ATI RN
Hematological System Questions
Question 1 of 5
Which of the following is not a good prognostic factor in patient with acute lymphoblastic leukemia?
Correct Answer: A
Rationale: The correct answer is A. Immunophenotype of mature B cell is not a good prognostic factor in acute lymphoblastic leukemia (ALL) because it indicates a more aggressive subtype. B: Gender being female is a good prognostic factor in ALL as females generally have better outcomes. C: Chromosomal number hyperploidy is a good prognostic factor as it is associated with a favorable prognosis. D: Age 4 to 10 years old is also a good prognostic factor as children in this age group tend to have better outcomes in ALL.
Question 2 of 5
A patient is presented with pallor, fatigue and dyspnea. Physical examination shows koilonychias and angular cheilitis. Which of the following is not expected in the laboratory finding of this patient?
Correct Answer: A
Rationale: Step 1: The patient presents with symptoms of iron deficiency anemia. Step 2: Koilonychias and angular cheilitis are characteristic of iron deficiency anemia. Step 3: Low total iron binding capacity (TIBC) is expected in iron deficiency anemia due to decreased iron stores. Step 4: High serum transferrin and low iron:TIBC ratio are also expected in iron deficiency anemia. Step 5: Therefore, the correct answer is A, as low TIBC is expected in iron deficiency anemia. Summary: B: High serum transferrin and C: Low iron:TIBC ratio are expected in iron deficiency anemia. D: Low serum ferritin is expected in iron deficiency anemia as it is a marker of decreased iron stores.
Question 3 of 5
Spherocytosis is a common cause of inherited hemolytic anemia. The most likely cause for spherocytosis is
Correct Answer: B
Rationale: The correct answer is B: Defects in the peripheral proteins. Spherocytosis is characterized by spherical-shaped red blood cells due to defects in the peripheral proteins of the cell membrane, such as spectrin or ankyrin. This results in decreased membrane stability and fragility, leading to hemolysis. Choices A, C, and D are incorrect. Choice A is not the most likely cause as spherocytosis is primarily due to defects in peripheral proteins, not integral proteins. Choice C is incorrect as "ropalux" is not a known factor in spherocytosis. Choice D is incorrect as sickle-shaped cells are characteristic of sickle cell anemia, not spherocytosis.
Question 4 of 5
Myelodysplastic syndromes are a group of clonal stem cell disorders. Which of the following type has the poorest prognosis according to the FAB system of classifications?
Correct Answer: D
Rationale: The correct answer is D: RA with excess blasts in transformation. This type has the poorest prognosis as it represents a progression to acute myeloid leukemia, which is associated with a high mortality rate. In the FAB system, this category indicates a higher blast count than RA with excess blasts (choice C), leading to a worse outcome. Choices A and B are associated with a lower risk of progression to AML compared to choices C and D. Therefore, D is the correct answer due to its direct association with the most aggressive form of the disease.
Question 5 of 5
A peripheral blood smear showing increase in numbers of neutrophils, band cells, metamyelocytes, myelocytes, basophils, eosinophils, and platelets is most suggestive
Correct Answer: C
Rationale: The correct answer is C: Chronic myelocytic leukemia. This is suggested by the presence of increased numbers of neutrophils, band cells, metamyelocytes, and myelocytes in the peripheral blood smear, which are characteristic of chronic myeloid leukemia. Basophils and eosinophils are also increased in CML. Platelets may be increased due to reactive thrombocytosis. Acute myeloid leukemia (A) typically presents with more blasts in the peripheral blood. Acute lymphoid leukemia (B) would show lymphoblasts instead of myeloid cells. Chronic lymphocytic leukemia (D) is characterized by an increase in mature lymphocytes, not myeloid cells.