What is the distinguishing feature of Hodgkin disease noted on histologic exam?
- A. Reed-Sternberg cells
- B. Red-stained cells
- C. Human Papillomavirus
- D. B-cells and T-cells
Correct Answer: A
Rationale: The correct answer is A: Reed-Sternberg cells. Reed-Sternberg cells are large, abnormal B-cells that are characteristic of Hodgkin's lymphoma. These cells are identified on histologic examination of lymph node biopsies from patients with Hodgkin disease. Choice B, 'Red-stained cells,' is vague and does not describe a specific feature of Hodgkin disease. Choice C, 'Human Papillomavirus,' is incorrect as Hodgkin disease is not caused by HPV. Choice D, 'B-cells and T-cells,' is incorrect as Hodgkin disease is characterized by the presence of Reed-Sternberg cells, which are abnormal B-cells.
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What aspect of this woman's current health status would contraindicate the use of oral contraceptives?
- A. The woman has a diagnosis of type 2 diabetes.
- B. The woman has asthma and uses inhaled corticosteroids and bronchodilators.
- C. The woman has a family history of breast cancer.
- D. The woman takes an antiplatelet medication for coronary artery disease.
Correct Answer: A
Rationale: The correct answer is A. Women with type 2 diabetes are at higher risk of developing cardiovascular complications. Oral contraceptives further increase this risk due to their potential effects on blood pressure, lipid metabolism, and clotting factors. Choice B is incorrect as inhaled corticosteroids and bronchodilators do not contraindicate the use of oral contraceptives. Choice C is incorrect as a family history of breast cancer does not directly contraindicate the use of oral contraceptives. Choice D is also incorrect as taking an antiplatelet medication for coronary artery disease does not necessarily contraindicate the use of oral contraceptives.
A tension pneumothorax requires a needle thoracostomy and/or chest tube placement as treatment to which component of the pathophysiology of the condition?
- A. An accumulation of blood in the pleural space, which makes it difficult for the lungs to exchange gases.
- B. Extreme pain caused by a fractured rib
- C. A large accumulation of trapped air in the pleural space affecting both the lungs and heart.
- D. Sudden failure of the respiratory system due to fluid accumulation in the alveoli
Correct Answer: C
Rationale: A tension pneumothorax is characterized by a large accumulation of trapped air in the pleural space, creating pressure that affects both the lungs and heart. This condition can lead to life-threatening consequences by shifting mediastinal structures and impairing cardiac function. Treatment involves decompressing the trapped air to relieve the tension. Choices A, B, and D are incorrect as they do not describe the primary pathophysiological mechanism of tension pneumothorax, which is the accumulation of air in the pleural space, not blood, rib fractures, or alveolar fluid accumulation.
During the cellular stage of acute inflammation, which type of cells arrive first and in great numbers?
- A. Basophils
- B. Lymphocytes
- C. Neutrophils
- D. Platelets
Correct Answer: C
Rationale: During the cellular stage of acute inflammation, neutrophils are the first responders. Neutrophils arrive at the site of injury in large numbers to combat pathogens and remove debris. Basophils and lymphocytes are also involved in the inflammatory response, but they are not the first to arrive. Platelets play a role in hemostasis and blood clotting, rather than being the primary cells involved in the initial inflammatory response.
A healthcare provider is explaining to a patient the difference between primary and secondary immunodeficiency disorders and explains that secondary immunodeficiencies (select ONE that does not apply):
- A. May develop after viral infections
- B. Develop before birth
- C. May develop following immunosuppressive therapies
- D. Are caused by superimposed conditions
Correct Answer: B
Rationale: The correct statements about secondary immunodeficiencies are that they may develop after viral infections, following immunosuppressive therapies, and are caused by superimposed conditions. Choice B ('Develop before birth') is incorrect because secondary immunodeficiencies do not develop before birth. They are acquired later in life. Therefore, the correct answers are A, C, and D.
In a patient with HIV infected with Mycobacterium avium complex from an indoor pool, which of the following medications is the recommended treatment for MAC?
- A. Clarithromycin
- B. Isoniazid (INH)
- C. Rifabutin
- D. Azithromycin
Correct Answer: A
Rationale: The correct answer is Clarithromycin. Clarithromycin is one of the recommended medications for treating Mycobacterium avium complex (MAC) infections in patients with HIV. It is a macrolide antibiotic that is effective against MAC. Isoniazid (INH) is used to treat tuberculosis, not MAC. Rifabutin is another medication used in the treatment of MAC infections, but clarithromycin is preferred as a first-line agent. Azithromycin is also used in the treatment of MAC infections; however, clarithromycin is more commonly recommended due to its efficacy and safety profile.