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A patient with systemic lupus erythematosus (SLE) is admitted to the hospital for evaluation and management of acute joint inflammation. Which information obtained in the admission laboratory testing concerns you most?
- A. The blood urea nitrogen (BUN) level is elevated.
- B. The C-reactive protein (CRP) level is increased.
- C. The anti-nuclear antibody (ANA) test is positive.
- D. The lupus erythematosus (LE) cell prep is positive.
Correct Answer: A
Rationale: An elevated BUN level may indicate kidney involvement which is a serious complication of SLE. The other findings are expected in SLE and do not indicate an urgent problem. CRP is a marker of inflammation and positive ANA and LE cell prep are diagnostic of SLE but do not indicate acute complications.
You may also like to solve these questions
Which TLR is primarily responsible for recognizing lipopolysaccharide (LPS)?
- A. TLR2
- B. TLR4
- C. TLR5
- D. TLR9
Correct Answer: B
Rationale: The correct answer is B: TLR4. TLR4 is primarily responsible for recognizing lipopolysaccharide (LPS) found in the outer membrane of Gram-negative bacteria. It forms a complex with MD-2 and CD14 to trigger downstream signaling pathways. TLR2 recognizes other microbial components such as lipoproteins. TLR5 recognizes flagellin, a component of bacterial flagella. TLR9 recognizes unmethylated CpG DNA motifs. Therefore, TLR4 is specifically involved in detecting LPS, making it the correct answer in this scenario.
What is a significant consequence of the evolutionary arms race between hosts and pathogens?
- A. Pathogens evolve slower than hosts
- B. Hosts develop epigenetic changes for immune adaptation
- C. Mutations in hosts always outpace pathogen evolution
- D. Hosts and pathogens remain static in their interactions
Correct Answer: B
Rationale: The correct answer is B because hosts developing epigenetic changes for immune adaptation is a significant consequence of the evolutionary arms race between hosts and pathogens. This adaptation allows hosts to better defend against evolving pathogens over time. This process is dynamic, as both hosts and pathogens continuously evolve in response to each other.
Choice A is incorrect because pathogens can evolve rapidly to adapt to host defenses. Choice C is incorrect because while hosts may have mutations that provide advantages, pathogens can also evolve to overcome host defenses. Choice D is incorrect as the interaction between hosts and pathogens is characterized by constant adaptation and change, not remaining static.
Match the immunoglobulins with their primary functions:
- A. 1-C, 2-A, 3-B, 4-D
- B. 1-B, 2-C, 3-D, 4-A
- C. 1-D, 2-B, 3-C, 4-A
- D. 1-A, 2-D, 3-B, 4-C
Correct Answer: A
Rationale: The correct answer is A: 1-C, 2-A, 3-B, 4-D. Immunoglobulins are antibodies with different functions:
1. IgG (C) - Main antibody in secondary immune response.
2. IgA (A) - Found in mucosal areas, neutralizes pathogens.
3. IgM (B) - First antibody produced in primary immune response.
4. IgE (D) - Involved in allergic reactions and defense against parasites. Other choices are incorrect as they mismatch the immunoglobulins with their functions.
A clinical indicator of inflammation is:
- A. Decreased concentration of C3b
- B. Increased concentration of C-reactive protein
- C. Decreased concentration of MBL
- D. All of the above
Correct Answer: B
Rationale: The correct answer is B: Increased concentration of C-reactive protein. This is because C-reactive protein is a well-established clinical indicator of inflammation, produced by the liver in response to inflammation. Choice A is incorrect because a decreased concentration of C3b is not a typical indicator of inflammation. Choice C is incorrect because mannose-binding lectin (MBL) is an acute-phase reactant that increases in response to inflammation, so a decreased concentration of MBL would not be indicative of inflammation. Choice D is incorrect as it includes all options, but only B is a valid clinical indicator of inflammation.
The nurse is caring for a patient who just returned from surgical decompression of the carpal tunnel. Which finding requires the nurse's immediate action?
- A. The patient's fingers swollen and warm.
- B. The patient complains of generalized pain 5/10.
- C. The capillary refill time is 8 seconds.
- D. The patient's fingers are pink and cool bilaterally.
Correct Answer: C
Rationale: The correct answer is C because a capillary refill time of 8 seconds indicates poor perfusion, which could be a sign of compromised blood flow to the fingers post-surgical decompression. This finding requires immediate action to prevent complications such as ischemia or impaired wound healing.
A: Swollen and warm fingers are expected after surgery due to inflammation.
B: Generalized pain can be managed with appropriate pain relief measures and is not an immediate concern post-surgery.
D: Pink and cool fingers indicate adequate perfusion and are normal findings post-surgery.