Most but not all symptoms of anemia are similar in older and younger people. Which of the following symptoms is more likely to occur in older people with anemia than in younger people with anemia?

Correct Answer: A

Rationale: The correct answer is A: Confusion and agitation. In older people with anemia, decreased oxygen supply to the brain can lead to cognitive symptoms like confusion and agitation. This is more likely in older individuals due to age-related changes in the brain's ability to compensate for decreased oxygen levels. Explanation of why other choices are incorrect: B: Increased thirst is a common symptom of anemia in all age groups due to the body's attempt to increase blood volume. C: Shortness of breath is a common symptom of anemia regardless of age, as it is a result of decreased oxygen-carrying capacity of the blood. D: Weak and rapid pulse is a common symptom of anemia in all age groups due to the heart working harder to compensate for decreased oxygen levels.

Correct Answer: B

Rationale: The correct answer is B: FALSE. Folic acid therapy does not cause sickle cell anemia. Folic acid is a B vitamin that helps in the production of red blood cells and is commonly used to treat anemia. Sickle cell anemia is a genetic disorder where red blood cells become sickle-shaped, leading to various health complications. Folic acid therapy is not known to cause this genetic condition. Choices A, C, and D are incorrect because folic acid therapy does not lead to sickle cell anemia in any circumstances or age group.

Correct Answer: B

Rationale: Certainly. The correct answer is B (FALSE) because antimalarial drugs and high dose birth control do not increase riboflavin levels. Riboflavin is a water-soluble vitamin that is not affected by these medications. Choice A (TRUE) is incorrect as there is no evidence to support an increase in riboflavin due to these drugs. Choice C (Sometimes) is incorrect because there is no situation where these medications would lead to an increase in riboflavin. Choice D (Only in pregnancy) is also incorrect as riboflavin levels are not specifically affected by pregnancy or these medications.

Correct Answer: D

Rationale: Step-by-step rationale for choice D (Liver impairment) being correct: 1. Warfarin is metabolized in the liver. 2. Liver impairment can alter the metabolism of warfarin, leading to potential over-anticoagulation. 3. Monitoring of INR levels is crucial in patients with liver impairment to prevent bleeding risks. 4. Caution is necessary to adjust warfarin dosages based on liver function tests. Summary of why other choices are incorrect: A: Alcoholic liver disease - Although liver function is compromised, specific liver impairment poses a higher risk with warfarin. B: Gastrointestinal bleeding - While a concern with anticoagulants, liver impairment directly affects warfarin metabolism. C: Recent neurosurgery - Not directly related to liver function, so does not impact warfarin metabolism.

Correct Answer: A

Rationale: The correct answer is A: Stage 0 in the Rai Staging System for Chronic Lymphocytic Leukemia (CLL). In stage 0, patients have lymphocytosis without any other symptoms or signs of advanced disease. This indicates a low-risk group with a favorable prognosis and no need for immediate treatment. Other choices are incorrect because they correspond to stages with increasing severity and additional symptoms such as lymphadenopathy, hepatosplenomegaly, anemia, or thrombocytopenia, which are not present in this case.