Nokea
A patient with pancytopenia has a bone marrow aspiration from the left posterior iliac crest. Which action would be important for the nurse to take after the procedure?
- A. Elevate the head of the bed to 45 degrees.
- B. Apply a sterile 2-inch gauze dressing to the site.
- C. Use a half-inch sterile gauze to pack the wound.
- D. Have the patient lie on the left side for 1 hour.
Correct Answer: D
Rationale: The correct answer is D: Have the patient lie on the left side for 1 hour. This position helps prevent bleeding by applying pressure to the site. Elevating the head of the bed (A) is not necessary for this procedure. Applying a 2-inch gauze dressing (B) may disrupt the site and increase the risk of bleeding. Using half-inch sterile gauze to pack the wound (C) is not recommended for bone marrow aspiration sites as it can lead to infection.
You may also like to solve these questions
A laboratory finding of aplastic anaemia
- A. Pancytopaenia
- B. Erythrocytosis
- C. Bone marrow hypercellularity
- D. Reticulocytosis
Correct Answer: A
Rationale: Rationale:
1. Aplastic anemia is characterized by bone marrow failure, leading to decreased production of all blood cell types.
2. Pancytopenia refers to low levels of red blood cells, white blood cells, and platelets, consistent with aplastic anemia.
3. Erythrocytosis is an increase in red blood cell count, contradictory to the reduced production in aplastic anemia.
4. Bone marrow hypercellularity indicates increased cellularity, opposite to the hypocellularity seen in aplastic anemia.
5. Reticulocytosis is an elevated number of immature red blood cells, which is not typically seen in the context of bone marrow failure in aplastic anemia.
Summary:
A is correct as it aligns with the characteristic pancytopenia in aplastic anemia. B, C, and D are incorrect due to their inconsistency with the pathophysiology of the condition.
Presence of an --jaundice --splenomegaly with increase MCH is seen in:
- A. liver cirrhosis
- B. th.major
- C. PNH
- D. herditary spherocytosis
Correct Answer: D
Rationale: The correct answer is D, hereditary spherocytosis. In this condition, the presence of jaundice and splenomegaly is due to the destruction of red blood cells by the spleen, leading to increased MCH. In liver cirrhosis (choice A), jaundice is due to impaired liver function. Thalassemia major (choice B) presents with severe anemia, not jaundice. Paroxysmal nocturnal hemoglobinuria (choice C) is characterized by hemolytic anemia and not typically associated with splenomegaly and jaundice. Therefore, the presence of jaundice, splenomegaly, and increased MCH points towards hereditary spherocytosis.
You are seeing a 2-year-old girl with new onset of fever and bronchitis. She has maculopapular rash and hepatosplenomegaly. Blood smear shows leukocytosis (100,000/mm3), anemia, and thrombocytopenia. Ancillary tests include fetal hemoglobin of 80% and normal blood karyotype. What is the most likely diagnosis?
- A. Leukemoid Reaction
- B. Acute lymphoblastic leukemia (ALL)
- C. Chronic myeloid leukemia (CML)
- D. Juvenile myelomonocytic leukemia (JMML)
Correct Answer: D
Rationale: The most likely diagnosis in this case is Juvenile myelomonocytic leukemia (JMML). JMML is a rare myelodysplastic/myeloproliferative neoplasm seen in young children. The clinical presentation of fever, rash, hepatosplenomegaly, leukocytosis, anemia, and thrombocytopenia is consistent with JMML. The presence of fetal hemoglobin of 80% is a key finding in JMML, as it is a distinguishing feature. Additionally, a normal blood karyotype rules out chromosomal abnormalities commonly seen in other leukemias. Leukemoid reaction (Choice A) is characterized by a reactive increase in leukocyte count due to an underlying condition, but it does not explain the other findings in this case. Acute lymphoblastic leukemia (ALL - Choice B) primarily affects lymphoid cells, not myeloid cells as seen in this case. Chronic myeloid leukemia (C
A laboratory finding of aplastic anaemia
- A. Pancytopaenia
- B. Erythrocytosis
- C. Bone marrow hypercellularity
- D. Reticulocytosis
Correct Answer: A
Rationale: The correct answer is A: Pancytopenia. Aplastic anemia is characterized by a decrease in all blood cell types (red blood cells, white blood cells, and platelets), leading to pancytopenia. This is due to bone marrow failure, resulting in decreased production of blood cells. Erythrocytosis (B) is an increase in red blood cells, which is the opposite of what is seen in aplastic anemia. Bone marrow hypercellularity (C) is not typically observed in aplastic anemia, as the bone marrow is usually hypocellular. Reticulocytosis (D) is an increase in immature red blood cells and is not a characteristic finding in aplastic anemia where there is decreased production of all blood cell types.
The following pathological features is true regarding non-Hodgkin lymphoma (NHL)
- A. Classical Reed-Sternberg (RS) cells are neoplastic cells
- B. B cell phenotype is more common
- C. Contiguous group of lymph nodes are affected
- D. It is not associated with leukemic phase of disease
Correct Answer: B
Rationale: Step 1: Non-Hodgkin lymphoma (NHL) can arise from either B cells or T cells. B cell NHL is more common than T cell NHL.
Step 2: The B cell phenotype is predominant in NHL, making choice B correct.
Step 3: Classical Reed-Sternberg cells are characteristic of Hodgkin lymphoma, not NHL, making choice A incorrect.
Step 4: NHL can involve non-contiguous lymph nodes, ruling out choice C.
Step 5: NHL can present with leukemic involvement, refuting choice D.
Overall, the B cell phenotype being more common in NHL makes choice B the correct answer.