Which Of The Following Is True Of Sickle Cell Disease

Question: Which of the following is TRUE concerning sickle cell anemia?a. It is a hereditary disease involving abnormal hemoglobin.b. It is a hereditary disease involving lack of intrinsic factor.c. It is an autoimmune disease in which the body destroys its own hemoglobind. It is an acquired disease in which the body cannot absorb iron.

Answer: a. It is a hereditary disease involving abnormal hemoglobin.

Question: Your patient is undergoing chemotherapy and s complaining of bleeding from the gums and blood in his stool. Which of the following will best address the patient's problem?a. Stopping the chemotherapyb. Administering plateletsc. Administering erythropoietind. Administering vitamin K

Answer: b. Administering platelets

Question: In an emergency situation if you administer blood to a patient whose blood type is unknown, you should administer type __________ blood. a. O positiveb. O negativec. AB positived. AB negative

Answer: b. O negative

Question: Prehospital treatment for a hemophiliac patient who is bleeding is to:a. Contact online medical control for factor VIII infusionb. Provide aggressive IV therapy with isotonic crystalloidsc. Control bleeding with direct pressured. Administer IV colloid solutions.

Answer: c. Control bleeding with direct pressure

Question: Humoral and cell-mediated immunity differ in hat cell-mediated immunity uses:a. B cells, which generate effector cells to combat such invaders as intracellular organisms, while cellular immunity uses T cells that reside in the lymph tissue and produce antibodies to combat foreign invaders. b. T cells, which generate effector cells to combat such invaders as intracellular organisms, while cellular immunity uses B cells that reside in the lymph tissue and produce antibodies to combat foreign invaders. c. B cells, which generate effector cells to combat such invaders as intracellular organisms, while humoral immunity uses T cells that reside in the lymph tissue and produce antibodies to combat foreign invaders. d. T cells, which reside in lymph tissue and produce antibodies combat foregin invader, while humoral immunity uses B cells that generate effector cells to combat such invaders as intracelluar organisms.

Answer: b. T cells, which generate effector cells to combat such invaders as intracellular organisms, while cellular immunity uses B cells that reside in the lymph tissue and produce antibodies to combat foreign invaders.

Question: Which of the following sitiuations would NOT result in Anemia?a. Blood lossb. Destruction of red blood cellsc. Increased produciton of erythropoetind. Irion deficiency

Answer: c. Increased produciton of erythropoetin

Question: Which of the following situations would result in a right shift of the oxygen-hemoglobin dissociation curve?a. Hypothermiab. Hyperventilationc. Sepsisd. Increase in 2,3-BPG

Answer: d. Increase in 2,3-BPG

Question: Which of the following statements about sickle cell disease is FALSE?a. Patients with chronic sickle cell disease have chronic hemolytic anemiab. Sickled red blood cells have longer life spans that normal red blood cells.c. Sickle hemoglobin has a flawed chemical structure that results in erythrocyte deformity when oxygen levels are low.d. Splenomegaly is a common problem of sickle cell disease

Answer: b. Sickled red blood cells have longer life spans that normal red blood cells.

Question: A patient with hemophilia has suffered a large and deep laceration to the right forearm after cutting it on a mirror, which fell while he was hanging it. The wood is hemorrhaging a steady amount of dark red blood. Given the history of hemophilia, you immediate action on reaching the patient's side and putting on gloves would be to:a. Request that the ED have Factor VIII standing by on your arrival.b. Sarta nadn IV and administer 1 L NS bolusc. Apply a tourniquet proximal to the wound.d. Apply direct pressure with a bulky dressing.

Answer: d. Apply direct pressure with a bulky dressing.

Question: You patient is an 18-year-old female suffering from sickle cell crisis. Which of the following is the best course of treatment for this patient?a. High-flow oxygen, IV NS KVO, diphenhydramineb. High flow-oxygen, IV bolus of NSc. High flow-oxygen, IV bolus of NS, morphine sulfated. High flow-oxygen, IV NS KVO

Answer: c. High flow-oxygen, IV bolus of NS, morphine sulfate

Question: For a patient with hemophilia B, which of the following statements is TRUE?a. The patient's father had hemophilia B, and the mother was a carrier of the defective gene.b. The patient's father had hemophilia B, and the mother was unaffected.c. The patient's father was a carrier for the defective gene, and her mother did not carry the defective gene.d. The patient's mother was a carrier for the defective gene, and her father did not carry the defective gene.

