Question 1

What is the most common cause of microcytic anemia?

Accepted Answer

Iron-deficiency anemia is the most common cause of microcytic anemia. In this type of anemia, there is a lack of sufficient iron to produce hemoglobin, resulting in smaller and paler red blood cells. Anemia of chronic disease, sideroblastic anemia, and thalassemia can also cause microcytic anemia but are less common than iron-deficiency anemia.

Question 2

Dryness of the eyes and mouth is typical of which condition?

Accepted Answer

Dryness of the eyes and mouth are classic symptoms of Sjögren’s syndrome, an autoimmune disorder that primarily affects the glands that produce tears and saliva.

Question 3

After returning from visiting his grandchildren in England, George, age 59, complains of a flulike illness, including fever, chills, and myalgia.He reports having discovered a rash or red spot that grew in size on his right leg.What disease are you considering?

Accepted Answer

Lyme disease is suggested by the symptoms and the characteristic expanding rash (erythema migrans), which is commonly associated with tick bites. George's recent visit to England, an area where Lyme disease is endemic, further supports this diagnosis.

Question 4

What is the most common cause of generalized musculoskeletal pain in women ages 20 to 55?

Accepted Answer

Fibromyalgia syndrome (FMS) is the most common cause of generalized musculoskeletal pain in women ages 20 to 55.

Question 5

If the international normalized ratio (INR) result is above the therapeutic range in a patient with atrial fibrillation on warfarin, what might the clinician do?

Accepted Answer

If the INR result is above the therapeutic range, withholding one or more days of anticoagulant therapy is usually the initial management approach to reduce the INR to the desired level. Restarting therapy at a lower dose immediately is not recommended as it may cause an increased risk of thrombotic events. Stopping the warfarin for a week is not necessary unless the patient is at risk of bleeding. The prothrombin time and INR should be reevaluated within 1-2 weeks after any dosage adjustments or changes in therapy.

Question 6

Which of the following is identified as an eating disorder in which a person craves food substitutes, such as clay, ice chips, and cotton, and is considered an objective finding associated with severe iron deficiency?

Accepted Answer

Pica is an eating disorder that involves craving and consuming non-food substances such as clay, ice chips, and cotton. It is commonly associated with iron deficiency, particularly severe iron deficiency anemia. Ferritin is a protein that stores iron, Porter's syndrome is not a recognized medical condition, and hypochromasia is a term used to describe red blood cells that are pale due to low hemoglobin levels, which can be caused by iron deficiency anemia.

Question 7

Which type of bone marrow transplant is obtained from an identical twin?

Accepted Answer

Syngeneic bone marrow transplant involves obtaining healthy bone marrow from an identical twin, who will have the same genetic makeup as the recipient. This makes the transplant less likely to be rejected by the recipient's immune system, as there is no genetic difference between them. Autogenic bone marrow transplant involves obtaining bone marrow from the patient's own body before undergoing chemotherapy, while autologous bone marrow transplant involves obtaining bone marrow from the patient's own body after undergoing chemotherapy. Allogeneic bone marrow transplant involves obtaining bone marrow from a donor who is not an identical twin, such as a sibling or a matched unrelated donor.

Question 8

Sandra is 42 years old and has just been diagnosed with leukemia.She is complaining of bone and joint pain.Which type of leukemia is most likely the culprit?

Accepted Answer

Acute myelogenous leukemia (AML) is often associated with bone and joint pain, especially in older adults. The other types of leukemia listed may also cause bone pain, but AML is the most likely culprit given Sandra's age and symptoms.

Question 9

After the initial treatment for anaphylaxis, which medication should be added to prevent late-phase anaphylactic reactions?

Accepted Answer

After initial treatment with epinephrine and other supportive measures, corticosteroids such as prednisone or methylprednisolone are recommended to prevent late-phase anaphylactic reactions. These medications work by reducing inflammation and stabilizing mast cells, thus preventing the release of more histamine and other mediators. Albuterol is a bronchodilator that may be used to relieve bronchospasm, but it does not prevent late-phase reactions. Diphenhydramine is an antihistamine that can relieve itching and hives, but it is not effective in preventing late-phase reactions. An H₂ blocker is not a known medication and may be a typo or an abbreviation for a specific medication.

