Nokea
A patient who is infected with hookworms produces signs and symptoms of anemia. Which of the following can be seen in the peripheral blood smear of the patient?
- A. Howell-Jolly bodies
- B. Basophilic stippling
- C. Target cells
- D. Spherocytes
Correct Answer: B
Rationale: The correct answer is B: Basophilic stippling. Basophilic stippling is a common finding in the peripheral blood smear of patients infected with hookworms due to lead poisoning, which can occur as a result of hookworm infection. Basophilic stippling is seen as the presence of small, dark blue granules within red blood cells and is indicative of impaired heme synthesis. Howell-Jolly bodies (A) are remnants of nuclear material in red blood cells and are typically seen in patients with functional asplenia. Target cells (C) are seen in conditions such as liver disease and hemoglobinopathies. Spherocytes (D) are seen in conditions like hereditary spherocytosis or autoimmune hemolytic anemia, but not specifically in hookworm infection.
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Which of the following is not true in thrombasthenia:
- A. prolonged bleeding time
- B. normal plat .Count
- C. plat .Aggregation defect
- D. prolonged clotting time
Correct Answer: D
Rationale: In thrombasthenia, there is a deficiency or dysfunction of integrin αIIbβ3 (GPIIb/IIIa), leading to impaired platelet aggregation. Prolonged bleeding time (A) is seen due to defective platelet function. Platelet count (B) is typically normal as thrombasthenia does not affect platelet production. Platelet aggregation defect (C) is a characteristic feature of thrombasthenia. Prolonged clotting time (D) is not associated with thrombasthenia as it primarily affects platelet function, not the coagulation cascade. Hence, choice D is the correct answer.
A patient has an altered level of T and B cells. The nurse realizes that these cells are members of which cell type?
- A. Platelets
- B. Eosinophils
- C. Lymphocytes
- D. Red blood cells
Correct Answer: C
Rationale: The correct answer is C: Lymphocytes. T and B cells are types of lymphocytes, a crucial component of the immune system responsible for fighting infections. T cells regulate immune responses, while B cells produce antibodies. Platelets (A), eosinophils (B), and red blood cells (D) are not involved in immune responses and do not possess the functions of T and B cells. Platelets are involved in blood clotting, eosinophils are a type of white blood cell involved in allergic reactions, and red blood cells are responsible for oxygen transport.
A nurse is caring for a client who has chronic stable angina. The nurse should identify that which of the following drugs inhibits the action of adenosine diphosphate receptors (ADP) on platelets and can be prescribed to reduce the client's risk for myocardial infarction?
- A. Clopidogrel
- B. Heparin
- C. Warfarin
- D. Alteplase
Correct Answer: A
Rationale: 1. Clopidogrel inhibits ADP receptors on platelets, reducing platelet aggregation and clot formation.
2. By reducing platelet aggregation, clopidogrel decreases the risk of myocardial infarction in patients with chronic stable angina.
3. Heparin acts by inhibiting thrombin and factor Xa, not ADP receptors.
4. Warfarin inhibits vitamin K-dependent clotting factors, not ADP receptors.
5. Alteplase is a thrombolytic agent that dissolves blood clots, not an ADP receptor inhibitor.
A nurse is caring for a client who is about to begin therapy with recombinant factor IX to treat hemophilia B. The client asks the nurse about the risk of disease transmission with recombinant factor IX as compared with plasma derived factor IX. The nurse should explain that the recombinant factor IX practically eliminates the risk for which of the following?
- A. HIV
- B. Cytomegalovirus
- C. Creutzfeldt-Jakob disease
- D. Anaphylaxis
Correct Answer: C
Rationale: Rationale: The correct answer is C: Creutzfeldt-Jakob disease (CJD). Recombinant factor IX is produced synthetically in a laboratory, eliminating the risk of transmitting prion diseases like CJD. Plasma-derived products, on the other hand, carry a theoretical risk of transmitting CJD due to potential contamination. HIV and cytomegalovirus can be transmitted through blood products, but both plasma-derived and recombinant factor IX are rigorously tested for these viruses. Anaphylaxis is a potential risk with any factor IX product, regardless of the source. Therefore, the nurse should explain to the client that recombinant factor IX practically eliminates the risk of CJD transmission compared to plasma-derived factor IX.
You are seeing a 12-year-old female who presented to the emergency department with the sudden onset of severe abdominal pain. Imaging that was obtained to rule out appendicitis revealed a mass adjacent to the bladder. The mass was surgically resected, and pathology demonstrated a paraganglioma. Which of the studies below would be most useful to determine disease stage for this patient?
- A. Bone Scan
- B. Lumbar puncture for cerebrospinal fluid cytology
- C. Bone marrow aspirate and biopsy
- D. Ga 68-DOTATATE PET/CT
Correct Answer: D
Rationale: The correct answer is D: Ga 68-DOTATATE PET/CT. This imaging study is the most useful for determining the disease stage in a patient with paraganglioma. Paragangliomas are neuroendocrine tumors that express somatostatin receptors, which can be detected using Ga 68-DOTATATE PET/CT. This imaging modality helps to localize primary and metastatic lesions, as well as assess disease extent and stage.
Now let's analyze the other options:
A: Bone Scan - Not useful for determining disease stage in paraganglioma.
B: Lumbar puncture for cerebrospinal fluid cytology - Not indicated for staging paraganglioma.
C: Bone marrow aspirate and biopsy - Not specific for staging paraganglioma.
In summary, Ga 68-DOTATATE PET/CT is the most appropriate study for determining disease stage in a patient with paraganglioma due to its