Nokea
Which of the following alters the function of thrombin from a procoagulant protein to one that downregulates the formation of fibrinogen?
- A. Protein C
- B. Protein S
- C. Antithrombin
- D. Thrombomodulin
Correct Answer: D
Rationale: The correct answer is D: Thrombomodulin. Thrombomodulin binds to thrombin and changes its function from procoagulant to anticoagulant by activating protein C. This leads to the downregulation of fibrinogen formation. Protein C (choice A) and its cofactor Protein S (choice B) are involved in the anticoagulant pathway but do not directly alter thrombin's function. Antithrombin (choice C) inhibits thrombin and other coagulation factors, but it doesn't specifically change thrombin's function from procoagulant to anticoagulant.
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An older client asks the nurse why 'people my age' have weaker immune systems than younger people. What responses by the nurse are best? (Select all that apply.)
- A. Bone marrow produces more blood cells as you age.'
- B. You may have decreased levels of circulating platelets.'
- C. You have lower levels of plasma proteins in the blood.'
- D. Lymphocytes become more reactive to antigens.'
Correct Answer: C
Rationale: Rationale:
- As we age, there is a decrease in the production of plasma proteins, which are essential for immune function.
- Lower levels of plasma proteins can lead to a weaker immune response.
- This decline in plasma proteins can make older individuals more susceptible to infections.
- Choices A, B, and D are incorrect as they do not directly address the impact of aging on immune system function.
Which of the following requires IL-2 and IL-4 in the conversion of unilineage progenitor cell into mature circulating cell?
- A. Neutrophil
- B. Eosinophil
- C. Basophil
- D. B lymphocyte
Correct Answer: D
Rationale: The correct answer is D: B lymphocyte. IL-2 and IL-4 are crucial for the differentiation of B lymphocytes from unilineage progenitor cells. IL-2 supports proliferation and survival of B cells, while IL-4 promotes their differentiation into mature circulating cells. Neutrophils, eosinophils, and basophils develop independently of IL-2 and IL-4. Neutrophils mainly require granulocyte colony-stimulating factor (G-CSF), eosinophils require IL-5, and basophils are influenced by IL-3 and IL-5. Therefore, the correct answer is D as B lymphocytes specifically rely on IL-2 and IL-4 for their maturation.
A nurse is caring for a client who has hemophilia A and is about to begin taking desmopressin to prevent bleeding. The nurse should monitor the client for which of the following adverse reactions?
- A. Weight loss
- B. Edema
- C. Polyuria
- D. Bradycardia
Correct Answer: B
Rationale: The correct answer is B: Edema. Desmopressin is a synthetic form of vasopressin that can cause fluid retention, leading to edema. This is a common adverse reaction associated with desmopressin use. Weight loss (choice A) is not a typical adverse reaction of desmopressin. Polyuria (choice C) is actually a desired effect of desmopressin, as it helps to concentrate urine. Bradycardia (choice D) is not directly associated with desmopressin use. Monitoring for edema is important to ensure the client's safety and adjust treatment as needed.
A patient is scheduled for upcoming surgery. He is on nonsteroidal anti-inflammatory drugs (NSAIDs) for rheumatoid arthritis. You are being asked what to do with his medications for the surgery. What is the mechanism of action of NSAIDS?
- A. Irreversible inhibition of cyclooxygenase 1
- B. Irreversible inhibition of cyclooxygenase 2
- C. Reversible inhibition of cyclooxygenase 1
- D. Reversible inhibition of cyclooxygenase 2
Correct Answer: C
Rationale: The correct answer is C: Reversible inhibition of cyclooxygenase 1. NSAIDs work by reversibly inhibiting cyclooxygenase enzymes, particularly COX-1 and COX-2, which are involved in the synthesis of prostaglandins. In this case, reversible inhibition is crucial because it allows for the temporary suppression of prostaglandin production, leading to pain relief and anti-inflammatory effects.
Explanation of other choices:
A: Irreversible inhibition of cyclooxygenase 1 - This is incorrect because NSAIDs typically do not irreversibly inhibit COX-1.
B: Irreversible inhibition of cyclooxygenase 2 - This is incorrect because NSAIDs do not irreversibly inhibit COX-2.
D: Reversible inhibition of cyclooxygenase 2 - This is incorrect because while NSAIDs can inhibit COX-2, the primary target is COX-1 for their therapeutic effects.
You are seeing a 12-year-old boy in the survivorship program who presented at 2 years old with a desmoplastic nodular medulloblastoma. You note the child recently underwent germline genetic testing and was found to have nevoid basal cell carcinoma syndrome. In which gene is the child most likely to have a pathogenic variant?
- A. PTEN
- B. CDKN2A
- C. SUFU
- D. SMARCB1
Correct Answer: C
Rationale: Rationale:
1. Nevoid basal cell carcinoma syndrome is also known as Gorlin syndrome, caused by mutations in SUFU.
2. SUFU gene regulates the Hedgehog signaling pathway, implicated in medulloblastoma development.
3. Desmoplastic nodular medulloblastoma is commonly seen in Gorlin syndrome.
4. PTEN is associated with Cowden syndrome, CDKN2A with melanoma, and SMARCB1 with rhabdoid tumors, not typically seen in Gorlin syndrome.