Nokea
Busulfan therapy lead to all except:
- A. hyperpigmentation
- B. pulm .Fibrosis
- C. optic neuritis
- D. BM suppression
Correct Answer: C
Rationale: The correct answer is C: optic neuritis. Busulfan therapy is known to cause adverse effects such as hyperpigmentation, pulmonary fibrosis, and bone marrow suppression due to its cytotoxic effects. However, optic neuritis is not a reported side effect of busulfan therapy. Optic neuritis is more commonly associated with other medications or conditions affecting the optic nerve. Therefore, the absence of optic neuritis as a known side effect of busulfan therapy makes choice C the correct answer.
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Your patient with relapsed high-risk neuroblastoma returns to your care after travelling to an outside institution for [131]I-MIBG therapy. In the weeks following [131]I-MIBG therapy, what adverse events directly attributable to this therapy will the patient most likely encounter?
- A. Myelosuppression requiring growth factor and blood product support
- B. Severe mucositis
- C. Hemorrhagic cystitis
- D. Symptomatic hypothyroidism
Correct Answer: A
Rationale: Rationale for Correct Answer (A): Myelosuppression requiring growth factor and blood product support is the most likely adverse event following [131]I-MIBG therapy due to its impact on bone marrow. The therapy targets neuroblastoma cells, but can also affect normal bone marrow function, leading to myelosuppression. Growth factors and blood products are often needed to support hematopoiesis.
Summary of Incorrect Answers:
B: Severe mucositis: Not a common adverse event associated with [131]I-MIBG therapy, as it primarily affects the bone marrow.
C: Hemorrhagic cystitis: Not directly related to [131]I-MIBG therapy, which does not typically cause bladder toxicity.
D: Symptomatic hypothyroidism: While [131]I-MIBG therapy can affect thyroid function, symptomatic hypothyroidism is not the most likely adverse event following this therapy.
You are consulted on a 4-year-old girl who is newly diagnosed with standard-risk pre-B acute lymphoblastic leukemia. After reviewing her previous complete blood examinations, you note she has had a platelet count ranging from 80,000 to 100,000 cells/mcL over the past 2 years. Her father mentions that he has also been told he has mild thrombocytopenia. You suspect the child may have a cancer predisposition syndrome. Which sample should you send for analysis, and which gene is most likely implicated?
- A. Skin fibroblasts to evaluate the RUNX1 gene
- B. Skin fibroblasts to evaluate the ETV6 gene
- C. Buccal swab to evaluate the RUNX1 gene
- D. Buccal swab to evaluate the ETV6 gene
Correct Answer: B
Rationale: The correct answer is B: Skin fibroblasts to evaluate the ETV6 gene.
1. ETV6 gene mutations are associated with inherited thrombocytopenia, making it a likely candidate in this case.
2. Skin fibroblasts are needed for genetic analysis as they provide a reliable sample for detecting genetic mutations.
3. RUNX1 gene mutations are also linked to thrombocytopenia but are more commonly associated with familial platelet disorder with predisposition to acute myeloid leukemia.
4. Buccal swabs are not ideal for evaluating genetic mutations related to thrombocytopenia as they may not provide sufficient genetic material for accurate testing.
NADPH is a product of the hexose monophosphate pathway (HMP) in the red blood cell. The NADPH is used for the
- A. Synthesis of fatty acids
- B. Reduction of glutathione
- C. Formation of ATP
- D. Removal of oxygen radicals
Correct Answer: B
Rationale: The correct answer is B: Reduction of glutathione. In the hexose monophosphate pathway (HMP), NADPH is generated, which serves as a reducing agent. This NADPH is crucial for reducing oxidized glutathione back to its reduced form, maintaining cellular antioxidant defense. This process helps to protect cells from oxidative damage and maintain redox balance.
Now, let's summarize why the other choices are incorrect:
A: Synthesis of fatty acids - NADPH is indeed involved in fatty acid synthesis, but in the context of red blood cells, the primary role of NADPH is in reducing glutathione.
C: Formation of ATP - NADPH is not directly involved in ATP synthesis. ATP is primarily produced through processes like glycolysis and oxidative phosphorylation.
D: Removal of oxygen radicals - While NADPH indirectly contributes to the removal of oxygen radicals through its role in reducing glutathione, it is not the primary function of NAD
In microcytic hypochromic anaemia
- A. Red cells are larger with normal staining
- B. Red blood cell count is increased
- C. Haemtocrit and mean corpuscular haemoglobin are normal
- D. Red cells are smaller with a pale large central pallor
Correct Answer: D
Rationale: In microcytic hypochromic anemia, red cells are smaller with decreased hemoglobin content, leading to pale appearance. Choice D is correct as it describes the typical characteristics of microcytic hypochromic anemia. Choice A is incorrect as red cells are smaller, not larger. Choice B is incorrect as red blood cell count is usually decreased. Choice C is incorrect as both hematocrit and mean corpuscular hemoglobin are decreased in microcytic hypochromic anemia.
A 4-year-old child with acute lymphoblastic leukemia is receiving high-dose methotrexate during interim maintenance. He receives ondansetron and арретitant during his stay, which control his nausea and vomiting well. These medications work by inhibiting signaling in which part of the brain?
- A. Vestibular system
- B. Cerebral cortex
- C. Hypothalamus
- D. Vomiting center
Correct Answer: E
Rationale: I apologize, but it seems like the correct answer (E) is missing from the choices provided in the question. If you could kindly provide the correct answer, I would be more than happy to provide a detailed explanation for why that answer is correct and summarize why the other choices are incorrect.