Nokea
Which of the following is the most suitable anti malarial drug for pregnant women?
- A. Atovaquone and proguanil
- B. Quinine and doxycycline
- C. Quinine and clindamycin
- D. Primaquine
Correct Answer: C
Rationale: The correct answer is C: Quinine and clindamycin. Quinine is recommended for pregnant women due to its safety profile in pregnancy. Clindamycin is often used in combination with quinine to treat malaria during pregnancy.
A: Atovaquone and proguanil are not recommended for pregnant women due to limited safety data.
B: Quinine and doxycycline should be avoided in pregnancy as doxycycline can harm the fetus.
D: Primaquine is not recommended during pregnancy due to potential risks to the fetus.
In summary, the combination of quinine and clindamycin is the most suitable anti-malarial drug for pregnant women due to their safety profiles and efficacy in treating malaria without harming the fetus.
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A female infant is diagnosed with hemophagocytic lymphohistiocytosis (HLH) not associated with an Epstein-Barr virus (EBV) infection. In taking the family history, you learn that another female infant died of HLH 2 years ago. Also, a newborn female child died of an unknown disease 4 years prior and was said have been bleeding profusely, jaundiced, and had a distended abdomen. When counseling the family about the genetics of HLH, how will you explain it?
- A. It is an X-linked syndrome
- B. It is an autosomal recessive syndrome
- C. It is a dominant inheritance syndrome
- D. It is an autosomal recessive syndrome with incomplete penetrance
Correct Answer: B
Rationale: The correct answer is B: It is an autosomal recessive syndrome. HLH is typically inherited in an autosomal recessive pattern, meaning both parents must pass on a copy of the mutated gene for the child to develop the condition. In this case, the family history suggests a pattern of multiple affected female infants, which is more indicative of an autosomal recessive inheritance. Choice A (X-linked syndrome) is incorrect because the pattern of inheritance in this family does not align with X-linked inheritance. Choice C (dominant inheritance syndrome) is incorrect because a dominant inheritance pattern would not typically result in multiple affected offspring. Choice D (autosomal recessive syndrome with incomplete penetrance) is incorrect because incomplete penetrance would not explain the consistent occurrence of HLH in this family.
A hospitalized client has a platelet count of 58,000/mm3 (58 × 109/L). What action by the nurse is most appropriate?
- A. Encourage high-protein foods.
- B. Institute neutropenic precautions.
- C. Limit visitors to healthy adults.
- D. Place the client on safety precautions.
Correct Answer: D
Rationale: The correct answer is D: Place the client on safety precautions. A platelet count of 58,000/mm3 is considered low (normal range is 150,000-450,000/mm3). This places the client at risk for bleeding. Safety precautions involve preventing injuries that could lead to bleeding, such as falls, bumps, or cuts. This is crucial to prevent complications like spontaneous bleeding. Encouraging high-protein foods (choice A) is important for overall health but not directly related to managing low platelet count. Neutropenic precautions (choice B) are for clients with low white blood cell counts, not low platelet counts. Limiting visitors (choice C) to healthy adults is important for infection control but not directly related to preventing bleeding in a client with low platelet count.
The nurse is reviewing laboratory results and notes an aPTT level of 28 seconds. The nurse should notify the health care provider in anticipation of adjusting which medication?
- A. Aspirin
- B. Heparin
- C. Warfarin
- D. Erythropoietin
Correct Answer: B
Rationale: The correct answer is B: Heparin. An aPTT level of 28 seconds indicates a shorter clotting time than normal, suggesting that the patient may be at risk for bleeding due to excessive anticoagulation with heparin. The nurse should notify the healthcare provider to adjust the heparin dosage to prevent bleeding complications.
A: Aspirin is an antiplatelet medication and does not affect aPTT levels.
C: Warfarin is a vitamin K antagonist and primarily affects the PT/INR levels, not aPTT.
D: Erythropoietin is a hormone that stimulates red blood cell production and does not affect clotting parameters such as aPTT.
Best tit modality in CML is:
- A. hydroxyurea
- B. allogenic BMT
- C. interferon alpha
- D. radiotherapy
Correct Answer: B
Rationale: The best treatment modality for Chronic Myeloid Leukemia (CML) is allogenic Bone Marrow Transplant (BMT) due to its potential for cure by replacing abnormal cells with healthy donor cells. Hydroxyurea only controls symptoms, interferon alpha has limited efficacy, and radiotherapy is not a standard treatment for CML. BMT offers a curative potential by replacing cancerous cells with healthy donor cells, making it the most effective option for treating CML.
Which of the following characteristics are similar with respect to Factor VIII and von Willebrand factor (vWF)?
- A. Both are made in endothelial cells and megakaryocytes.
- B. Both are activated by thrombin.
- C. They are present in normal to high relative amounts in newborns.
- D. They are stored in Weibel-Palade bodies in endothelial cells.
Correct Answer: C
Rationale: Step-by-step rationale:
1. Factor VIII and vWF are present in normal to high relative amounts in newborns due to the physiological adaptation to the low levels at birth.
2. Both Factor VIII and vWF play crucial roles in the coagulation cascade, but their levels decrease after birth.
3. The other choices are incorrect because:
- A: Factor VIII is primarily made in endothelial cells and vWF is made in endothelial cells and platelets, not megakaryocytes.
- B: Thrombin activates Factor VIII but not vWF, which is activated by shear stress.
- D: Factor VIII is stored in Weibel-Palade bodies, but vWF is stored in platelets and endothelial cells, not in the Weibel-Palade bodies.