Nokea
Peripheral bl. Picture is most useful in:
- A. NHL
- B. multiple myeloma
- C. myelodysplastic syndrome
- D. CML
Correct Answer: D
Rationale: The correct answer is D: CML. Peripheral blood picture is most useful in diagnosing CML due to the characteristic presence of increased mature and immature granulocytes, especially neutrophils, in the blood smear. This finding is known as a "left-shift" and is a hallmark of CML. In contrast, NHL (choice A) primarily involves lymphocytes, multiple myeloma (choice B) is characterized by abnormal plasma cells, and myelodysplastic syndrome (choice C) typically presents with dysplastic changes in blood cell precursors. Therefore, based on the specific blood cell findings, CML is the most likely diagnosis when observing a peripheral blood picture.
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Which of the following is not the criteria in the international prognostic index for non Hodgkin's lymphoma?
- A. Number of extranodal sites
- B. LDH level
- C. Lymphocyte count
- D. Performance status
Correct Answer: C
Rationale: The correct answer is C: Lymphocyte count. In the International Prognostic Index for Non Hodgkin's Lymphoma, the criteria are based on the number of extranodal sites, LDH level, and performance status. Lymphocyte count is not included in the IPI criteria because it does not play a significant role in predicting the prognosis of Non Hodgkin's Lymphoma. Lymphocyte count is not a commonly used parameter in prognostic scoring systems for this type of cancer. Therefore, the absence of lymphocyte count as a criteria in the IPI is justified.
According to the FAB classification, the L2 stage is characterized by:
- A. Large heterogenous blasts with prominent nucleoli
- B. Small homogenous blasts with scanty nucleoli and higher nucleus to cytoplasm ratio
- C. Large homogenous blasts with scanty nucleoli and higher nucleus to cytoplasm ratio
- D. Large blasts with basophilic vacuolated cytoplasm
Correct Answer: C
Rationale: The correct answer is C because according to the FAB classification, the L2 stage is characterized by large homogenous blasts with scanty nucleoli and a higher nucleus to cytoplasm ratio. This stage represents acute lymphoblastic leukemia with a high risk of relapse. Choice A is incorrect as it describes the L1 stage. Choice B is incorrect as it describes the L3 stage. Choice D is incorrect as it does not accurately describe the characteristics of the L2 stage.
An emergency department nurse is triaging a 77-year-old man who presents with uncharacteristic fatigue as well as back and rib pain. The patient denies any recent injuries. The nurse should recognize the need for this patient to be assessed for what health problem?
- A. Hodgkin disease
- B. Non-Hodgkin Lymphoma
- C. Multiple Myeloma
- D. Acute Thrombocytopenia
Correct Answer: C
Rationale: The correct answer is C: Multiple Myeloma. This condition commonly presents with symptoms such as fatigue, back pain, and rib pain due to bone involvement. In older adults, these symptoms should raise suspicion for multiple myeloma, a type of cancer that affects plasma cells in the bone marrow. The nurse should assess for further signs such as anemia, hypercalcemia, renal impairment, and bone lesions. Hodgkin and Non-Hodgkin Lymphoma usually present with lymphadenopathy rather than bone pain. Acute Thrombocytopenia would present with symptoms related to low platelet count, such as bruising or bleeding, not fatigue and bone pain.
A 50-year-old male who had frequent infections of his upper respiratory tract manifested with subcutaneous petechiae over his arms and legs. Investigations revealed low hemoglobin and a dry tap marrow. The most likely condition the patient is suffering from
- A. Iron deficiency anemia
- B. Megaloblastic anemia
- C. Hemolytic anemia
- D. Aplastic anemia
Correct Answer: D
Rationale: The correct answer is D: Aplastic anemia. Aplastic anemia is characterized by pancytopenia, which includes low hemoglobin levels leading to anemia. The dry tap marrow indicates bone marrow failure, which is a hallmark of aplastic anemia. The subcutaneous petechiae are due to thrombocytopenia, another feature of this condition. Iron deficiency anemia (A) typically presents with microcytic hypochromic red blood cells and is not associated with bone marrow failure. Megaloblastic anemia (B) is characterized by macrocytic red blood cells and is usually due to deficiencies in vitamin B12 or folate. Hemolytic anemia (C) involves the premature destruction of red blood cells and is not typically associated with bone marrow failure.
A 4-year-old child with acute lymphoblastic leukemia is receiving high-dose methotrexate during interim maintenance. He receives ondansetron and арrepitant 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: The correct answer is D: Vomiting center. Ondansetron and aprepitant are antiemetic medications that work by inhibiting signaling in the vomiting center of the brain. The vomiting center is located in the medulla oblongata in the brainstem, which plays a crucial role in triggering the reflexes that lead to nausea and vomiting. By blocking signals in the vomiting center, these medications effectively prevent and control nausea and vomiting.
Incorrect choices:
A: The vestibular system is responsible for balance and spatial orientation, not for controlling nausea and vomiting.
B: The cerebral cortex is involved in higher brain functions such as thinking and decision-making, not in regulating nausea and vomiting.
C: The hypothalamus regulates various physiological processes like temperature regulation and hormone release, but it is not directly involved in controlling nausea and vomiting.