ATI RN
ATI Hematologic System Questions
Question 1 of 5
Blinatumomab, a bispecific T-cell engaging molecule, is active against which CD antigen that is expressed on B-lymphoblasts?
Correct Answer: C
Rationale: Rationale: 1. Blinatumomab is designed to engage T cells to target CD19 antigen on B-lymphoblasts. 2. CD19 is a specific marker expressed on B cells, making it a target for Blinatumomab. 3. CD10 is not targeted by Blinatumomab and is commonly found on early B-cell precursors. 4. CD15 and CD20 are not targeted by Blinatumomab and have different functions unrelated to B-lymphoblasts. Summary: - CD19 is the correct answer as it is the specific target for Blinatumomab on B-lymphoblasts. - CD10, CD15, and CD20 are incorrect as they are not the targeted antigens for Blinatumomab and have different roles in immune function.
Question 2 of 5
A newborn infant develops jaundice on day of life 2. Labs are drawn, and she has a hemoglobin of 7.4 g/dL with a reticulocyte count of 8%. Upon peripheral blood smear review, she is found to have bizarre red cell forms with significant polkilocytosis. Although her parents have normal blood counts, on review of their peripheral blood smears, they both have a moderate number of ovalocytes. Which of the following is the most likely cause of the infant's red cell findings?
Correct Answer: C
Rationale: The correct answer is C because the infant's red cell findings of ovalocytes and polikilocytosis are consistent with hereditary elliptocytosis, which is caused by mutations in genes encoding spectrin. In this scenario, the inheritance pattern aligns with the infant receiving an alpha-spectrin mutation from both parents, leading to the observed erythrocyte abnormalities. This condition may improve over time due to compensatory mechanisms. Choice A (autosomal dominant ankyrin mutation causing hereditary spherocytosis) is incorrect because the clinical presentation and red cell morphology do not support a diagnosis of hereditary spherocytosis. Choice B (inherited band 3 variants and need for splenectomy) is incorrect as the infant's condition does not match the characteristics of hereditary spherocytosis requiring splenectomy. Choice D (PKLR variant and pyruvate kinase deficiency) is incorrect as the infant's red cell morphology is not indicative
Question 3 of 5
A 15-year-old female presents with 1 month of fatigue and 3 days of chest pain and shortness of breath. Her physical exam is unremarkable. A chest x-ray shows a large mediastinal mass that is greater than 33% of the diameter of her chest cavity. A biopsy shows nodular sclerosing, classic Hodgkin lymphoma (cHL). Metastatic workup at diagnosis, including CT scan of neck, chest, abdomen, and pelvis and PET scan, shows no other site of disease. According to the Ann Arbor staging system, the patient has which stage of cHL?
Correct Answer: A
Rationale: The correct answer is A: Stage I. In the Ann Arbor staging system for Hodgkin lymphoma, Stage I indicates involvement of a single lymph node region (I) or a single extralymphatic site (IE) without systemic symptoms. In this case, the patient has a large mediastinal mass but no other sites of disease on metastatic workup. This corresponds to Stage I disease. Choice B: Stage II would indicate involvement of two or more lymph node regions on the same side of the diaphragm. Choice C: Stage III would indicate involvement of lymph node regions on both sides of the diaphragm. Choice D: Stage IV would indicate disseminated involvement of one or more extralymphatic organs or tissues. Therefore, based on the information provided, the correct stage for this patient is Stage I as per the Ann Arbor staging system.
Question 4 of 5
When reviewing the chemistry panel of a newly diagnosed patient with acute lymphoblastic leukemia who is lethargic, complaining of flank pain, and experiencing nausea and vomiting, which of the following would you expect to see?
Correct Answer: D
Rationale: Step-by-step rationale: 1. Lethargy, flank pain, nausea, vomiting in leukemia can suggest tumor lysis syndrome (TLS). 2. TLS can cause hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia, and elevated BUN. 3. Choice D has the highest potassium, phosphorus, uric acid, and BUN levels, and the lowest calcium level. 4. Therefore, choice D is the most consistent with the expected lab findings in tumor lysis syndrome. Summary: - Choice A has normal potassium, phosphorus, uric acid, calcium levels, and lower BUN. - Choice B has high potassium but normal phosphorus, uric acid, calcium, and slightly elevated BUN. - Choice C has low potassium, normal phosphorus, and elevated uric acid, calcium, and BUN. - Choice D aligns most closely with the expected lab findings in tumor lysis syndrome due to the pattern of
Question 5 of 5
A pediatric fellow is planning a project intended to decrease the incidence of acute chest syndrome among patients with sickle cell disease who are already admitted to the hospital for other reasons. The fellow discussed with her mentor whether the project proposal should be submitted for review by the Institutional Review Board (IRB). The mentor explains that, at their intuition, quality improvement activities do not require IRB review but research projects must be submitted to the IRB. Which of the following is NOT a relevant consideration in determining whether the project is research or quality improvement?
Correct Answer: C
Rationale: The correct answer is C because the intent to publish results in a peer-reviewed journal is not a relevant consideration in determining whether a project is research or quality improvement. Here's a step-by-step rationale: 1. Quality improvement aims to enhance processes within a specific institution, while research seeks to generate generalizable knowledge. 2. Methodology using Plan-Do-Study-Act cycles is common in both quality improvement and research projects. 3. Efforts to stabilize biases/confounders over time align with both quality improvement and research principles. 4. Intent to publish in a peer-reviewed journal does not define the project as research; it is possible to publish quality improvement initiatives as well.