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Can you please help with these questions 

A 12-year-old African American male child is brought to the emergency room with high fever, chest pains, and dyspnea. His past medical history suggestive of recurrent admissions due to joints pains and infections. When he was 2 years old diagnosed as HbSS. On examination, mucous membranes are pale and has jaundice. On examination, decreased lung sounds in the right lower lobe. Temp 102F. Further investigations showed HB 7gm/dl, bilateral pulmonary infiltrates in the both lobes of the lung on CX-Ray and blood cultures showed no bacterial growth. Most likely cause for his symptoms are due to.

A) Aplastic crisis 

B) Fat embolism with crisis

 C) Bacterial pneumonia 

D) Left ventricular failure

 E) Sequestration crisis

 

2) A 64-year-old manager of a small firm presents to clinic with progressive fatigue and occasional heart palpitations over the last six months. He states that, he was under a lot of stress recently due to some problems at work. He smokes cigarettes 20 per/day and drinks alcohol regularly. Her blood hemoglobin level is 8.5 g/dL, MCV 68fL and the peripheral blood smear reveals microcytic hypochromic anemia. The initial evaluation of this patient anemia should be focused on identifying which of the following? 

A) Poor nutrition 

B) Hemolysis

 C) Chronic Blood loss 

D) Bronchogenic carcinoma 

E) Liver disease

 

3) A 62 years old male was admitted in the hospital for severe shortness of breath and chest pain. He is a known hypertensive for past 20 years and taking meds for it. On examination, he has generalized pitting edema with bilateral crepitation’s in the lungs. Blood studies on admission showed 10mg/dl, MCV 82/fL and creatinine levels 2.8gm/dl (0.6-1.8gm/dl). Patient was admitted in the hospital and treated for congested cardiac failure. After 5 days patient symptoms were improved well. Before discharge blood studies showed Hb 18gm/dl, MCV 84/fl and creatinine levels 2.6gm/dl. Most likely cause for his improved blood results is due to? 

A) Improved renal function

 B) Increased production of erythropoietin

 C) Cardiac valve defects 

D) Decreased plasma volume

 E) Improved oxygen saturation

 

4) A 58-year-old man is seen by his primary care physician with a chief complaint of fatigue, tingling and numbness in the fingers. He was chronic alcoholic for the past 20 years but stopped 2 years ago. A complete blood count (CBC) shows a hemoglobin of 7.8 gm/dL and a mean cell volume (MCV) of 118 fL. An endoscopic procedure reveals atrophic gastritis. Which of the following abnormalities will be seen in this patient?

 A) Abnormal alpha chain synthesis 

B) Decreased red blood cell G6PD

 C) Increased serum methylmalonic acid level

 D) Decreased serum ferritin 

E) Decreased folate levels

 

5) A 10 years old boy was bought to the ER complain of abdominal pain started after he fell from a bicycle. No previous medical problems. On examination, a firm mass over the left of the abdomen with mild tenderness but no guarding is present. CT scan of the abdomen found to have renal cell tumor. Blood studies showed Hb 19 gm/dl, HCT 55% MCV 72. What other abnormalities do you expect to see in this patient? 

A) Increased Plasma Volume B) Decreased Sao2 

C) Increased ectopic Erythropoietin 

D) Hyperactivity of JAK2 kinase

 E) Hyperactivity of erythropoietin receptor

 

6) A 3 years old male child bought to physician complaining of throat pain and bleeding from the nose. He doesn’t have any previous medical abnormities. On examination, his mucous membranes are pale and no jaundice. Physical examination showed absent right thumb and unable to feel the left radial bone. Ultrasound results came as hypoplasia of the kidney. Most likely diagnosis is? 

A) Pancytopenia due to drug toxicity

 B) Anemia due to renal disease 

C) Fanconi Anemia 

D) Red cell membrane defects

 E) JAK2 gene mutations

 

7) A 35 years old woman who visited for regular ante-natal clinic. On examination, BP 150/100 is mm of Hg, 24 weeks gestational size abdomen and mild pedal edema. Obstetrician suspected pregnancy induced hypertension and prescribed anti-hypertensive drugs. After two weeks of taking treatment patient return back complaining of weakness and tiredness. On examination her mucous membranes are pale and has Jaundice. Blood studies showed Hb 7mg/dl and indirect bilirubin levels were increased. Most likely cause for her anaemia is due to. 

A) IgM antibodies induced complement fixation

 B) Iron deficiency anemia 

C) Folate deficiency anemia 

D) IgG antibodies against RBC Rh antigens 

E) Bacterial toxins induced

 

8) A 12 years old boy is bought to the physician complaining of weakness, tiredness and passing dark colored urine since he got medicines for throat infection 4 days ago. No previous other medical problems. On examination, he appears pale and jaundice. Blood studies showed Hb 9mg/dl, MCV 82/fL and bilirubin levels were increased. Peripheral smear shows which of the following? 

A) Schistocytes

 B) Target cells 

C) Spherocytes 

D) Bite cells 

E) Macro-ovalocytes

 

9) A 32 weeks’ neonate born with severe jaundice, anemia, and generalized edema. Infant mother was Rh negative, and infant was Rh positive. His blood studies showed Hemoglobin 7 mg/dl; indirect bilirubin levels were 22 mg/dl. Neonate was admitted in intensive care unit for further management. Due to the complications of prematurity, neonate died in ICU after 5 days. Autopsy was done on the neonate. Which of the following autopsy findings due you expected see in this child?

 A) Hepatic Necrosis 

B) Hemorrhages in thymus 

C) Acute renal failure 

D) Cerebral Hemorrhages

 E) Kernicterus in basal ganglia

 

10) A 3 years old child bought the physician because of abdominal pain started after he fell from the stairs. On examination he has a unilateral, firm, fixed, mild tender mass in the right side of abdomen extending towards left half of abdomen. He has proptosis and periorbital ecchymosis. Which of the following immunohistochemical staining is helpful in diagnosis? 

A) Non-Specific esterase 

B) Tartrate-resistant acid phosphatase stain 

C) Terminal deoxynucleotidyl transferase 

D) Neuron-specific enolase 

E) GFAP stain

 

 

SCIENCE
HEALTH SCIENCE
NURSING
BIO 224

 

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