Which of the following is false regarding Burkitt's lymphoma?

Correct Answer: A

Rationale: In this case, the correct answer is A) Associated with translocation of c-myc gene on chromosome 18. Burkitt's lymphoma is indeed associated with a translocation involving the c-myc gene on chromosome 8, not chromosome 18. This genetic abnormality plays a crucial role in the pathogenesis of Burkitt's lymphoma by leading to the dysregulation of cell growth and division. Option B is incorrect because Burkitt's lymphoma typically presents with jaw and facial bone involvement, rather than abdominal involvement in HIV patients. Option C is incorrect as the development of Burkitt's lymphoma in African children is primarily linked to Epstein Barr virus infection, with malaria exposure not being a significant factor. Option D is incorrect because Burkitt's lymphoma is histologically characterized by a "starry sky" appearance, where macrophages phagocytose apoptotic tumor cells, giving the background a starry appearance. Educationally, understanding the genetic basis, clinical presentation, and histological features of Burkitt's lymphoma is crucial for healthcare professionals, especially hematologists and oncologists. This knowledge is essential for accurate diagnosis, appropriate treatment selection, and better patient outcomes. By differentiating between the true and false statements related to Burkitt's lymphoma, learners can deepen their understanding of this specific type of lymphoma and improve their clinical decision-making skills.

Correct Answer: D

Rationale: Koilonychias, also known as spoon nails, is a specific feature associated with iron deficiency anemia (Option D). This condition causes the nails to become brittle, thin, and concave in shape, resembling a spoon. The rationale behind why iron deficiency anemia is the correct answer lies in understanding the role of iron in the body. Iron is essential for the production of hemoglobin, the protein in red blood cells that carries oxygen to tissues. When there is a deficiency of iron, the body is unable to produce an adequate amount of healthy red blood cells, leading to anemia and characteristic symptoms like koilonychias. Looking at the other options: - Haemolytic anemia (Option A) is characterized by the premature destruction of red blood cells, but it is not typically associated with koilonychias. - Sickle cell disease (Option B) is a genetic disorder affecting hemoglobin structure, leading to sickle-shaped red blood cells. While nail changes can occur in sickle cell disease, koilonychias are not a typical feature. - Thalassemia major (Option C) is a genetic disorder affecting hemoglobin production, but it is not commonly associated with koilonychias. In an educational context, understanding the specific clinical manifestations associated with different types of anemia is crucial for healthcare providers to make accurate diagnoses and provide appropriate treatment. Recognizing koilonychias as a key indicator of iron deficiency anemia can prompt healthcare professionals to further investigate the patient's iron status and implement necessary interventions to address the underlying cause of the anemia.

Correct Answer: D

Rationale: The correct answer is D) Aplastic anaemia. Aplastic anemia is characterized by a decrease in all three blood cell types (red blood cells, white blood cells, and platelets) due to failure of the bone marrow to produce these cells. In the case presented, the patient's symptoms of frequent infections, subcutaneous petechiae, low hemoglobin, and dry tap marrow are indicative of aplastic anemia. Option A) Iron deficiency anemia is characterized by low hemoglobin due to inadequate iron levels, but it typically does not present with frequent infections or a dry tap marrow. Option B) Megaloblastic anemia is usually caused by vitamin B12 or folate deficiency, leading to large, immature red blood cells. It does not typically present with the symptoms described in the scenario. Option C) Hemolytic anemia is characterized by the premature destruction of red blood cells, leading to anemia. It is unlikely to manifest with the combination of symptoms seen in the patient in this case. Educationally, understanding the different types of anemia and their characteristic features is crucial for healthcare providers to make accurate diagnoses and provide appropriate treatment. Recognizing the specific signs and symptoms of aplastic anemia, such as pancytopenia and dry tap marrow, helps in differentiating it from other types of anemia and guiding management strategies for the patient.

Correct Answer: B

Rationale: In the context of bone marrow transplantation, Graft versus Host Disease (GVHD) is a serious complication that can occur when donor immune cells attack the recipient's tissues. This complication can be best avoided by irradiating the blood components before transfusion. Irradiation of blood components helps to prevent GVHD by destroying T lymphocytes in the donor blood that could potentially cause the harmful immune response in the recipient. This process reduces the risk of GVHD without compromising the therapeutic benefits of the transfusion. Transfusion of packed cells (Option A) may still contain viable T lymphocytes and therefore not fully prevent GVHD. Transfusing fresh whole blood (Option C) would also not eliminate the risk of GVHD as it does not address the presence of donor T lymphocytes. Replacement by crystalloids (Option D) is not a suitable alternative as it does not provide the necessary components found in blood for transfusion. Educationally, understanding the rationale behind irradiating blood components to prevent GVHD highlights the importance of safety measures in transfusion medicine, particularly in the context of bone marrow transplantation. It emphasizes the need for healthcare professionals to be aware of specific interventions that can mitigate potential risks and improve patient outcomes in such complex clinical scenarios.

Correct Answer: B

Rationale: In hematology, the presence of schistocytes indicates a phenomenon called microangiopathic hemolytic anemia. Schistocytes are fragmented red blood cells that result from mechanical trauma as blood passes through vessels obstructed by clots or narrow vessels. In conditions like thrombotic thrombocytopenic purpura or hemolytic-uremic syndrome, schistocytes are commonly seen due to the formation of microthrombi in small blood vessels. Therefore, option B is correct. Option A, thalassemia, is a genetic disorder involving abnormal hemoglobin production, not mechanical fragmentation of RBCs. Option C, idiopathic thrombocytopenic purpura, is characterized by a low platelet count due to immune destruction of platelets, not RBC fragmentation. Option D, Gilbert's syndrome, is a benign liver condition resulting in mild jaundice due to impaired bilirubin metabolism, which does not cause schistocytes formation. Understanding the significance of schistocytes is crucial in diagnosing and managing various hematological disorders. This knowledge helps healthcare professionals differentiate between different types of anemias and guide appropriate treatment strategies. Identifying specific morphological changes in blood cells, like schistocytes, provides valuable diagnostic clues in clinical practice.