Which of the following immune cells is primarily responsible for coordinating and regulating immune responses by producing cytokines that direct the activities of other immune cells?
- A. T helper cells (Th cells)
- B. Cytotoxic T cells (CTLs)
- C. B cells
- D. Natural killer (NK) cells
Correct Answer: A
Rationale: T helper cells (Th cells) are primarily responsible for coordinating and regulating immune responses by producing cytokines that direct the activities of other immune cells. These cytokines help in activating cytotoxic T cells, B cells, macrophages, and other cells involved in the immune response. Th cells play a crucial role in mounting an effective immune response against infections and diseases by providing the necessary signals to activate and control various immune cells. Thus, T helper cells are considered the central coordinators of the immune system.
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A patient with a history of rheumatoid arthritis presents with acute pain and swelling of the wrist joint. Physical examination reveals ulnar deviation of the fingers and swan-neck deformity of the digits. Which imaging modality is most appropriate for further evaluation of wrist involvement in rheumatoid arthritis?
- A. X-ray
- B. Magnetic resonance imaging (MRI)
- C. Ultrasound
- D. Dual-energy X-ray absorptiometry (DEXA) scan
Correct Answer: A
Rationale: X-ray is the most appropriate imaging modality for evaluating wrist involvement in rheumatoid arthritis. It can show joint space narrowing, erosions, soft tissue swelling, and periarticular osteopenia. X-rays are readily available, cost-effective, and provide valuable information about joint damage and disease progression in rheumatoid arthritis. In this case, X-ray would be able to confirm the presence of erosions, joint deformities, and assess the severity of the disease in the wrist joint. While MRI and ultrasound can also be helpful in evaluating rheumatoid arthritis, X-ray remains the initial imaging modality of choice due to its convenience and ability to assess bony changes. Dual-energy X-ray absorptiometry (DEXA) scan is not indicated for evaluating wrist involvement in rheumatoid arthritis.
To prevent complications from their heart disease the nurse recommends to the patient regular monitoring of their blood
- A. Cholesterol
- B. Type
- C. Nitrogen
- D. Oxygenation
Correct Answer: A
Rationale: The nurse recommends regular monitoring of the patient's blood cholesterol levels to prevent complications from their heart disease. High levels of cholesterol can lead to the buildup of plaque in the arteries, increasing the risk of heart problems such as heart attacks and strokes. Monitoring cholesterol levels allows healthcare providers to assess the patient's risk and make appropriate recommendations for managing their heart disease. Regular monitoring can help track the effectiveness of lifestyle changes or medications in lowering cholesterol levels and reducing the risk of complications.
Bleeding is the most serious complication of Dengue infection. When is the patient be watched for symptoms of bleeding?
- A. 4 th to 7 days
- B. 2nd to 3rd day
- C. At the onset of symptoms
- D. 1St day
Correct Answer: A
Rationale: Bleeding is the most serious complication of Dengue infection, typically occurring between the 4th to 7th day after the onset of symptoms. This is known as the critical phase of Dengue fever, where the patient is at a higher risk of developing severe symptoms such as bleeding manifestations. Monitoring for symptoms of bleeding during this period is crucial for timely intervention and proper management to prevent further complications or fatalities. While bleeding can occur outside this timeframe in some cases, the 4th to 7th day window is when the risk is highest and vigilance is most needed.
Which of the following actions is a violation of a psychiatric patient's rights?
- A. Paranoid patient with delusions about his family is told that if he makes a will, it might not be valid.
- B. The nurse confiscated the cellphone from patient's room and tell him it is being locked in the vault.
- C. Staff members confiscated written letters done by patients addressed to local newspaper.
- D. Patient is paid minimum wage for helping in the hospital kitchen.
Correct Answer: C
Rationale: In this scenario, the action that violates a psychiatric patient's rights is option C, where staff members confiscated written letters done by patients addressed to the local newspaper. Patients have the right to communicate freely and express their thoughts and feelings through various means, such as letter-writing. Confiscating these letters is a violation of their rights to free expression and communication. It is essential to respect and uphold the rights of psychiatric patients, including their right to communicate with others.
A patient presents with redness, pain, and photophobia in the left eye. Slit-lamp examination reveals ciliary injection, corneal edema, and a mid-dilated pupil with fixed reaction to light. Which of the following conditions is most likely responsible for this presentation?
- A. Anterior uveitis
- B. Acute angle-closure glaucoma
- C. Endophthalmitis
- D. Corneal abrasion
Correct Answer: A
Rationale: The presentation described in the question is characteristic of anterior uveitis. Anterior uveitis is inflammation of the iris and ciliary body in the eye. Patients typically present with symptoms such as redness, pain, and photophobia. Slit-lamp examination findings include ciliary injection (redness and engorgement of blood vessels in the ciliary body), corneal edema (swelling of the cornea), and a mid-dilated pupil with a fixed reaction to light due to involvement of the iris muscles. These features differentiate anterior uveitis from other conditions. Treatment of anterior uveitis may involve topical steroids and cycloplegics to reduce inflammation and alleviate symptoms.