Answer: a. The patient's father had hemophilia B, and the mother was a carrier of the defective gene.

Question: Your patient is a 26-year-old African-American male who is alert but in severe distress, complaining of pain in his hands and feet, as well as abdominal pain. The pain began the morning but has progressed from an initial rating of 5/10 to a 9/10 at the present time. The patient has a history of sickle cell anemia and denies any trauma. Physical examination reveals cool, diaphoretic skin; splenomegaly; and a priapism. HR =132, BP = 140/90, RR = 16. Select the most appropriate acute diagnosis and treatment for this patient.a. Sickle cell occlusive crisis; administer oxygen by nonrebreather mask, isotonic crystalloids, and morphineb. Sickle cell trait; administer oxygen according to pulse oximetry readings, and give a 500 mL bolus of isotonic crystalloid solutionc. Sickle cell occlusive crisis; administer oxygen by nonrebreather mask, isotonic crystalloids and aspirin. d. Sickle cell disease; administer oxygen according to pulse oximetry readings, start an IV of normal saline and administer ketorolac of pain.

Answer: a. Sickle cell occlusive crisis; administer oxygen by nonrebreather mask, isotonic crystalloids, and morphine

Question: In the presence of calcium, thrombin will encourage:a. Fibrin clot formation b. Prothrombin activationc. Platelet aggregationd. Plasminogen release

Answer: c. Platelet aggregation

Question: When a patient receives a laceration, the clotting process that occurs is primarily mediated by the __________ pathway. a. Plateletb. Commonc. Extrinsicd. Intrinsic

Answer: c. Extrinsic

Question: What is the underlying mechanism that causes pain in the patient with sickle cell crisis?a. Hypoglycemia b. Ischemiac. Hyperthyroidismd. Hypercapnia

Answer: b. Ischemia

Question: In the patient with a hematological disease resulting in production of high numbers of abnormal red blood cells, which of the following would you be most likely to find?a. Splenomegalyb. Feverc. Hepatomegalyd. Florid skin

Answer: a. Splenomegaly

Question: Which of the following would directly result in decreased fibrinolysis?a. Increased factor Xb. Decreased plasminogen secretionc. Increased plasmin secretiond. Hypercalcemia

Answer: b. Decreased plasminogen secretion

Question: Which of the following statements about immunity is TRUE?a. T cells mature in the bone marrow.b. Lymphocytes are primary cells involved in the immune response.c. Humoral immunity uses cytotoxic chemicals to destroy pathogens.d. Cell-mediated immunity uses antibody formation to combat pathogens.

Answer: b. Lymphoctes are primary cells invovled int he immune response.

Question: Your patient has a history of pernicious anemia. If not treated, your primary concern for this patient should be:a. Hypovolemiab. Prolonged blood clotting timec. Hypoxiad. Infection

Answer: c. Hypoxia

Question: All of the following are components of the inflammatory process EXCEPT:a. Vasodilationb. Increased capillary permeabilityc. Increased blood flowd. Decreased chemotaxis

Answer: d. Decreased chemotaxis

Question: Which of the following is NOT a goal of the inflammatory process?a. To produce antibodies to combat pathogensb. To activate systemic defenses to overcome invading pathogens and facilitate repairsc. To slow the spread of pathogens from the injury sited. To perform temporary repair at the site of the injury and prevent the access of addition patahogens

Answer: a. To produce antibodies to combat pathogens

Question: Endogenous fibrinolysis occurs as result of the:a. Administationo of heparinb. Production of plasminc. Conversion of plasmin to plaminogend. Administration of tissue plasminogen activator

Answer: b. Production of plasmin

Question: Your patient is type !+ blood. Which of the following statemtns about the patient's bood is TRUE?a. The patient produces antiA antibodiesb. The blood cells lack Rh antigens.c. There are type A antigens on the surface of the red blood cellsd. The patients can only recieve A+ blood infusion is needed

Answer: c. There are type A antigens on the surface of the red blood cells

Question: Which of the following situations would result in erythropoietin secretion?a. CVAb. Hypoxiac. Alkalemiad. Hemophilia

Answer: b. Hypoxia

Question: Your patient is taking an immunosuppressant drug to prevent rejection of a transplanted kidney. As a consequence the patient is more prone to:a. Prolonged blood clotting timeb. Aplastic anemiac. Infection d. Polycythemia

