Waldeyer's ring does not include:
- A. faucal tonsils
- B. submandibular glands
- C. adenoids
- D. lingual tonsils
Correct Answer: B
Rationale: The correct answer is B: submandibular glands. Waldeyer's ring consists of the pharyngeal tonsil (adenoids), tubal tonsils, palatine tonsils (faucal tonsils), and lingual tonsils. The submandibular glands are salivary glands located outside of Waldeyer's ring. The other choices are incorrect because they are all part of Waldeyer's ring, which is a ring of lymphoid tissue located in the pharynx.
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When should autologous hematopoietic stem cell transplantation be used, and what are the common cancers it is used for?
- A. It should be used when high dose therapy is needed to maximize response. Most common cancers it is used for include lymphoma, late relapse of acute lymphoblastic leukemia, neuroblastoma, and Ewing sarcoma.
- B. It should be used any time this approach can provide a meaningful survival benefit over chemotherapy. Most common cancers it is used for include neuroblastoma, responsive brain tumors in young children to avoid/minimize early radiation therapy, and relapsed lymphoma.
- C. It should be used for tumors in which a graft-versus-tumor effect does not occur. Most common cancers include neuroblastoma, lymphoma, selected brain tumors, rhabdomyosarcoma, and Ewing sarcoma with lung metastases.
- D. It should be used to avoid extensive treatment with chemotherapy and to shorten treatment. Most common cancers include neuroblastoma, relapsed Wilms' tumor, and selected brain tumors.
Correct Answer: B
Rationale: The correct answer is B because autologous hematopoietic stem cell transplantation should be used when it can provide a survival benefit over chemotherapy. This approach is particularly beneficial for certain cancers such as neuroblastoma and relapsed lymphoma.
- Choice A is incorrect because the indication for autologous transplantation is not solely based on the need for high-dose therapy, but rather on providing a meaningful survival benefit over chemotherapy. The listed cancers are not the most common ones treated with this approach.
- Choice C is incorrect because the graft-versus-tumor effect is actually desired in some cases of autologous transplantation, and the listed cancers are not the most common ones treated with this approach.
- Choice D is incorrect because the purpose of autologous transplantation is not to avoid extensive chemotherapy but to provide a survival benefit. The listed cancers are not the most common ones treated with this approach.
After receiving a diagnosis of acute lymphocytic leukemia, a patient is visibly distraught, stating, 'I have no idea where to go from here.' How should the nurse prepare to meet this patient's psychosocial needs?
- A. Assess the patient's previous experience with the health care system.
- B. Reassure the patient that treatment will be challenging but successful.
- C. Assess the patient's specific needs for education and support.
- D. Identify the patient's plan of medical care.
Correct Answer: C
Rationale: Rationale for Choice C (Correct Answer): Assessing the patient's specific needs for education and support is crucial in meeting the psychosocial needs of a patient diagnosed with acute lymphocytic leukemia. By understanding the patient's informational and emotional needs, the nurse can provide tailored support and resources, enhancing the patient's coping abilities and overall well-being. This approach fosters a therapeutic relationship and promotes patient-centered care.
Summary of Other Choices:
A: Assessing the patient's previous experience with the health care system is important but may not directly address the immediate psychosocial needs related to the new diagnosis.
B: Reassuring the patient about treatment success is premature and may invalidate the patient's feelings of distress and uncertainty.
D: Identifying the patient's plan of medical care is essential but focuses more on the medical aspect rather than the psychosocial aspect of care.
Artemisinin and its derivatives are used in the treatment of severe forms of chloroquine-resistant falciparum because they have:
- A. Rapid gametocidal activity
- B. The ability to prevent further development of hypnozoites
- C. Rapid sporontocidal activity
- D. Rapid schizonticidal activity
Correct Answer: D
Rationale: The correct answer is D: Rapid schizonticidal activity. Artemisinin and its derivatives target the malaria parasite at the schizont stage, which is crucial for the parasite's replication and survival. By rapidly killing schizonts, these drugs help in controlling the infection and preventing severe complications.
Choice A (Rapid gametocidal activity) is incorrect because artemisinin and its derivatives primarily target asexual stages of the parasite, not gametocytes. Choice B (The ability to prevent further development of hypnozoites) is incorrect as these drugs do not target the liver stages where hypnozoites develop. Choice C (Rapid sporontocidal activity) is incorrect as artemisinin derivatives do not primarily target the sexual stages of the parasite.
In summary, the correct answer is D because of the drugs' effectiveness against the schizont stage, while the other choices are incorrect as they do not align with the mechanism of action of artemisinin
A 17-year-old patient is referred to you for a platelet count of 1,200,000/mm3. On history, she notes that she often has numbness and tingling in her hands and feet and has frequent epistaxis. She is otherwise well-appearing and has no recent infections. On her exam, you note splenomegaly. What do you expect to see on further evaluation?
- A. Elevated C-reactive protein
- B. Low ferritin
- C. A hypocellular bone marrow
- D. Low von Willebrand factor activity
Correct Answer: D
Rationale: The correct answer is D: Low von Willebrand factor activity. This patient likely has Essential Thrombocythemia, a disorder characterized by excessive production of platelets by the bone marrow. This condition can lead to abnormal bleeding and clotting. The patient's symptoms of numbness, tingling, epistaxis, and splenomegaly are consistent with this diagnosis. Low von Willebrand factor activity is expected in Essential Thrombocythemia due to platelet dysfunction. Elevated C-reactive protein, low ferritin, and a hypocellular bone marrow are not typically associated with Essential Thrombocythemia and are less likely to be seen in this patient.
A young child with consanguineous parents has developmental delay and a history of multiple recurrent bacterial infections and short stature. He presents to the emergency department following trauma and requires a blood transfusion. Blood work identifies leukocytosis, neutrophilia, and the Bombay blood group (absent H antigen as well as absent A and B antigens). What is this patient's diagnosis?
- A. Chediak-Higashi syndrome
- B. Leukocyte adhesion deficiency (LAD) Type II
- C. CD18 deficiency
- D. Griscelli syndrome
Correct Answer: B
Rationale: The correct answer is B: Leukocyte adhesion deficiency (LAD) Type II. This patient's symptoms of recurrent bacterial infections, leukocytosis, neutrophilia, short stature, and Bombay blood group (lack of H antigen) are characteristic of LAD Type II. In LAD Type II, there is a defect in fucose metabolism, leading to impaired leukocyte adhesion and migration, causing immune dysfunction. Chediak-Higashi syndrome (A) presents with oculocutaneous albinism, recurrent infections, and giant granules in leukocytes. CD18 deficiency (C) is a type of LAD characterized by mutations in the CD18 gene causing impaired integrin function. Griscelli syndrome (D) presents with silvery hair, immunodeficiency, and neurological deficits, not matching this patient's symptoms.