A patient shows prolonged prothrombin time and activated partial thromboplastin time. Blood test otherwise is normal. Which of the following is the most probably diagnosis for this patient's condition?

Correct Answer: D

Rationale: The correct answer is D: Vitamin K deficiency. Prolonged prothrombin time and activated partial thromboplastin time indicate impaired blood clotting, which is characteristic of vitamin K deficiency. Vitamin K is essential for synthesizing clotting factors II, VII, IX, and X. Hemophilia A (choice A) is a genetic disorder resulting in deficiency of clotting factor VIII, not vitamin K-dependent factors. Thrombocytopenia (choice B) is a condition characterized by low platelet count, not affecting clotting factor synthesis. Von Willebrand factor disease (choice C) involves a deficiency or dysfunction of von Willebrand factor, not related to vitamin K deficiency.

Correct Answer: D

Rationale: Step-by-step rationale for why the correct answer is D (Iron deficiency anemia): 1. Koilonychias is characterized by spoon-shaped nails, a classic sign of iron deficiency anemia due to changes in nail structure. 2. Iron deficiency leads to decreased production of keratin, causing nail deformities like koilonychias. 3. Hemolytic anemia (choice A) and Sickle cell disease (choice B) are not typically associated with koilonychias. 4. Thalassemia major (choice C) can cause nail changes, but koilonychias is more commonly seen in iron deficiency anemia.

Correct Answer: B

Rationale: The correct answer is B: Irradiating the blood components before transfusion. Graft versus host disease occurs when donor T-cells attack the recipient's tissues in bone marrow transplant patients. Irradiating blood components helps to deactivate T-cells in the donor blood, preventing them from attacking the recipient's tissues. Transfusion of packed cells (A) or fresh whole blood (C) does not address the issue of T-cell activation. Replacement by crystalloids (D) is not a solution for preventing graft versus host disease.

Correct Answer: C

Rationale: Rationale: A peripheral blood smear showing an increase in neutrophils, basophils, eosinophils, and platelets is indicative of Chronic Myelocytic Leukemia (CML). Neutrophils, basophils, and eosinophils are myeloid lineage cells typically elevated in CML. The presence of increased platelets is also common in CML due to the overproduction of cells in the bone marrow. Summary of other choices: A: Acute myeloid leukemia - Typically presents with a predominance of immature myeloid cells like blasts, rather than an increase in mature myeloid cells. B: Acute lymphoid leukemia - Primarily involves lymphoid lineage cells, not myeloid cells as seen in the blood smear. D: Chronic lymphocytic leukemia - Characterized by an increase in mature lymphocytes, not myeloid cells like neutrophils, basophils, and eosinophils.

Correct Answer: D

Rationale: The correct answer is D: Rapid schizonticidal activity. Artemisinin and its derivatives target the malaria parasite at the schizont stage, which is crucial for the parasite's replication and survival. By rapidly killing schizonts, these drugs help in controlling the infection and preventing severe complications. Choice A (Rapid gametocidal activity) is incorrect because artemisinin and its derivatives primarily target asexual stages of the parasite, not gametocytes. Choice B (The ability to prevent further development of hypnozoites) is incorrect as these drugs do not target the liver stages where hypnozoites develop. Choice C (Rapid sporontocidal activity) is incorrect as artemisinin derivatives do not primarily target the sexual stages of the parasite. In summary, the correct answer is D because of the drugs' effectiveness against the schizont stage, while the other choices are incorrect as they do not align with the mechanism of action of artemisinin