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 staging, CNS involvement is rare at initial presentation. Therefore, routine CSF analysis is not recommended unless there are specific neurological symptoms suggestive of CNS disease. A lumbar puncture carries risks of complications and should not be performed routinely. Choices A, B, and C are appropriate for staging in Hodgkin lymphoma to evaluate for distant metastases and characterize disease extent.
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. In this case, the clinical presentation of silvery hair and hypopigmented skin suggests a diagnosis of Chediak-Higashi syndrome, a rare autosomal recessive disorder affecting lysosomal function. The abnormal leukocyte count and neutrophil percentage indicate impaired immune function due to defective lysosomal biogenesis. The other choices, B: Abnormal ribosome function, C: Abnormal phagocytosis of opsonized particles, and D: Abnormal mitochondrial activity, do not align with the clinical presentation and laboratory findings of this specific case.
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: The correct answer is A. A semen analysis at this point would provide accurate information about future fertility because it assesses sperm count, motility, and morphology, which are crucial indicators of fertility potential. This is important for the patient to understand his current fertility status and make informed decisions about future fertility preservation options. Choice B is incorrect because males are also susceptible to gonadal toxicity from alkylating agents, and there is no evidence to suggest that they can maintain gonadal function at higher dosages compared to females. Choice C is incorrect because sperm cryopreservation should ideally have been offered at the time of leukemia diagnosis, but it is not too late to assess current fertility status with a semen analysis. Choice D is incorrect as the patient's primary concern is infertility, not testosterone deficiency, which is a different issue altogether.
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 answer is C: The mean is greater than the median and mode. In a highly right-skewed distribution, the mean is pulled towards the higher end by the extreme values, making it greater than the median, which is the middle value. The mode is the most frequent value, which is typically lower than the mean in a right-skewed distribution. In summary, the mean is influenced by extreme values, causing it to be greater than both the median and the 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. 1. ETV6 gene mutations are associated with inherited thrombocytopenia, making it a likely candidate in this case. 2. Skin fibroblasts are needed for genetic analysis as they provide a reliable sample for detecting genetic mutations. 3. RUNX1 gene mutations are also linked to thrombocytopenia but are more commonly associated with familial platelet disorder with predisposition to acute myeloid leukemia. 4. Buccal swabs are not ideal for evaluating genetic mutations related to thrombocytopenia as they may not provide sufficient genetic material for accurate testing.