Nokea
Increase serum iron:-decrease IBC a feature of:
- A. Hookworm infestation
- B. sideroblastic an.
- C. alcoholic liver dis.
- D. th.major
Correct Answer: B
Rationale: The correct answer is B: sideroblastic anemia. In sideroblastic anemia, there is impaired heme synthesis leading to the accumulation of iron in the mitochondria of red blood cell precursors. This results in increased serum iron levels due to the release of iron from the mitochondria. Decreased Iron Binding Capacity (IBC) occurs as a compensatory mechanism due to the increased serum iron levels.
Choice A, hookworm infestation, would typically result in iron deficiency anemia with decreased serum iron levels and normal to increased IBC. Choice C, alcoholic liver disease, is associated with decreased serum iron levels and normal to increased IBC due to impaired iron metabolism. Choice D, thalassemia major, presents with normal to decreased serum iron levels and normal to increased IBC due to ineffective erythropoiesis.
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A patient with abdominal injuries from a motor vehicle crash is scheduled for surgery to remove the spleen. What bodily function will be affected by the removal of this organ?
- A. Filtration of waste products
- B. Removal of old red blood cells from circulation
- C. Clearance of mucous in the tracheobronchial tree
- D. Facilitation of glucose to be used by the cell for energy
Correct Answer: B
Rationale: The correct answer is B: Removal of old red blood cells from circulation. The spleen is responsible for filtering and removing old or damaged red blood cells from the bloodstream. When the spleen is removed, this function is compromised, leading to a decreased ability to clear out old red blood cells. This can result in an increased risk of anemia and other complications related to the breakdown of red blood cells.
Choices A, C, and D are incorrect:
A: Filtration of waste products - The spleen primarily filters blood cells, not waste products.
C: Clearance of mucous in the tracheobronchial tree - This function is mainly carried out by the respiratory system, not the spleen.
D: Facilitation of glucose to be used by the cell for energy - This is a function of the pancreas and insulin, not the spleen.
The main vector transmitting malaria in Sabah is Anopheles balabacensis. This vector breeds in
- A. Artificial containers in urban centres
- B. Drains
- C. Temporary collecting of water in jungles
- D. Rock pools in control areas
Correct Answer: C
Rationale: The correct answer is C because Anopheles balabacensis, the main vector transmitting malaria in Sabah, breeds in temporary water collections in jungles. This is supported by research showing that this mosquito species prefers breeding in natural habitats like jungle pools. Choices A, B, and D are incorrect because Anopheles balabacensis is not typically found breeding in artificial containers in urban centers, drains, or rock pools in control areas. These habitats do not provide the specific environmental conditions required for the breeding and survival of this particular mosquito species.
You are discussing prognosis with the mother of a patient with stage 3, group III rhabdomyosarcoma. Which of the following is the most unfavorable primary site?
- A. Extremity
- B. Prostate
- C. Infratemporal fossa
- D. Neck
Correct Answer: A
Rationale: The correct answer is A: Extremity. Rhabdomyosarcoma in extremities has a worse prognosis due to difficulties in achieving complete surgical resection and higher risk of metastasis. Extremity tumors are often larger and more challenging to remove completely, leading to a higher chance of recurrence and poor outcomes. Prostate (B) and neck (D) sites are more favorable as they are easier to access for surgery and have lower rates of metastasis. Infratemporal fossa (C) is also a difficult site, but extremity tumors generally have a worse prognosis due to their anatomical and surgical challenges.
A nurse is caring for a client who is scheduled for an outpatient surgical procedure and reports taking aspirin 81 mg daily, including this morning. The nurse should identify that this places the client at risk for which of the following complications?
- A. Uncontrolled bleeding
- B. Myocardial infarction
- C. Respiratory depression
- D. Decreased renal perfusion
Correct Answer: A
Rationale: The correct answer is A: Uncontrolled bleeding. Aspirin is an antiplatelet medication that inhibits platelet aggregation, leading to decreased clotting ability. This places the client at risk for uncontrolled bleeding during and after surgery. Myocardial infarction (B) is not directly associated with aspirin use. Respiratory depression (C) is not a common complication of aspirin. Decreased renal perfusion (D) is not a typical complication of aspirin use.
A laboratory study is conducted to determine the optimal usage of platelets for transfusion. The blood bank inventory along with the transfusion records and medical records of subjects who were recipients of platelet transfusion are reviewed. Which of the following conclusions is most likely to be made from this study?
- A. Frozen storage of platelets helps increase the units available.
- B. Platelet transfusions are rarely successful in patients with autoimmune thrombocytopenia.
- C. Platelet units carry no risk for transmission of hepatitis C infection.
- D. Pooled donor platelets are preferred over single-donor platelets.
Correct Answer: B
Rationale: Step-by-step rationale for why answer B is correct:
1. Autoimmune thrombocytopenia is a condition where the body's immune system attacks and destroys its own platelets.
2. Platelet transfusions in patients with autoimmune thrombocytopenia are less likely to be successful due to the underlying immune response.
3. Reviewing transfusion records of subjects with this condition would likely show a pattern of unsuccessful platelet transfusions.
4. This conclusion is supported by medical knowledge and understanding of autoimmune thrombocytopenia.
Summary:
- Choice A is incorrect because frozen storage of platelets does not necessarily increase units available in the context of the study.
- Choice C is incorrect as platelet units can carry a risk of transmission for hepatitis C infection.
- Choice D is incorrect as the preference for pooled donor platelets over single-donor platelets is not a conclusion that can be drawn from the study.