Question 10

In the United States, what is the second most common connective tissue disease and the most destructive to the joints?

Accepted Answer

Rheumatoid arthritis is the second most common connective tissue disease in the United States and is the most destructive to the joints. Osteoarthritis is the most common connective tissue disease, but it is not as destructive to the joints as rheumatoid arthritis. Systemic lupus erythematosus and Sjšgren's syndrome are also connective tissue diseases, but they are not as common as rheumatoid arthritis.

Question 11

Which statement about HIV postexposure prophylaxis (PEP) for health-care workers is the most accurate?

Accepted Answer

PEP should be started within hours of exposure to be effective.

Question 12

During treatment for anaphylaxis, what site is used for the initial injection of epinephrine?

Accepted Answer

The upper lateral thigh is the recommended site for initial injection of epinephrine during treatment for anaphylaxis. It has better absorption and quicker onset of action compared to other sites. IV injection is not recommended for initial treatment and a trained medical professional should administer it. The abdomen and deltoid can also be used but have slower absorption and longer onset of action.

Question 13

Which of the following disease-modifying antirheumatic drugs is a folic acid antagonist?

Accepted Answer

Methotrexate is a folic acid antagonist, which interferes with the metabolism of folic acid, an important vitamin required for cell growth and division. This action leads to suppression of immune function, which is beneficial in treating rheumatoid arthritis. The other drugs listed are not folic acid antagonists.

Question 14

Which household solution should be used to clean a bathroom if sharing with a friend who has HIV?

Accepted Answer

Nine parts of hydrogen peroxide to one part of bleach solution is recommended for cleaning surfaces that may have come into contact with blood or other body fluids from a person who has HIV. This solution is effective in killing the virus and reducing the risk of transmission. Using 100% bleach can be too harsh and corrosive, and 50% bleach and 50% vinegar may not be strong enough to kill the virus. The option of the friend having their own bathroom is not practical in many situations.

Question 15

When analyzing synovial fluid, if it is opaque, white, or translucent; has 5,000 leukocytes/Ml; 80% polymorphonuclear leukocytes (PMN); and a low red blood cell count, it may be indicative of which of the following conditions?

Accepted Answer

An opaque, white, or translucent synovial fluid with 5,000 leukocytes/mL, 80% PMN, and a low red blood cell count is typical of rheumatoid arthritis. This could indicate joint inflammation and a possible autoimmune condition. However, in normal synovial fluid, leukocytes count is much lower, and there are no signs of inflammation. The other options are incorrect because scleroderma and sickle cell disease do not usually affect the joints or synovial fluid.

Question 16

Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process?

Accepted Answer

C-reactive protein (CRP) is a nonspecific blood test that increases in response to inflammation in the body. It is a useful marker for evaluating the severity and course of an inflammatory process, such as in infections, autoimmune diseases, and cardiovascular disease. CRP levels can also be used to monitor response to treatment and disease activity.

Question 17

Infectious mononucleosis results from an acute infection with which of the following?

Accepted Answer

Infectious mononucleosis is commonly caused by an acute infection with the Epstein-Barr virus (EBV). The other choices listed do not typically result in infectious mononucleosis.

Question 18

As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin?

Accepted Answer

The estimated level of hematocrit is approximately three times the value of the hemoglobin. This is a commonly used rule of thumb in medicine to estimate the hematocrit percentage from the hemoglobin concentration in g/dL.

Question 19

The cardinal subjective symptom of sickle cell crisis is which of the following?

Accepted Answer

The cardinal subjective symptom of sickle cell crisis is pain. This pain can be severe and may occur in various parts of the body, including the joints, chest, and abdomen. Nausea, light-headedness, and palpitations may be present as well, but they are not considered the primary symptom of a sickle cell crisis.

Question 20

Reuben, age 24, has HIV and just had a routine viral load test done.The results show a falling viral load.What does this indicate?

Accepted Answer

A falling viral load indicates a favorable prognostic trend, meaning that the HIV is being suppressed by the current medication regimen and Reuben's immune system is responding well. It does not indicate disease progression or eradication of HIV, and may not necessarily require more aggressive medication at this time.

Quiz 17: Hematologic and Immune Problems