In sickle cell anemia there is a greater incidence of gall stones. What other situation might confuse the diagnosis:

Correct Answer: B

Rationale: Sickle cell anemia's gallstones (pigment stones) overlap with sickle cell crisis (B) both cause abdominal pain, jaundice (e.g., bilirubin >3 mg/dL), mimicking cholecystitis. Icterus (A) is a sign, not diagnosis. Joint pain (C) is articular. Coronary infarction (D) or perforated viscus differ chest, peritonitis. Crisis's vaso-occlusion confuses, key in nursing for imaging and pain differentiation.

Correct Answer: C

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: B

Rationale: Idiopathic pulmonary fibrosis (IPF) is a restrictive lung disease marked by progressive scarring of the lung interstitium, reducing lung elasticity and function. Total lung capacity (TLC) decreases in IPF because fibrotic tissue stiffens the lungs, limiting their expansion. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) are both reduced, but the FEV1/FVC ratio remains normal or elevated, unlike in obstructive diseases. Arterial oxygen partial pressure (PaO2) drops due to impaired gas exchange across thickened alveolar walls, leading to hypoxemia. However, total pulmonary vascular resistance (PVR) increases in IPF as fibrosis compresses and obliterates pulmonary capillaries, narrowing the vascular bed and elevating resistance to blood flow. This increase can strain the right heart, potentially causing cor pulmonale. Among the options, only total pulmonary vascular resistance is expected to be higher than normal, aligning with IPF's impact on the pulmonary vasculature rather than lung volumes or oxygenation, which decline.

Correct Answer: D

Rationale: Inspiration occurs when air moves into the lungs due to a pressure gradient, as per Boyle's law: expanding the thoracic cavity decreases intrapulmonary pressure below atmospheric pressure (760 mmHg to ~758 mmHg), driving air inward. This gradient, the pressure difference between atmospheric and intrapulmonary pressure, is the primary force, created by diaphragm and intercostal muscle contraction. Atmospheric pressure alone isn't a force' but a reference; it's the difference that matters. Muscular spasm implies involuntary action, not the controlled contraction of respiration. Reduced surface tension, via surfactant, aids lung expansion but isn't the driving force it reduces resistance to expansion. Muscle relaxation occurs in expiration, not inspiration. The pressure difference is the fundamental mechanism, quantifiable (e.g., 1-2 mmHg drop suffices for tidal breathing), and directly ties muscle action to airflow, distinguishing it as the essential driver of ventilation.