Answer: c. Infection

Question: Which of the following statements about disseminated intravascular coagulation (DIC) is TRUE?a. The leeding typical of DIC is a result of an increased fibrinogen level.b. DIC most commonly results from hemophilia, hypertension, and severe tissue injuryc. Causes of DIC include reduced fibrinogen levels, consumption of coagulation factors, and thrombocytopenia.d. Activated thrombin converts fibrinogen to fibrin in the circulating blood

Answer: d. Activated thrombin converts fibrinogen to fibrin in the circulating blood

Question: Which of the following medications would be most useful in the event of transfusion reaction?a. Aspirinb. Diphenhydraminec. Magnesium sulfated. Furosemide

Answer: b. Diphenhydramine

Question: Which of the following statement regarding polycythemia is most accurate?a. It decreases the patient's risk of infection.b. It decreases the ability of blood clot.c. It increases the patient's risk of infection d. It increases the patient's risk of stroke and heart attack.

Answer: d. It increases the patient's risk of stroke and heart attack.

Question: Which of the following statements about leukocytes is FALSE?a. Leukocytes follow chemical signals to an infection site.b. Leukocytes engulf and destroy foreign invaders via leukopoiesis.c. Leukocytes engulf and destroy foreign invaders via leukopoiesis d. Leukocytes can travel through blood vessel walls into the surrounding tissue.

Answer: c. Leukocytes engulf and destroy foreign invaders via leukopoiesis

Question: A male will express hemophilia if he acquires ________ Chromosome(s).a. Defective X and Yb. One defective Xc. Two defective Xd. One defective Y

Answer: b. One defective X

Question: You are pruning a rosebush and puncture the skin on your thumb ith a thorn. The next day you note that the area is swollen. Which of the following best explains the swelling that has occurred?a. Humoral immunity activation results in localized tissue damage and edema of the tissue surroundin the injury site.b. Localized vasolidation and increased capillary premeability results in plasma leakage into thtissue surrounding the injury site.c. Cell-mediated immunity activation results in chemotaxis and increased capillary permeability.d. There is an ainfection, resulting in edema to the surrounding tissue.

Answer: b. Localized vasolidation and increased capillary premeability results in plasma leakage into thtissue surrounding the injury site.

Question: A patient with sickle cell disease is being transported to the hospital. What would the preferred patient position on the wheeled cot, as long as no other contraindications exits?a. High Fowler'sb. Semi-Fowler'sc. Low Fowler'sd. Supine

Answer: b. Semi-Fowler's

Question: Your patient is a 22-year-old male complaining of a two-day history of a sore throat. He denies difficulty breathing, nausea, vomiting or chest pain. He has no medical history and takes no medications. HR =72, BP = 120/78, RR = 12, SaO2 = 99%. Physical examination reveals cool, dry sin. Which of the following findings would be most likely?a. Rhonchi upon auscultation of the lungsb. Swelling of the cervical lymph nodesc. Generalized erythemad. Positive murphy's sign

Answer: b. Swelling of the cervical lymph nodes

Question: Dehydration is most likely to result in:a. Thrombocytopeniab. Leukocytosisc. Increased hematocritd. Increased Prothrombin time.

Answer: c. Increased hematocrit

Question: Which of the following statements about leukemia is TRUE:a. Infection secondary to low levels of circulating neutrophils are common.b. The pediatric mortality rate is greater than 50 percent.c. Leukemia is a disease of children and young adults, no older adults.d. Leukemias are cancer of erythrocytes.

Answer: a. Infection secondary to low levels of circulating neutrophils are common.

Question: If your patient has type O+ blood, what other blood type(s) can she receive?a. O-b. AB-c. AB+d. AB- and O-

Answer: a. O-

Question: A smoker who also takes supplemental vitamin K would be expected to:a. Have a higher incidence of polycythemiab. Have enhanced clotting abilityc. Have a lower risk of developing pulmonary embolismd. Be unable to generate active forms of clotting factors, II, VII, IX and X.

