Questions About Chronic Wasting Disease

Questions About Chronic Wasting Disease Related

Review Questions About Chronic Wasting Disease related questions and content

Mr Soh, a 40-year-old accountant on allopurinol 200 mg OM for the past eight months, reports two recent gout attacks in the past year. He has no other known past medical history. When you probe, he is adherent to allopurinol except for missing it perhaps once or twice a month. His BMI 25 kg/m², BP 144/94 mm Hg. His last uric acid was one month ago, which was 405 mmol/L. He is having a gout attack now. He tells you that his gout attacks are usually aborted with colchicine TDS for two days. Whilst on colchicine, he does not experience diarrhoea except for one episode of loose stools, after which he stops colchicine. Which is the most appropriate next step?

  • A. Start Hydrochlorothiazide for hypertension
  • B. Start Losartan for hypertension
  • C. Stop Allopurinol during this acute gout attack and start colchicine. Consider checking a baseline creatinine if not recently available
  • D. Continue allopurinol at 200 mg OM despite the attack and start colchicine. Consider checking an updated uric acid level and creatinine two weeks after the attack resolves. If uric acid is >360, explain that allopurinol 200 mg OM is insufficient and needs to be up titrated
Correct Answer: D

Rationale: Gout mid-attack 405 uric acid on 200 mg allopurinol says it's not enough. Keep it rolling, add colchicine to quash the flare, then recheck labs post-calm to titrate up if >360. Stopping allopurinol spikes urate; HCTZ worsens gout; Losartan's fine but sidesteps; upping now risks confusion. Clinicians stick this path, steering chronic control smart.

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A 65-year-old female presented to the emergency room with complaint of progressively worsening fatigue, shortness of breath, and palpitations. Upon assessment, heart rate is 130 beats per minute and irregular, and there is positive jugular vein distention. Heart tones reveal a high-pitched holosystolic murmur. Which of the following disorders are consistent with these findings?

  • A. Mitral regurgitation
  • B. Mitral stenosis
  • C. Mitral valve prolapse
  • D. Aortic regurgitation
Correct Answer: A

Rationale: Mitral regurgitation leaks blood back holosystolic murmur, irregular tachycardia, JVD, and dyspnea fit, as left heart flops, backing up into veins. Stenosis murmurs diastolic; prolapse clicks midsystolic; aortic regurgitation's early diastolic. Nurses tie this to MR's volume overload, anticipating echo, a match for this failing valve tale.

Which ONE of the following is NOT a diagnostic criterion for Kawasaki's disease?

  • A. fever for 5 days
  • B. bilateral non purulent conjunctivitis
  • C. generalised lymphadenopathy
  • D. polymorphous rash
Correct Answer: C

Rationale: Kawasaki fever, eyes, rash, hands fit; lymph's one node, not general. Nurses count this chronic five, not six.

A 54-year-old has a diagnosis of breast cancer and is tearfully discussing her diagnosis with the nurse. The patient states, 'They tell me my cancer is malignant, while my coworker's breast tumor was benign. I just don't understand at all.' When preparing a response to this patient, the nurse should be cognizant of what characteristic that distinguishes malignant cells from benign cells of the same tissue type?

  • A. Slow rate of mitosis of cancer cells
  • B. Different proteins in the cell membrane
  • C. Differing size of the cells
  • D. Different molecular structure in the cells
Correct Answer: B

Rationale: Malignant breast cancer cells flaunt tumor-specific antigens (e.g., CEA) on their membranes, unlike benign ones from the same tissue think of it as a wanted' sign for the immune system. Mitosis isn't slow it's fast in malignant cells. Size varies, not the defining split. Molecular structure shifts, but membrane proteins are the standout marker. Nurses use this to explain why her cancer's a threat those antigens tag it as invasive, a core oncology lesson for scared patients piecing it together.

The nurse is assessing a 14-year-old girl with a tumor. Which of the following findings would indicate Ewing sarcoma?

  • A. Child complains of dull bone pain just above the knee.
  • B. Palpation reveals non-tender swelling on the right ribs.
  • C. Parents report a mass on the abdomen that crosses the midline.
  • D. Palpation reveals asymptomatic mass on the upper back.
Correct Answer: B

Rationale: Ewing sarcoma is a rare bone cancer primarily affecting children and adolescents, typically arising in flat bones like the pelvis, chest wall (e.g., ribs), or vertebrae, and the diaphysis of long bones. A hallmark is a palpable, non-tender mass, making non-tender swelling on the ribs a strong indicator, as it aligns with the tumor's common chest wall location and lack of initial pain sensitivity. Dull bone pain above the knee suggests a long bone issue, possibly osteosarcoma, which favors the metaphysis, not Ewing's typical diaphysis site. An abdominal mass crossing the midline is more characteristic of Wilms tumor or neuroblastoma, not Ewing sarcoma. An asymptomatic upper back mass could suggest various tumors, but lacks specificity for Ewing's flat bone preference. Nurses must recognize this presentation to facilitate prompt imaging and biopsy, critical for early diagnosis and treatment planning in pediatric oncology.

For a patient with osteogenic sarcoma, you would be particularly vigilant for elevations in which laboratory value?

  • A. Sodium
  • B. Calcium
  • C. Potassium
  • D. Hematocrit
Correct Answer: B

Rationale: Osteogenic sarcoma, a bone cancer, often triggers hypercalcemia bone destruction releases calcium into blood, risking arrhythmias or kidney damage, a life-threatening shift demanding close watch. Sodium and potassium imbalances aren't bone-specific, more tied to general metabolism or treatment side effects. Hematocrit reflects anemia, common in cancer but not osteogenic sarcoma's hallmark. Calcium's spike, linked to osteolysis, makes it the nurse's focus elevations signal tumor activity or progression, prompting urgent interventions like fluids or bisphosphonates, a vigilance rooted in this cancer's skeletal impact and metabolic havoc.

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