Nokea
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: Temporary collecting of water in jungles. Anopheles balabacensis is a forest-dwelling mosquito species commonly found in jungle environments. They prefer to breed in temporary water collections such as rainwater puddles, small ponds, or stream edges within the jungle. Breeding in urban areas, drains, or rock pools would not be typical for this species based on its natural habitat preference. Therefore, the most suitable breeding site for this vector in Sabah would be temporary water collections in jungles.
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A leukemia investigator plans to obtain bone marrow under general anesthesia to measure minimal residual disease (MRD) and to see if this time point can predict early relapse. The specimen will be obtained at a time point when otherwise no bone marrow would be sampled. The results are not shared with the treating oncologist, and no therapeutic interventions are decided or based on the results. Which of the following statements is most accurate about this intervention?
- A. It constitutes a minimal-risk procedure because bone marrow assessments are considered routine for patients diagnosed with acute lymphoblastic leukemia.
- B. It constitutes a minimal-risk procedure because it is a single additional procedure being performed during the course of treatment.
- C. It constitutes a greater than minimal-risk procedure because it is being done under general anesthesia.
- D. It is justifiable because future patients may benefit from knowledge gained by the research.
Correct Answer: C
Rationale: Step 1: General anesthesia carries inherent risks, making the procedure more than minimal-risk.
Step 2: The absence of therapeutic interventions based on results does not make the procedure low-risk.
Step 3: Performing an additional procedure does not automatically make it minimal-risk.
Step 4: Not sharing results with the treating oncologist may raise ethical concerns.
Summary: Choice C is correct because the use of general anesthesia increases the risk level of the procedure, making it greater than minimal-risk. Choices A, B, and D are incorrect as they do not adequately address the specific risk associated with the use of general anesthesia in this scenario.
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.
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: The correct answer is B. Platelet transfusions are rarely successful in patients with autoimmune thrombocytopenia.
Rationale:
1. Patients with autoimmune thrombocytopenia have low platelet levels due to immune destruction.
2. Platelet transfusions may not be effective as the underlying autoimmune process continues to destroy transfused platelets.
3. Reviewing transfusion records of these patients would likely show low success rates of platelet transfusions.
Summary of Incorrect Choices:
A: Frozen storage of platelets increasing units available is not directly related to the success of platelet transfusions in autoimmune thrombocytopenia.
C: Platelet units do carry a risk of transmitting hepatitis C infection, so this conclusion is incorrect.
D: Preference for pooled donor platelets over single-donor platelets does not address the success of platelet transfusions in autoimmune thrombocytopenia.
Splenectomy is curative in:
- A. G6PD def.
- B. ITP
- C. thalassemia
- D. hereditary spherocytosis
Correct Answer: D
Rationale: Rationale: Splenectomy is curative in hereditary spherocytosis because it removes the site of red blood cell destruction. The spleen is responsible for filtering out abnormal or damaged red blood cells in this condition. Removing the spleen stops the destruction of spherocytes, leading to an improvement in anemia.
Summary of other choices:
A: G6PD def. - Splenectomy does not address the underlying enzyme deficiency causing hemolysis.
B: ITP - Splenectomy is used in refractory cases of ITP, but not considered curative.
C: Thalassemia - Splenectomy can be used to manage complications in thalassemia but does not cure the underlying genetic defect.
A nurse is caring for a patient with Hodgkin lymphoma at the oncology clinic. The nurse should be aware of what main goal of care?
- A. Cure of the disease
- B. Enhancing quality of life
- C. Controlling symptoms
- D. Palliation
Correct Answer: A
Rationale: The correct answer is A: Cure of the disease. In Hodgkin lymphoma, the main goal of care is to achieve a cure whenever possible. This is because Hodgkin lymphoma is a potentially curable cancer with appropriate treatment. Curative intent focuses on eradicating the cancer completely, leading to long-term remission or cure. Enhancing quality of life (B) is important but not the main goal in Hodgkin lymphoma as the primary aim is to eliminate the disease. Controlling symptoms (C) is important for comfort but not the main goal in curable cases. Palliation (D) is more relevant in advanced or incurable cases, not the main goal in Hodgkin lymphoma.