ATI Hematologic System Test

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A patient with abdominal injuries from a motor vehicle crash is scheduled for surgery to remove the spleen. What bodily function will be affected by the removal of this organ?

  • A. Filtration of waste products
  • B. Removal of old red blood cells from circulation
  • C. Clearance of mucous in the tracheobronchial tree
  • D. Facilitation of glucose to be used by the cell for energy
Correct Answer: B

Rationale: The correct answer is B: Removal of old red blood cells from circulation. The spleen plays a crucial role in filtering and removing old or damaged red blood cells from circulation. When the spleen is removed, this function is compromised, leading to a decrease in the body's ability to clear out these cells efficiently. This can result in an increased risk of anemia and other complications related to the buildup of old red blood cells in the bloodstream.

A: Filtration of waste products - While the spleen does play a role in filtering blood, its primary function is related to red blood cells, not waste products.

C: Clearance of mucous in the tracheobronchial tree - This function is primarily carried out by the respiratory system, particularly the cilia and mucous membranes in the airways, not the spleen.

D: Facilitation of glucose to be used by the cell for energy - This function is primarily related to the pancreas and insulin production, not the

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A 7-year-old boy presents with recent onset of vomiting and lethargy. Blood smear shows increased neutrophils with a left shift and 8% abnormal cells. Bone marrow contains 60% of the same cells. Flow cytometry shows that the cells are TdT–, CD10+, CD19+, CD20+, sIg+. What is the most likely diagnosis?

  • A. Burkitt leukemia/lymphoma
  • B. B-cell acute lymphoblastic leukemia (ALL)
  • C. T-cell ALL
  • D. Hematogones
Correct Answer: A

Rationale: The correct answer is A: Burkitt leukemia/lymphoma. The key features in the case are increased neutrophils with a left shift, presence of abnormal cells in blood and bone marrow, and flow cytometry showing TdT–, CD10+, CD19+, CD20+, sIg+. These findings are consistent with Burkitt leukemia/lymphoma, a highly aggressive B-cell neoplasm. The presence of CD10, CD19, and CD20, along with sIg positivity, points towards a B-cell origin. Additionally, the characteristic translocation t(8;14) involving c-Myc oncogene is commonly seen in Burkitt lymphoma. The absence of TdT expression rules out T-cell ALL (Choice C). Hematogones (Choice D) are normal precursor B-cells found in bone marrow, but they do not typically present with the clinical features described. B-cell ALL (Choice B) lacks the specific features seen in this case

An 8-year-old boy undergoes a resection of a tumor in the right cerebrum next to the lateral ventricle (supratentorial). The pathologist feels the histology is most consistent with an ependymoma. The tumor is sent for advanced molecular and genetic testing. Which of the following findings would further support a diagnosis of ependymoma?

  • A. BRAFKIAA1549 fusion
  • B. BRAFV600E mutation
  • C. RELA fusion
  • D. H3K27M mutation
Correct Answer: C

Rationale: The correct answer is C: RELA fusion. Ependymomas are known to have specific genetic alterations, including RELA fusions. The fusion of RELA gene is a hallmark genetic abnormality observed in certain subtypes of ependymomas, aiding in the diagnosis. Conversely, choices A, B, and D are associated with other types of brain tumors such as pilocytic astrocytoma (A), melanoma (B), and diffuse intrinsic pontine glioma (D), respectively. These genetic alterations are not characteristic of ependymomas, making them incorrect choices in this context.

A study is designed to investigate the rates of central line–associated blood stream infections among pediatric hematology/oncology patients. Three common central line types (totally implanted catheter [port], peripherally inserted central catheter [PICC], and tunneled externalized catheter [TEC]) were included in the study. What data structure is central line type?

  • A. Continuous
  • B. Dichotomous
  • C. Nominal
  • D. Ordinal
Correct Answer: C

Rationale: The correct answer is C: Nominal. The central line type is a categorical variable with no inherent order or ranking. Each type is distinct and cannot be quantitatively ordered or measured. It is not continuous (A), as it is not on a scale. It is not dichotomous (B) as there are more than two categories. It is not ordinal (D) because the types do not have a clear order or ranking. Therefore, central line type is best represented by a nominal data structure.

A nurse is caring for a client who is scheduled for an outpatient surgical procedure and reports taking aspirin 81 mg daily, including this morning. The nurse should identify that this places the client at risk for which of the following complications?

  • A. Uncontrolled bleeding
  • B. Myocardial infarction
  • C. Respiratory depression
  • D. Decreased renal perfusion
Correct Answer: A

Rationale: Rationale: Aspirin is an antiplatelet medication that inhibits platelet aggregation, increasing the risk of uncontrolled bleeding during surgical procedures. By taking aspirin, the client's blood clotting ability is impaired, leading to potential excessive bleeding during and after surgery. This can result in complications such as prolonged bleeding, hematoma formation, and delayed wound healing. Therefore, the correct answer is A: Uncontrolled bleeding.

Summary:
- B: Myocardial infarction is not directly related to taking aspirin; it is actually used to prevent heart attacks.
- C: Respiratory depression is not a common complication associated with aspirin use.
- D: Decreased renal perfusion is not a typical risk of taking aspirin; it primarily affects the cardiovascular system.

Basophilic stippling is classically seen in:

  • A. CML
  • B. myelosclerosis
  • C. chronic lead poisoning
  • D. iron def anemia
Correct Answer: C

Rationale: Basophilic stippling refers to the presence of blue-staining granules in red blood cells, which is a classic finding in chronic lead poisoning due to the inhibition of heme synthesis. In CML, the primary feature is the presence of the Philadelphia chromosome. Myelosclerosis is characterized by bone marrow fibrosis, not basophilic stippling. Iron deficiency anemia typically presents with microcytic hypochromic red blood cells, not basophilic stippling. Therefore, the correct answer is C: chronic lead poisoning.

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