Splenectomy is curative in:

Correct Answer: D

Rationale: The correct answer is D: hereditary spherocytosis. Splenectomy is curative in hereditary spherocytosis because the spleen is responsible for the destruction of the abnormal spherocytes in this condition. Removing the spleen eliminates the primary site of red blood cell destruction, leading to an improvement in anemia and other symptoms. Incorrect choices: A: Splenectomy is contraindicated in G6PD deficiency as it can worsen hemolysis by increasing the workload on other organs. B: Splenectomy can be beneficial in ITP to increase platelet counts but is not curative as the underlying autoimmune process persists. C: Splenectomy is not curative in thalassemia as it does not address the underlying genetic defect causing abnormal hemoglobin synthesis.

Correct Answer: B

Rationale: The correct answer is B: sideroblastic anemia. In sideroblastic anemia, there is impaired heme synthesis leading to the accumulation of iron in the mitochondria of red blood cell precursors. This results in increased serum iron levels due to the release of iron from the mitochondria. Decreased Iron Binding Capacity (IBC) occurs as a compensatory mechanism due to the increased serum iron levels. Choice A, hookworm infestation, would typically result in iron deficiency anemia with decreased serum iron levels and normal to increased IBC. Choice C, alcoholic liver disease, is associated with decreased serum iron levels and normal to increased IBC due to impaired iron metabolism. Choice D, thalassemia major, presents with normal to decreased serum iron levels and normal to increased IBC due to ineffective erythropoiesis.

Correct Answer: D

Rationale: The correct answer is D, shortly after hemolysis, because G6PD deficiency leads to a false-normal result due to the presence of reticulocytes in the blood following hemolysis. This is because reticulocytes have normal enzyme activity, masking the underlying deficiency. Iron deficiency anemia (A), hypoplastic anemia (B), and hairy cell leukemia (C) do not involve the same mechanism of false-normal reports in C6PD deficiency as seen in hemolysis.

Correct Answer: A

Rationale: The correct answer is A because all subtypes of leukemia involve unregulated proliferation of white blood cells (WBC). Leukemia is a type of cancer that starts in the blood-forming tissues, leading to the production of abnormal WBCs in the bone marrow. This uncontrolled growth of WBCs interferes with the production of normal blood cells. Choice B is incorrect because leukemia does not involve unregulated proliferation of red blood cells, but rather white blood cells. It also does not necessarily result in decreased bone marrow function as stated in the choice. Choice C is incorrect because while some subtypes of leukemia may result in a decrease in the production of normal white blood cells, the primary issue is the unregulated proliferation of abnormal WBCs. Choice D is incorrect because leukemia is not specifically related to cancer development in the lymphatic system. Leukemia primarily affects the bone marrow and blood.

Correct Answer: C

Rationale: The correct answer is C: Five-year survival for patients over 75 years old is less than 2%. This is because older age is a significant risk factor for poorer outcomes in acute myeloid leukemia (AML) due to factors such as frailty, comorbidities, and reduced tolerance to aggressive treatments. Older adults are less likely to tolerate intensive chemotherapy and have lower overall survival rates compared to younger patients. Choice A is incorrect because early diagnosis alone does not guarantee good outcomes in AML, especially in older adults. Choice B is incorrect because the five-year survival rate for older adults with AML is much lower than 50%. Choice D is incorrect because while pre-illness health may influence survival rates, age is a more significant factor in predicting outcomes in older patients with AML.