- B. Thalassemia minor
- C. Hereditary spherocytosis
- D. Glucose 6-phosphate dehydrogenase deficiency (G6PD)
Correct Answer: D
Rationale: The correct answer is D: Glucose 6-phosphate dehydrogenase deficiency (G6PD). Sulfonamides can trigger hemolysis in patients with G6PD deficiency due to oxidative stress on red blood cells. G6PD enzyme deficiency impairs the ability of red blood cells to combat oxidative damage, leading to hemolysis. In this case, the patient's hemoglobin decreased significantly after sulfonamide treatment, indicating red blood cell destruction. The other choices (A: Sickle cell disease, B: Thalassemia minor, C: Hereditary spherocytosis) are not directly associated with sulfonamide-induced hemolysis and would not explain the observed decrease in hemoglobin levels after treatment.
A nurse should identify that clopidogrel is contraindicated for clients who have which of the following conditions?
- A. Myocardial infarction
- B. Peptic ulcer disease
- C. Pancreatitis
- D. Myasthenia gravis
Correct Answer: B
Rationale: Clopidogrel is contraindicated for clients with peptic ulcer disease due to its antiplatelet effect, which can increase the risk of gastrointestinal bleeding. Myocardial infarction, pancreatitis, and myasthenia gravis are not direct contraindications for clopidogrel. Myocardial infarction can actually be an indication for clopidogrel use to prevent further cardiovascular events. Pancreatitis and myasthenia gravis are not known to have specific contraindications with clopidogrel.
Macrocytosis is a characteristic of all except:
- A. an. Of myxedema
- B. methotrexate induced
- C. chronic alcoholism induced liver dis.
- D. SLE
Correct Answer: D
Rationale: Step-by-step rationale:
1. Macrocytosis refers to larger-than-normal red blood cells.
2. Systemic Lupus Erythematosus (SLE) is not typically associated with macrocytosis.
3. Anemia of myxedema, methotrexate-induced, and chronic alcoholism-induced liver disease can all lead to macrocytosis.
4. Therefore, the correct answer is D: SLE, as it is not commonly associated with macrocytosis.
Blinatumomab, a bispecific T-cell engaging molecule, is active against which CD antigen that is expressed on B-lymphoblasts?
- A. CD10
- B. CD15
- C. CD19
- D. CD20
Correct Answer: C
Rationale: Rationale:
1. Blinatumomab is designed to engage T cells to target CD19 antigen on B-lymphoblasts.
2. CD19 is a specific marker expressed on B cells, making it a target for Blinatumomab.
3. CD10 is not targeted by Blinatumomab and is commonly found on early B-cell precursors.
4. CD15 and CD20 are not targeted by Blinatumomab and have different functions unrelated to B-lymphoblasts.
Summary:
- CD19 is the correct answer as it is the specific target for Blinatumomab on B-lymphoblasts.
- CD10, CD15, and CD20 are incorrect as they are not the targeted antigens for Blinatumomab and have different roles in immune function.