Nokea
Plat. Transfusion is not indicated in:
- A. aplastic an.
- B. uraemia with bleeding
- C. DIC
- D. immunogenic thrombocytopenia
Correct Answer: D
Rationale: The correct answer is D: immunogenic thrombocytopenia. Platelet transfusion is not indicated in immunogenic thrombocytopenia because it involves antibodies attacking platelets, which would render transfused platelets ineffective. Platelet transfusion is indicated in aplastic anemia (A) to increase platelet count, in uremia with bleeding (B) to replace dysfunctional platelets, and in DIC (C) to help manage severe bleeding. In summary, platelet transfusion is contraindicated in immunogenic thrombocytopenia due to ineffective platelet response.
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Virchow's node receives lymphatics from all except:
- A. testes
- B. stomach
- C. prostate
- D. breast
Correct Answer: C
Rationale: Virchow's node is a left supraclavicular lymph node that typically receives lymphatics from abdominal organs. The correct answer is C: prostate because the prostate is not an abdominal organ and does not drain into Virchow's node. The other choices, A: testes, B: stomach, and D: breast, all drain into the abdominal lymphatic system, making them potential sources of lymphatic drainage to Virchow's node.
Which of the following is not true in thrombasthenia:
- A. prolonged bleeding time
- B. normal plat .Count
- C. plat .Aggregation defect
- D. prolonged clotting time
Correct Answer: D
Rationale: In thrombasthenia, there is a deficiency or dysfunction of the glycoprotein IIb/IIIa receptor complex on platelets, leading to impaired platelet aggregation. This results in prolonged bleeding time due to ineffective platelet plug formation (choice A). Platelet count is typically normal (choice B). Platelet aggregation is defective (choice C). However, clotting time is not affected in thrombasthenia as it primarily involves platelet function, not the clotting factors involved in coagulation (choice D). Therefore, the correct answer is D.
A patient's complete blood count (CBC) shows a hemoglobin of 19 g/dL and a hematocrit of 54%. Which question should the nurse ask to determine possible causes of this finding?
- A. Have you had a recent weight loss?
- B. Do you have any history of lung disease?
- C. Have you noticed any dark or bloody stools?
- D. What is your dietary intake of meats and protein?
Correct Answer: B
Rationale: The correct answer is B: Do you have any history of lung disease? A high hemoglobin and hematocrit can be indicative of chronic hypoxia, often seen in lung diseases like COPD. The nurse should ask about lung disease to explore the possibility of chronic hypoxia as the underlying cause. Choices A, C, and D are incorrect as they do not directly relate to the potential cause of elevated hemoglobin and hematocrit levels in this scenario.
A 16-year-old female patient with severe factor XI deficiency presents with acute appendicitis and requires urgent surgery. You are called by the surgeon, who wants to know what, if any, blood products or treatments are required to reduce the risk of perioperative bleeding. The patient weighs 62 kg. What should you tell him to administer?
- A. Cryoprecipitate (five units), which will likely raise her factor XI level to 20%
- B. Factor XI concentrate (20 units/kg), which will raise her factor XI level to 20%
- C. Fresh frozen plasma (20 mL/kg), which will raise her factor XI level to 20%
- D. Prothrombin complex concentrate (40 units/kg), which will raise her factor XI level to 20%
Correct Answer: C
Rationale: The correct answer is C: Fresh frozen plasma (20 mL/kg), which will raise her factor XI level to 20%. Fresh frozen plasma contains various clotting factors, including factor XI. In patients with severe factor XI deficiency, like this 16-year-old female, fresh frozen plasma can provide factor XI replacement and improve hemostasis. The dose of 20 mL/kg is appropriate to achieve a factor XI level of around 20%, which is sufficient for hemostasis during surgery.
Now, let's analyze the other choices:
A: Cryoprecipitate (five units), which will likely raise her factor XI level to 20% - Cryoprecipitate contains factor VIII and fibrinogen, but the amount of factor XI in cryoprecipitate is minimal and may not significantly raise factor XI levels to the required 20%.
B: Factor XI concentrate (20 units/kg), which will raise her factor XI level to 20% - While factor XI concentrate is
Which of the following is a key feature of Factor XIII?
- A. Its half-life is about 10 days.
- B. It is an important activator of thrombin.
- C. Its levels are normal in newborns.
- D. It is part of the contact activation system.
Correct Answer: A
Rationale: The correct answer is A: Its half-life is about 10 days. Factor XIII has a long half-life due to its stable tetrameric structure, allowing it to circulate in the blood for about 10-14 days. This extended half-life is crucial for its role in stabilizing fibrin clots.
Explanation for why other choices are incorrect:
B: Factor XIII is not an activator of thrombin; rather, it crosslinks fibrin strands to strengthen clots.
C: Factor XIII levels are low in newborns and gradually increase during the first few months of life.
D: Factor XIII is not part of the contact activation system, which involves factors XII, XI, and prekallikrein.