A parent of a 7-year-old girl with a repaired ventricular septal defect (VSD) calls the cardiology clinic and reports that the child is just not herself. Her appetite is decreased, she has had intermittent fevers around 38°C (100.4°F), and now her muscles and joints ache. Based on this information you advise the mother to:

Correct Answer: A

Rationale: The correct answer is A: Immediately bring the child to clinic for evaluation. Given the child's medical history of a repaired ventricular septal defect (VSD) and presenting symptoms of decreased appetite, fever, and muscle/joint aches, there is concern for a possible infection or cardiac-related issue. It is crucial to promptly assess the child's condition due to the potential risks associated with cardiac conditions and infections in this population. Delaying evaluation could lead to serious complications. Choices B and C are incorrect because waiting until next week or simply treating symptoms with acetaminophen may result in a missed opportunity to address a potentially serious issue. Choice D is incorrect as it dismisses the child's symptoms as manipulation, which is not a responsible or evidence-based approach to healthcare.

Correct Answer: A

Rationale: The correct answer is A because large granular lymphocytes are actually natural killer (NK) cells, not T cells. NK cells are part of the innate immune system, while T cells are part of the adaptive immune system. Megakaryocytes produce platelets, B cells differentiate into plasma cells to produce antibodies, and monocytes differentiate into macrophages to engulf pathogens. Therefore, choices B, C, and D are all correctly matched associations.

Correct Answer: D

Rationale: The correct answer is D: Retinal damage. Xanthine oxidase inhibitors like Allopurinol can lead to retinal damage due to accumulation of toxic metabolites. Bone marrow suppression (A), nausea (B), and vomiting (C) are not typically associated with xanthine oxidase inhibitors. This is because these drugs mainly affect purine metabolism, leading to increased uric acid levels, rather than directly affecting the bone marrow or gastrointestinal system.

Correct Answer: C

Rationale: The correct answer is C: Patient with hereditary hemochromatosis. This genetic condition causes the body to absorb too much iron, leading to iron overload. Iron supplements would exacerbate the condition. Patients experiencing blood loss (A) would benefit from iron supplements to replenish lost iron. Pregnant women (B) require increased iron for fetal development. Patients with limited access to healthy foods (D) may benefit from iron supplements to prevent deficiency.

Correct Answer: A

Rationale: The correct answer is A: Peripheral blood smear. This diagnostic test is used to evaluate the morphological features of blood cells by examining their size, shape, and structure under a microscope. It provides valuable information about red blood cells, white blood cells, and platelets. Reticulocyte count (B) measures immature red blood cells, not morphological features. Oxygen saturation (C) assesses the amount of oxygen carried by hemoglobin in the blood. Platelet count (D) quantifies the number of platelets in the blood, not their morphology.