Answer: b. Have enhanced clotting ability

Question: Patient with lymphoma are most likely to experience abnormal function of:a. Throbocytesb. B cellsc. Erythrocytesd. Neutrophils

Answer: b. B cells

Question: The more acidic the blood is, the more readily hemoglobin:a. Binds carbon dioxideb. Releases oxygenc. Releases carbon dioxided. Binds oxygen

Answer: d. Binds oxygen

Question: Of the following, which would be the most likely dysfunction experienced by a patient with multiple myeloma?a. Increased T cell productionb. Decreased T cell productionc. Decreased blood cell productiond. Increased blood cell production

Answer: c. Decreased blood cell production

Question: Your patient is a 23-year-old female who is 6 hours postpartum after a traumatic delivery resulting in a massive blood transfusion. She is to be transferred from a community hospital to a speciality hospital for further care. She is unconscious and intubated, with a number of intravenous lines. Your physical examination reveals a purpuric rash over the chest and abdomen and mottling on the fingers and toes and all of the venous access sites are oozing blood. In addition, auscultation of the lung fields reveals rales to the dependent regions. HR = 112, BP = 82/60, RR = 12 via ventilator. Which of the following best describes the patient's condition and treatment needs. In addition to continued ventilation and fluid administration?a. DIC; type O negative bloodb. Idiopathic hemophilia' corticosteroidsc. DIC; fresh frozen plasma and platelet administrationd. Idiopathic hemophilia; factor VIIa administration

Answer: c. DIC; fresh frozen plasma and platelet administration

Question: Which of the following statements regarding hemophilia is most accurate?a. hemophilia is a hereditary abnormality of the platelets.b. Hemophilia is a hereditary lack of certain proteins needed in the clotting cascadec. Hemophilia is a hereditary disease that causes fibrin clots to dissolve prematurely.d. Hemophilia is a hereditary disease in which the body is unable to produce vitamin K

Answer: b. Hemophilia is a hereditary lack of certain proteins needed in the clotting cascade

Question: Which of the following circumstances would result in activation of the coagulation cascade via the intrinsic pathway?a. Development of a plaque in a coronary artery resulting in turbulent blood flowb. Administration of warfarinc. Blunt-force traumad. Penetrating trauma resulting in soft tissue damage

Answer: a. Development of a plaque in a coronary artery resulting in turbulent blood flow

Question: A smoker who also takes supplemental vitmain K would be expected to:a. Have a higher incidence of polycythemiab. Have enhanced clotting abilityc. Have a lower risk of developing pulmonary embolismd. Be unable to generate active forms of clotting factors, II, VII, IX and X.

Answer: b. Have enhanced clotting ability

Question: A cat scratches a patient ont he arm. Twenty-four hours later, the area is wollenand red. What additional signs or symptoms is the patient most likely to exhibit?a. Fever and hypotensionb. Loss of appeitiec. Pain and warmth at the injury sited. Urticaria

Answer: c. Pain and warmth at the injury site

Question: Which of the following situations would result in a more rapid response by the immune system to an infection?a. First-time exposure to an antigen with memory T cell activationb. First-time exposure to an antigen with memory B cell activation c. First-time exposure to an antigen d. First-time exposure to an antigen with memory B cell activation

Answer: d. First-time exposure to an antigen with memory B cell activation

Question: Your patient is suffereing from end-stage liver disease. In which of the following ways would impairment of the hematologic system most likely be evident?a. Jaundiceb. Polycythemia resulting in a florid appearancec. Vaso-occlusive crisis resulting in joint pain d. Leukocytosis

Answer: a. Jaundice

Question: You are caring for a patient with a known history of sickle cell disease. The patient has severe abdominal and back pain. The patient is tachycardic and tachypneic. The blood pressure is normal. What should be one of the paramedic's first interventions?a. Administer Oxygenb. Initiate IVc. Give oral analgesicsd. Put the patient in a supine position

Answer: a. Administer Oxygen

Question: In which of the following situations is hemolytic disease of the newborn most likely to occur?a. An Rh positive mother delivers a first Rh negative newbornb. An Rh positive mother delivers a second Rh negative newbornc. An Rh negative mother delivers a first Rh positive newbornd. An Rh negative mother delivers a second Rh Positive newborn

Answer: d. An Rh negative mother delivers a second Rh Positive newborn

Question: What ethnicity is most likely to suffer from sickle cell disease?a. Native Americanb. Asainc. African Americand. Mditerranean Italian

Answer: c. African American

Question: A male will express hemophilia if he acquire ___________ chromosonme(s)a. Defective X and Yb. One defective Xc. Two defective Xd. One defective Y

Answer: b. One defective X