Nokea
A patient with a severe fungal infection demonstrates impaired neutrophil function. Which of the following cellular processes is most likely to be affected in this patient?
- A. Phagocytosis
- B. Antibody production
- C. Cytokine secretion
- D. Mast cell degranulation
Correct Answer: A
Rationale: Neutrophils are a type of white blood cell that play a crucial role in immune defense against pathogens, particularly in phagocytosis - the process by which they engulf and destroy invading microorganisms. In a severe fungal infection, impaired neutrophil function would most likely affect their ability to effectively perform phagocytosis, leading to a compromised immune response against the fungal pathogen. This would result in increased susceptibility to the infection and potentially severe outcomes for the patient. Antibody production, cytokine secretion, and mast cell degranulation are important components of the immune response, but neutrophils are primarily responsible for phagocytosis in the innate immune system.
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The BEST position for the patient to assume in case of shock is ______.
- A. modified Trendelenburg
- B. recumbent
- C. high Fowler's
- D. low Fowler's
Correct Answer: A
Rationale: The BEST position for a patient in shock is the modified Trendelenburg position. In this position, the patient's legs are elevated above the level of the heart to enhance blood flow back to the heart and vital organs. Placing the patient in the modified Trendelenburg position helps increase venous return, improves cardiac output, and promotes perfusion to vital organs, which can be crucial in managing shock. This position can help stabilize the patient's condition while awaiting further medical intervention.
During the active phase of labor, the nurse observes that the cervix is dilated to 6 cm and the contractions are regular, lasting 60 seconds each, occurring every 3 minutes. What action should the nurse take?
- A. Encourage the mother to push.
- B. Administer oxytocin to augment labor.
- C. Prepare for delivery.
- D. Continue to monitor the progress of labor.
Correct Answer: D
Rationale: During the active phase of labor, a cervical dilation of 6 cm and regular contractions lasting 60 seconds each, occurring every 3 minutes indicate good progress in labor. The nurse should continue to monitor the progress closely by assessing the mother's vital signs, fetal heart rate, and the pattern of contractions. It is important to provide support and encouragement to the mother, continue with comfort measures, and be prepared to assist with the delivery when the cervix is fully dilated. This stage of labor is focused on active dilation and effacement of the cervix, and it is not yet time for the mother to push or for the nurse to administer oxytocin to augment labor.
A patient presents with fever, chills, headache, and myalgia after returning from a trip to sub-Saharan Africa. Laboratory tests reveal intraerythrocytic ring forms and trophozoites on blood smear examination. Which of the following is the most likely causative agent?
- A. Plasmodium falciparum
- B. Trypanosoma cruzi
- C. Borrelia burgdorferi
- D. Leishmania donovani
Correct Answer: A
Rationale: The clinical presentation of fever, chills, headache, and myalgia after a trip to sub-Saharan Africa is highly indicative of malaria. Specifically, the presence of intraerythrocytic ring forms and trophozoites on blood smear examination points towards Plasmodium falciparum as the most likely causative agent. Plasmodium falciparum is the most deadly of the Plasmodium species that cause malaria and is responsible for the majority of severe malaria cases worldwide. It is transmitted through the bite of infected Anopheles mosquitoes. Treatment for Plasmodium falciparum infection usually involves antimalarial medications such as artemisinin-based combination therapies.
A patient presents with a well-demarcated, hyperpigmented patch with irregular borders and asymmetric color distribution on the face. The lesion has increased in size over the past few months. Which of the following conditions is most concerning for this presentation?
- A. Melanocytic nevus (mole)
- B. Lentigo simplex
- C. Seborrheic keratosis
- D. Melanoma
Correct Answer: D
Rationale: The presentation described, including a well-demarcated, hyperpigmented patch with irregular borders, asymmetric color distribution, and increase in size over a short period, is concerning for melanoma. Melanoma is a type of skin cancer that arises from melanocytes, the cells that produce pigment in the skin. The irregular borders, color variation, and growth over time are classic signs of melanoma. Melanomas are potentially dangerous and should be evaluated promptly by a healthcare provider for proper diagnosis and treatment. It is important to distinguish melanoma from other benign lesions like melanocytic nevus (mole), lentigo simplex, and seborrheic keratosis, as early detection and treatment of melanoma can significantly impact patient outcomes.
Which of the following cellular receptors is responsible for recognizing pathogen-associated molecular patterns (PAMPs) and initiating innate immune responses?
- A. Toll-like receptors (TLRs)
- B. B cell receptors (BCRs)
- C. T cell receptors (TCRs)
- D. Fc receptors
Correct Answer: A
Rationale: Toll-like receptors (TLRs) are a group of cellular receptors responsible for recognizing pathogen-associated molecular patterns (PAMPs), which are molecular components commonly found on pathogens like bacteria and viruses. When TLRs recognize these PAMPs, they initiate signaling pathways that trigger the innate immune response, leading to inflammation, antimicrobial defense, and the activation of adaptive immunity. B cell receptors (BCRs) and T cell receptors (TCRs) are involved in adaptive immune responses and recognize specific antigens rather than PAMPs. Fc receptors primarily bind to the Fc portion of antibodies and are involved in antibody-mediated immune responses. Thus, TLRs specifically play a critical role in sensing and responding to pathogens through the recognition of PAMPs.