24-year-old woman with bleeding history, normal aPTT, prolonged PT. Element of interest?

Correct Answer: D

Rationale: The correct answer is D: Factor VII level. The patient presents with a prolonged PT, indicating a deficiency in the extrinsic pathway of the coagulation cascade, which is primarily mediated by Factor VII. Normal aPTT rules out von Willebrand factor deficiency (choice A). Platelet count (choice B) is not directly related to the PT results. The statement about X chromosomes (choice C) is irrelevant to the patient's condition. Choice D directly addresses the specific factor deficiency leading to the prolonged PT in this case.

Correct Answer: A

Rationale: The correct answer is A: Nodular sclerosis subtype of Hodgkin's lymphoma is common in young women with a good prognosis due to its characteristic presentation of fibrotic bands dividing the lymph node into nodules. This subtype is associated with less aggressive behavior and better response to treatment compared to other subtypes. Incorrect choices: B: Mixed cellularity subtype is more common in older adults and associated with a worse prognosis. C: Lymphocyte predominance subtype is more common in males and has a unique histological appearance with lymphocytic and histiocytic cells. D: Lymphocyte depletion subtype is rare, aggressive, and associated with a poor prognosis.

Correct Answer: D

Rationale: The correct answer is D, G6PD deficiency. Sulfonamides can induce oxidative stress, leading to hemolysis in individuals with G6PD deficiency due to impaired red blood cell protection against oxidative damage. Sickle cell disease (A), thalassemia minor (B), and hereditary spherocytosis (C) do not predispose individuals to sulfonamide-induced hemolysis as they do not involve oxidative stress as a primary pathophysiological mechanism.

Correct Answer: C

Rationale: The increased presence of neutrophils, bands, basophils, eosinophils, and platelets suggests Chronic Myelocytic Leukemia (CML). In CML, there is a high proliferation of myeloid cells leading to an increase in these cell types. Neutrophils, basophils, and eosinophils are myeloid cells, and their elevated levels are characteristic of CML. Bands are immature neutrophils also seen in CML. Platelets can be increased due to the bone marrow's overproduction of cells. Acute myeloid leukemia (Choice A) typically presents with blasts, not mature cells like in this scenario. Acute lymphoid leukemia (Choice B) involves the overproduction of lymphoid cells, not myeloid cells as seen here. LAP score is typically low in CML, not high as in Choice D.

Correct Answer: B

Rationale: The correct answer is B: Unintact skin. Intact skin serves as a physical barrier protecting the body from pathogens. When the skin is not intact (broken or wounded), it loses its protective function, making it unable to effectively protect body surfaces. Therefore, unintact skin does not protect body surfaces. A: Mucus helps trap and remove pathogens from the respiratory and digestive systems. C: Gastric acid kills ingested pathogens in the stomach. D: Epithelial surface cilia help move mucus and trapped pathogens out of the respiratory system.