Nokea
Dohle bodies are patches of dilated endoplasmic reticulum that appear as cerulean blue cytoplasmic puddles. These findings are mostly seen in
- A. Chronic myeloid leukemia
- B. Leukemoid reaction
- C. Chediak-Higashi syndrome
- D. Infectious mononucleosis
Correct Answer: D
Rationale: Step-by-step rationale for why choice D (Infectious mononucleosis) is correct:
1. Infectious mononucleosis is caused by the Epstein-Barr virus.
2. Dohle bodies are seen in the peripheral blood of patients with infectious mononucleosis.
3. These bodies represent aggregates of rough endoplasmic reticulum in neutrophils.
4. The appearance of Dohle bodies is attributed to the viral infection in infectious mononucleosis.
Summary:
A: Chronic myeloid leukemia - Dohle bodies are not typically seen in this condition.
B: Leukemoid reaction - Dohle bodies are not specific to a leukemoid reaction.
C: Chediak-Higashi syndrome - This syndrome is characterized by giant granules in neutrophils, not Dohle bodies.
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When assessing a newly admitted patient, the nurse notes pallor of the skin and nail beds. The nurse should ensure that which laboratory test has been ordered?
- A. Platelet count
- B. Neutrophil count
- C. White blood cell count
- D. Hemoglobin (Hgb) level
Correct Answer: D
Rationale: The correct answer is D: Hemoglobin (Hgb) level. Pallor of the skin and nail beds indicates possible anemia, which is a decrease in red blood cells or hemoglobin. Checking the hemoglobin level will confirm if the patient is anemic. Platelet count (A) assesses for clotting ability, not anemia. Neutrophil count (B) and White blood cell count (C) are indicators of infection or inflammation, not anemia. Therefore, ensuring the hemoglobin level has been ordered is crucial for assessing the patient's pallor.
An otherwise healthy 18-year-old female is diagnosed with high-risk neuroblastoma after presenting with fatigue and bony pain. Imaging findings demonstrate a left adrenal mass with multiple osseous metastases. She successfully completes standard therapy for high-risk neuroblastoma, but experiences several episodes of disease recurrence and ultimately dies of her disease 10 years after her initial diagnosis. During her treatment, her tumor was sent for molecular analysis. Of the following, what molecular aberration was most likely to have been detected?
- A. ETV6-NTRK3 gene fusion
- B. PTPN11 mutation
- C. ATRX mutation
- D. WT1 mutation
Correct Answer: C
Rationale: The correct answer is C: ATRX mutation. In neuroblastoma, ATRX mutations are associated with poor prognosis and high-risk disease. ATRX gene mutations are commonly found in cases with aggressive behavior and poor outcomes, such as in this case where the patient experienced disease recurrence and ultimately died. ATRX mutations are linked to chromosomal instability and telomere dysfunction, which can contribute to tumor progression and resistance to therapy.
A: ETV6-NTRK3 gene fusion is more commonly associated with infantile fibrosarcoma and secretory breast carcinoma, not neuroblastoma.
B: PTPN11 mutations are typically seen in juvenile myelomonocytic leukemia and Noonan syndrome, not neuroblastoma.
D: WT1 mutations are more commonly found in Wilms tumor and acute myeloid leukemia, not neuroblastoma.
In summary, the ATRX mutation is the most likely molecular aberration detected in this patient with high-risk neuroblast
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
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Incorrect answers:
A: Continuous - Central line type does not have a continuous range of values, it is categorical.
B: Dichotomous - Dichotomous data structure has only two categories, while central line type has more than two distinct categories.
D: Ordinal - Ordinal data structure involves categories with a clear order or ranking, which is not applicable to central line types as they do not have a natural order.
The nurse is reviewing the activated partial thromboplastin time for a patient receiving heparin. Which value indicates that the medication is within the therapeutic range?
- A. 2.5 to 9.5 minutes
- B. 9.5 to 11.3 seconds
- C. 1.5 to 2.0 times normal
- D. 2.0 to 3.0 times normal
Correct Answer: C
Rationale: The correct answer is C (1.5 to 2.0 times normal) because the therapeutic range for heparin therapy is typically considered to be 1.5 to 2.0 times the normal control value for activated partial thromboplastin time (aPTT). This range ensures adequate anticoagulation to prevent clot formation without increasing the risk of bleeding. Options A, B, and D are incorrect because they provide ranges that are either too short or too long for the therapeutic goal of heparin therapy. Option A (2.5 to 9.5 minutes) and Option D (2.0 to 3.0 times normal) are outside the typical therapeutic range for heparin, indicating subtherapeutic and supratherapeutic levels, respectively. Option B (9.5 to 11.3 seconds) is also incorrect as it reflects a range for prothrombin time (PT) rather than aPTT.
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- A. Pleuropulmonary blastoma
- B. Hepatocellular carcinoma
- C. Cystic nephroma
- D. Nephroblastoma
Correct Answer: D
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Choice A: Pleuropulmonary blastoma is a rare lung tumor more commonly seen in children under 2 years old. It is not typically associated with Beckwith-Wiedemann syndrome.
Choice B: Hepatocellular carcinoma is a primary liver cancer more commonly seen in adults, not children with Beckwith-Wiedemann syndrome.
Choice C: Cystic nephroma is a benign kidney tumor typically seen in young children, but it is not associated with Beckwith-Wiedemann syndrome nor is it malignant