Change-of-shift report. Which patient to assess first?

Correct Answer: D

Rationale: The correct answer is D because a patient with neutropenia and fever is at high risk for infection, which can quickly become life-threatening. Assessing and addressing this patient's condition promptly is crucial for preventing sepsis. Choices A, B, and C, although important, do not pose an immediate threat to the patient's life like neutropenia with fever does. Thalassemia with low Hb, sickle cell crisis, and emotional distress in lymphoma are important but do not require immediate assessment compared to a potentially septic patient.

Correct Answer: B

Rationale: The correct answer is B: Protein C. Protein C is an anti-clotting substance that inhibits factors V and VIII in the coagulation cascade. Factor V and VIII are essential for the conversion of prothrombin to thrombin, a key step in blood clot formation. By inhibiting these factors, Protein C helps regulate the clotting process. Rationale: A: ATIII primarily inhibits factors IIa (thrombin) and Xa. C: TFPI (Tissue Factor Pathway Inhibitor) inhibits the extrinsic pathway of coagulation by binding to and inhibiting factor VIIa. D: Plasmin is involved in fibrinolysis, breaking down blood clots, and does not directly inhibit factors V and VIII in the coagulation cascade.

Correct Answer: A

Rationale: The correct answer is A: Microtubules. Microtubules are structural components of the cytoskeleton that help maintain the shape of a cell by providing support and stability. They also play a crucial role in cell division, intracellular transport, and cell motility. Spindle fibers are involved in cell division, ribosomes are responsible for protein synthesis, and centrioles are involved in organizing the microtubules during cell division. Therefore, the correct choice is A as it directly relates to maintaining cell shape.

Correct Answer: B

Rationale: The correct answer is B: Trypanosoma brucei gambiense. This parasite causes African Trypanosomiasis (sleeping sickness), characterized by fever, lymphadenopathy, and neurological symptoms. Choice A, Trypanosoma cruzi, causes Chagas disease, not presenting with lymphadenopathy. Choice C, Leishmania donovani, causes visceral leishmaniasis with hepatosplenomegaly, not cervical lymphadenopathy. Choice D, Onchocerca volvulus, causes onchocerciasis (river blindness) with skin and eye manifestations, not cervical lymphadenopathy.

Correct Answer: B

Rationale: The correct answer is B: Basophilic stippling. Basophilic stippling is a finding seen in blood smears of individuals with hookworm infection anemia. It represents aggregates of ribosomes in red blood cells due to lead poisoning or thalassemia. Howell-Jolly bodies (A) are nuclear remnants in red blood cells, typically seen in conditions causing splenic dysfunction. Target cells (C) are seen in liver disease or hemoglobinopathies. Spherocytes (D) are seen in conditions like hereditary spherocytosis or autoimmune hemolytic anemia.