Anatomy of Hematologic System

Anatomy of Hematologic System Related

Review Anatomy of Hematologic System related questions and content

An infant is born with a 7 cm × 6 cm lesion over the upper extremity from the elbow to the shoulder. The lesion is indurated and purpuric, with some petechiae around the edges. No other areas of petechiae are noted on the skin. The infant is doing well without other systemic problems. i were 9 and 9. You are called by the pediatric nurse practitioner to the NICU. What is the most appropriate next step?

  • A. Do nothing because the infant is doing well and had good Apgars.
  • B. Obtain an ultrasound for more information about the lesion.
  • C. Obtain an MRI to assess the extent of the lesion.
  • D. Obtain labs, including a CBC with platelet count and fibrinogen.
Correct Answer: D

Rationale: The correct answer is D: Obtain labs, including a CBC with platelet count and fibrinogen. This is the most appropriate next step because the infant's presentation with an indurated and purpuric lesion raises concern for a possible bleeding disorder or coagulopathy. By obtaining labs, including a CBC with platelet count and fibrinogen, we can assess the infant's hemostatic profile and rule out any underlying hematologic abnormalities. This step is crucial in ensuring the infant's well-being and guiding further management if any abnormalities are detected.

Why the other choices are incorrect:
A: Doing nothing is not appropriate as the presentation warrants further investigation.
B: An ultrasound may not provide useful information in this scenario as the lesion is concerning for a systemic issue.
C: An MRI is not the initial diagnostic test of choice for evaluating a possible bleeding disorder or coagulopathy.

You may also like to solve these questions

The nurse is reviewing the parts of the complete blood count and differential with a patient. Where should the nurse state that neutrophils, eosinophils, and basophils are produced?

  • A. Spleen
  • B. Thymus
  • C. Lymph nodes
  • D. Red bone marrow
Correct Answer: D

Rationale: The correct answer is D: Red bone marrow. Neutrophils, eosinophils, and basophils are all types of white blood cells that are produced in the red bone marrow. Red bone marrow is the primary site of hematopoiesis in adults, where all blood cells, including white blood cells, are produced. The red bone marrow contains stem cells that differentiate into various types of blood cells, including neutrophils, eosinophils, and basophils. Therefore, the nurse should explain to the patient that these specific types of white blood cells are produced in the red bone marrow. The other choices (A: Spleen, B: Thymus, C: Lymph nodes) are incorrect because they are not the primary sites for the production of these specific white blood cells.

You have a new patient consult in clinic this morning. The referral packet includes the newborn screen report, which is flagged abnormal hemoglobinopathy screen, F, A, Bart's, refer to hematology, and a complete blood count done at 4 years of age with a hemoglobin of 10 g/dL and an MCV of 68. The pediatrician has informed the parents the child has some form of alpha thalassemia. The older brother had the same newborn screen results but had a normal complete blood count when checked. The mother wants to know why her second child has an abnormal complete blood count when she and her husband do not have any blood problems. How would you respond to the child's mother?

  • A. The mother and father are both silent carriers and each passed a deleted alpha globin allele to their child. The child inherited a trans-deletion genotype alpha thalassemia trait.
  • B. The mother has cis deletion alpha thalassemia and the father has no alpha globin deletion, giving the child alpha thalassemia trait.
  • C. Neither parent has an alpha globin deletion; this was a new spontaneous mutation causing alpha thalassemia in the child.
  • D. Both parents carry cis deletions in the alpha globin gene cluster.
Correct Answer: A

Rationale: The correct answer is A because both parents are silent carriers, each passing a deleted alpha globin allele to their child, resulting in a trans-deletion genotype alpha thalassemia trait. This explanation aligns with the child's abnormal complete blood count and the family history.

Choice B is incorrect because it states that the mother has cis deletion alpha thalassemia, which is not supported by the information provided.

Choice C is incorrect as it suggests a new spontaneous mutation causing alpha thalassemia in the child, which is not consistent with the genetic inheritance pattern described.

Choice D is incorrect because it claims both parents carry cis deletions in the alpha globin gene cluster, which contradicts the scenario where the parents are silent carriers.

Waldeyer's ring does not include:

  • A. faucal tonsils
  • B. submandibular glands
  • C. adenoids
  • D. lingual tonsils
Correct Answer: B

Rationale: The correct answer is B: submandibular glands. Waldeyer's ring consists of a ring of lymphoid tissue in the pharynx, including the palatine tonsils (faucal tonsils), adenoids, and lingual tonsils. Submandibular glands are salivary glands located beneath the mandible and are not part of Waldeyer's ring. Therefore, B is the correct answer. Choices A, C, and D are incorrect because they are all components of Waldeyer's ring.

A 4-year-old girl with a history of recurrent epistaxis and easy bruising is referred to you for evaluation. She is found to have a prolonged PTT and a factor VIII level that is less than 1%. Both parents have a history of excessive bleeding. She is admitted with a severe episode of epistaxis, and your colleague orders 40 IU/kg of recombinant factor VIII. Her epistaxis resolves initially but within an hour starts again at the same severity as before. What is the best next step?

  • A. Infuse a von Willebrand factor concentrate.
  • B. Give another dose of recombinant factor VIII concentrate.
  • C. Call otorhinolaryngology to pack her nose.
  • D. Check for a factor VIII inhibitor.
Correct Answer: A

Rationale: The correct answer is A: Infuse a von Willebrand factor concentrate. In this scenario, the 4-year-old girl has a history of recurrent epistaxis and easy bruising, indicative of a bleeding disorder. The prolonged PTT and factor VIII level less than 1% suggest a deficiency in von Willebrand factor (VWF) or factor VIII. When the initial dose of recombinant factor VIII did not completely resolve the epistaxis, it indicates a possible deficiency in VWF activity. Therefore, the best next step is to infuse a von Willebrand factor concentrate to address the VWF deficiency, which should help control the bleeding.

Summary:
- Option B (Give another dose of recombinant factor VIII concentrate) is not the best choice because the initial dose did not fully resolve the bleeding, indicating a different factor may be deficient.
- Option C (Call otorhinolaryngology to pack her nose) addresses the symptom but does not

During haemostasis, prostacyclin

  • A. Cleaves prothrombin into thrombin
  • B. Causes vasodilation
  • C. Stimulates platelet aggregation
  • D. Activates fibrinolysis
Correct Answer: B

Rationale: Prostacyclin is a vasodilator, which means it causes blood vessels to widen, leading to decreased blood pressure and increased blood flow. During haemostasis, this vasodilation helps in maintaining blood flow and preventing platelet aggregation in the damaged area. Option A is incorrect because prostacyclin does not cleave prothrombin into thrombin. Option C is incorrect as prostacyclin inhibits platelet aggregation. Option D is incorrect because prostacyclin does not directly activate fibrinolysis. In summary, the correct answer is B because prostacyclin's vasodilation function plays a crucial role in haemostasis by preventing excessive clot formation and maintaining blood flow.

Copyright © 2025 Nokea. All rights reserved.