ATI RN
ATI Hematologic System Quizlet Questions
Question 1 of 5
A 17-year-old female presents with cervical adenopathy and a history of daily fevers and drenching night sweats. A biopsy is performed and reveals classic Hodgkin lymphoma. Which of the following is least appropriate as part of the staging workup?
Correct Answer: D
Rationale: The correct answer is D, Lumbar puncture and cerebrospinal fluid (CSF) analysis. In Hodgkin lymphoma, central nervous system involvement is rare at presentation, making routine CSF analysis unnecessary. Staging workup typically includes imaging studies (A, B, C) to assess disease extent and involvement of distant organs. CSF analysis is reserved for cases with neurological symptoms or signs suggestive of CNS involvement. Therefore, in this case, the least appropriate option for staging workup is D.
Question 2 of 5
The patient is a 2-month-old boy who presented with a skin abscess and is febrile. On exam, he is noted to have silvery hair and hypopigmented skin. A CBC shows a leukocyte count of 3.4 K/mcL with 10% neutrophils. What does the abnormality on the peripheral smear suggest?
Correct Answer: A
Rationale: The correct answer is A: Abnormal lysosomal biogenesis. The patient's presentation of silvery hair and hypopigmented skin suggests a lysosomal storage disorder like Chediak-Higashi syndrome. The peripheral smear showing 10% neutrophils with a low leukocyte count indicates impaired neutrophil function due to abnormal lysosomal biogenesis. This affects phagocytosis and intracellular killing of pathogens, leading to recurrent infections and abscess formation. Incorrect choices: B: Abnormal ribosome function - not related to the patient's presentation. C: Abnormal phagocytosis of opsonized particles - the primary issue is with lysosomal biogenesis, not phagocytosis. D: Abnormal mitochondrial activity - does not explain the silvery hair and hypopigmented skin seen in Chediak-Higashi syndrome.
Question 3 of 5
A 19-year old male patient with a history of acute lymphoblastic leukemia, currently 13 years from completion of therapy, presents for a fertility consultation. He is interested in his risk for infertility. Which of the following statements is true?
Correct Answer: A
Rationale: Step 1: Semen analysis is the gold standard for assessing male fertility. Step 2: The patient's history of ALL and completion of therapy make semen analysis relevant. Step 3: Long-term survivors of ALL are at risk for infertility due to treatment effects. Step 4: Semen analysis can provide valuable information on sperm count, motility, and morphology. Summary: - Option A is correct as semen analysis is crucial for assessing male fertility. - Option B is incorrect as alkylator dosages affect both males and females. - Option C is incorrect as sperm cryopreservation should ideally be offered at diagnosis. - Option D is incorrect as infertility risk may be higher than testosterone deficiency in this case.
Question 4 of 5
In a study to investigate the rates of central line–acquired bacterial infections, it is discovered that patient length of stay (LOS) is not normally distributed but is highly right-skewed. What is the correct relationship between the mean, median, and mode of LOS?
Correct Answer: C
Rationale: The correct relationship between mean, median, and mode in a highly right-skewed distribution is that the mean is greater than the median and mode. In a right-skewed distribution, the mean is pulled towards the longer tail, making it greater than the median, which is the middle value when the data is arranged in order. The mode is the most frequent value, but in a right-skewed distribution, it will be the smallest value, making the mean greater than both the median and mode. Therefore, choice C is correct. Choices A, B, and D are incorrect because they do not reflect the specific relationship between mean, median, and mode in a highly right-skewed distribution.
Question 5 of 5
You are consulted on a 4-year-old girl who is newly diagnosed with standard-risk pre-B acute lymphoblastic leukemia. After reviewing her previous complete blood examinations, you note she has had a platelet count ranging from 80,000 to 100,000 cells/mcL over the past 2 years. Her father mentions that he has also been told he has mild thrombocytopenia. You suspect the child may have a cancer predisposition syndrome. Which sample should you send for analysis, and which gene is most likely implicated?
Correct Answer: B
Rationale: The correct answer is B: Skin fibroblasts to evaluate the ETV6 gene. In this scenario, the presence of mild thrombocytopenia in both the father and the child raises suspicion of a genetic predisposition. ETV6 gene mutations are commonly associated with inherited thrombocytopenia and predisposition to leukemia. Skin fibroblasts are ideal for genetic testing due to their stable genetic material. Choice A is incorrect as RUNX1 gene mutations are linked to familial platelet disorder with predisposition to acute myeloid leukemia, not pre-B acute lymphoblastic leukemia. Choices C and D are incorrect as buccal swabs may not provide sufficient genetic material for comprehensive analysis.