Nokea
Increase Fe & normal TIBC are found in:
- A. thalassemia major
- B. haemosidrosis
- C. rheumatoid arthritis
- D. dissiminated malignancy
Correct Answer: C
Rationale: The correct answer is C: rheumatoid arthritis. In rheumatoid arthritis, there is chronic inflammation leading to elevated levels of ferritin (Fe) due to increased iron storage and a normal total iron-binding capacity (TIBC). This is because despite the increased iron stores, the body is unable to utilize it fully due to chronic inflammation.
Incorrect choices:
A: Thalassemia major would typically present with decreased TIBC due to increased iron absorption to compensate for the chronic anemia.
B: Haemosiderosis would show elevated Fe but a decreased TIBC due to iron overload.
D: Disseminated malignancy may show elevated Fe levels but typically with a decreased TIBC due to anemia of chronic disease.
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A study is designed to investigate the rates of central line–associated blood stream infections (CLABSI) among pediatric hematology/oncology patients. Investigators wish to compare the length of stay (LOS) between subjects receiving three common central line types (totally implanted catheter [port], peripherally inserted central catheter [PICC], and tunneled externalized catheter [TEC]). It is discovered that LOS is not normally distributed. What is the appropriate test for comparing the LOS between patients receiving the three central line types?
- A. Student's t test
- B. ANOVA
- C. Wilcoxon-Mann-Whitney test
- D. Kruskal-Wallis test
Correct Answer: D
Rationale: The correct answer is D: Kruskal-Wallis test. Since the LOS data is not normally distributed, parametric tests like Student's t test and ANOVA are not appropriate. The Kruskal-Wallis test is a non-parametric test used to compare three or more independent groups when the data is not normally distributed. It ranks the LOS values across the three central line types and tests whether there are differences in medians. The Wilcoxon-Mann-Whitney test (choice C) is used for comparing two independent groups, not three. Therefore, it is not the appropriate test in this scenario.
The nurse is assessing a client experiencing anemia. Which laboratory findings will the nurse expect for this client? (Select all that apply.)
- A. Increased hematocrit
- B. Decreased red blood cell count
- C. Decreased serum iron
- D. Decreased hemoglobin
Correct Answer: b
Rationale: Correct Answer: B - Decreased red blood cell count
Rationale:
1. Anemia is defined by a decrease in red blood cells, causing decreased oxygen-carrying capacity.
2. A decreased red blood cell count is a key indicator of anemia.
3. Other choices are incorrect:
A. Increased hematocrit is not expected in anemia, as it indicates a higher concentration of red blood cells.
C. Decreased serum iron may be seen in iron-deficiency anemia but is not a universal finding in all types of anemia.
D. Decreased hemoglobin is a common finding in anemia but is not as specific as a decreased red blood cell count.
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: Rationale for correct answer A:
1. Both parents must be carriers for the child to have alpha thalassemia.
2. The child has an abnormal complete blood count, indicating a hemoglobinopathy.
3. The child inherited a trans-deletion genotype alpha thalassemia trait from both parents.
4. Silent carriers have no symptoms but can pass on the trait.
Summary for incorrect choices:
B: In cis deletion, both parents would have to pass on the trait, which is not the case here.
C: Spontaneous mutation is unlikely for alpha thalassemia.
D: Both parents having cis deletions would result in a more severe form of alpha thalassemia.
A nurse reviews the laboratory data for an older patient. The nurse would be most concerned about which finding?
- A. Hematocrit of 35%
- B. Hemoglobin of 11.8 g/dL
- C. Platelet count of 400000/L
- D. White blood cell (WBC) count of 2800/L
Correct Answer: D
Rationale: The correct answer is D: White blood cell (WBC) count of 2800/L. A low WBC count (leukopenia) in an older patient can indicate an impaired immune system, making them vulnerable to infections. This is concerning as older adults have a weakened immune response. A: Hematocrit of 35% is within the normal range. B: Hemoglobin of 11.8 g/dL is slightly low but not a major concern as long as it's not significantly lower. C: Platelet count of 400000/L is within the normal range and not typically a cause for concern.
Half life of plat. Is:
- A. 1-2days
- B. 3-4days
- C. 5-6days
- D. 7-8days
Correct Answer: B
Rationale: The correct answer is B (3-4 days) because the half-life of platinum is known to be around 3-4 days based on scientific research and studies. This means that within this time frame, half of the amount of platinum will decay or disintegrate. The other choices (A, C, D) are incorrect because they do not align with the established half-life value of platinum. Option A (1-2 days), C (5-6 days), and D (7-8 days) do not fall within the typical range of platinum's half-life duration as determined by scientific data and experimentation. Therefore, option B is the most accurate and scientifically supported choice for the half-life of platinum.