A 76-year-old woman with pancreatic mass, weight loss. Paraneoplastic syndrome?

Correct Answer: D

Rationale: The correct answer is D: Migratory thrombophlebitis. In a patient with a pancreatic mass and weight loss, migratory thrombophlebitis, also known as Trousseau syndrome, is a paraneoplastic syndrome commonly associated with pancreatic adenocarcinoma. This syndrome results from the release of procoagulant substances by the tumor, leading to migratory superficial thrombophlebitis. The other choices are not typically associated with pancreatic cancer. A: Hypercalcemia is more commonly seen in hyperparathyroidism or certain types of cancer. B: SIADH is commonly associated with small cell lung cancer. C: Hypoglycemia is seen in pancreatic insulinomas, not pancreatic adenocarcinoma.

Correct Answer: C

Rationale: The correct answer is C: Abdominal pain with palpation. After a splenectomy, patients are at risk for splenic complications such as splenic infarction or abscess. Abdominal pain with palpation could indicate an emergency situation requiring immediate medical attention to rule out these complications. Unprotected sex (A) is not the most immediate concern in this scenario. Temp of 100°F (B) may not be directly related to post-splenectomy complications. Occasional marijuana use (D) is not an immediate concern post-splenectomy.

Correct Answer: C

Rationale: The correct answer is C: Hb-F. Hemoglobin F (Hb-F) does not predispose to sickling because it has a higher affinity for oxygen, inhibiting the polymerization of Hb-S molecules that leads to sickling. Hb-C (choice A) and Hb-S (choice D) both have structural abnormalities that can lead to sickling. Hb-E (choice B) is a beta-thalassemia variant that can also contribute to sickling under certain conditions.

Correct Answer: C

Rationale: The correct answer is C: Aspirin-induced platelet dysfunction. Aspirin inhibits platelet function, leading to easy bruising. Von Willebrand disease and Factor VIII deficiency are inherited bleeding disorders, not typically related to easy bruising. Grackelguber's disease is a fictional distractor.

Correct Answer: B

Rationale: B: Stored in mast cells. Heparin is not stored in mast cells; it is synthesized in mast cells and basophils. Heparin is stored in granules within these cells and released upon activation. This is why choice B is false. The other choices are true: A) SubQ injection can lead to hematomas due to its anticoagulant effect, C) Heparin binds to antithrombin III to inhibit thrombin, and D) Protamine sulfate is used as an antidote to heparin overdose by binding to heparin and neutralizing its effects.