Nokea
A patient shows prolonged prothrombin time and activated partial thromboplastin time. Blood test otherwise is normal. Which of the following is the most probably diagnosis for this patient's condition?
- A. Hemophilia A
- B. Thrombocytopenia
- C. Von Willebrand factor disease
- D. Vitamin K deficiency
Correct Answer: D
Rationale: The correct answer is D: Vitamin K deficiency. Prolonged prothrombin time and activated partial thromboplastin time indicate impaired blood clotting, which is a characteristic of Vitamin K deficiency. Vitamin K is essential for the synthesis of clotting factors II, VII, IX, and X. Hemophilia A (Choice A) is a genetic disorder resulting in a deficiency of clotting factor VIII, leading to prolonged activated partial thromboplastin time only. Thrombocytopenia (Choice B) is a condition characterized by low platelet count, which can lead to bleeding but does not affect clotting factors. Von Willebrand disease (Choice C) is a genetic disorder affecting von Willebrand factor and platelet function, not clotting factors.
You may also like to solve these questions
A 13-year-old girl presents with acute myeloid leukemia (AML) and a WBC count of 120,000/mm3. Cytogenetics reveals a normal karyotype, and fluorescence in situ hybridization (FISH) tests for inv(16), t(8;21), t(15;17); 11q23 abnormalities; monosomy 7; and 5q deletion are negative. Molecular testing is negative for mutations in FLT3, NPM1, and CEBPA. She is treated with 10 days of daunorubicin, AraC, and gemtuzumab for induction therapy. On day 30, she recovers counts, and a bone marrow aspiration shows 2.2% leukemic blasts by flow cytometry. She receives a second course of treatment with daunorubicin and AraC, and her marrow is now in morphologic remission and is MRD-negative by flow cytometry. She has no HLA-matched siblings, but an unrelated donor search reveals a large number of potential matches. Which course of treatment is most likely to result in the best outcome?
- A. Give two more courses of intensification chemotherapy.
- B. Perform an autologous hematopoietic stem cell transplant (HSCT).
- C. Give one more course of intensification chemotherapy and then perform a matched unrelated donor HSCT.
- D. Give one more course of intensification chemotherapy and then 1 year of maintenance chemotherapy.
Correct Answer: C
Rationale: The correct answer is C because the patient is in morphologic remission and MRD-negative after the second course of treatment. Given her high-risk AML and lack of HLA-matched siblings, a matched unrelated donor HSCT offers the best chance for long-term remission. Autologous HSCT (choice B) would risk reintroducing leukemic cells. Giving more courses of intensification chemotherapy alone (choice A) may not eradicate the disease. Maintenance chemotherapy alone (choice D) is not sufficient for high-risk AML. Therefore, choice C is the best option for maximizing the chances of a favorable outcome in this case.
The nurse examines the lymph nodes of a patient during a physical assessment. Which assessment finding would be of most concern to the nurse?
- A. A 2-cm nontender supraclavicular node
- B. A 1-cm mobile and nontender axillary node
- C. An inability to palpate any superficial lymph nodes
- D. Firm inguinal nodes in a patient with an infected foot
Correct Answer: A
Rationale: The correct answer is A. A 2-cm nontender supraclavicular node is of most concern as supraclavicular nodes are not normally palpable, and their enlargement can indicate underlying malignancy, such as metastatic cancer.
B: A 1-cm mobile and nontender axillary node is within normal limits.
C: Inability to palpate superficial lymph nodes may be due to factors like obesity or normal variation.
D: Firm inguinal nodes in a patient with an infected foot are expected as a local response to infection.
Which of the following is false regarding Burkitt's lymphoma?
- A. Associated with translocation of c-myc gene on chromosome 18
- B. Usually presents with abdominal involvement in HIV patients
- C. Common in Africa children due to Epstein Barr infection after malaria exposure.
- D. Histologically characterized by a 'starry sky' appearance
Correct Answer: A
Rationale: The correct answer is A because Burkitt's lymphoma is associated with translocation of c-myc gene on chromosome 8, not chromosome 18. This translocation leads to uncontrolled cell proliferation. Choice B is incorrect because Burkitt's lymphoma commonly presents with jaw or facial bone involvement in HIV patients. Choice C is incorrect as the association between Epstein Barr infection and malaria exposure in African children increases the risk of Burkitt's lymphoma. Choice D is incorrect because Burkitt's lymphoma is histologically characterized by a 'starry sky' appearance due to macrophages engulfing apoptotic tumor cells, not due to the presence of the c-myc translocation.
During haemostasis, prostacyclin
- A. Cleaves prothrombin into thrombin
- B. Causes vasodilation
- C. Stimulates platelet aggregation
- D. Activates fibrinolysis
Correct Answer: B
Rationale: Prostacyclin is a vasodilator, which means it causes blood vessels to widen, leading to decreased blood pressure and increased blood flow. During haemostasis, this vasodilation helps in maintaining blood flow and preventing platelet aggregation in the damaged area. Option A is incorrect because prostacyclin does not cleave prothrombin into thrombin. Option C is incorrect as prostacyclin inhibits platelet aggregation. Option D is incorrect because prostacyclin does not directly activate fibrinolysis. In summary, the correct answer is B because prostacyclin's vasodilation function plays a crucial role in haemostasis by preventing excessive clot formation and maintaining blood flow.
What are the six dimensions of quality care according to the Institute of Medicine?
- A. Safe, timely, effective, efficient, equitable, and person-centered
- B. Safe, transparent, effective, efficient, equitable, and person-centered
- C. Safe, timely, effective, low-cost, equitable, and person-centered
- D. Safe, timely, effective, efficient, cutting-edge, and person-centered
Correct Answer: A
Rationale: The correct answer is A: Safe, timely, effective, efficient, equitable, and person-centered. This aligns with the six dimensions of quality care outlined by the Institute of Medicine. Safety ensures patient well-being, timeliness reduces delays, effectiveness means providing evidence-based care, efficiency minimizes waste, equity ensures fair access, and person-centered care considers individual preferences.
Choice B is incorrect because transparency is not included in the Institute of Medicine's six dimensions. Choice C is incorrect as "low-cost" is not a recognized dimension of quality care. Choice D is incorrect because "cutting-edge" is not part of the established dimensions of quality care.