Which of the following is usually the first treatment given to patients with autoimmune hemolytic anemia?

Correct Answer: A

Rationale: The correct answer is A: Corticosteroid. Corticosteroids are typically the first-line treatment for autoimmune hemolytic anemia as they help suppress the immune system's attack on red blood cells. They reduce inflammation and prevent further destruction of red blood cells. Blood transfusions (B) may be necessary in severe cases to address anemia but do not treat the underlying autoimmune process. Immunosuppressant drugs (C) are used if corticosteroids are ineffective or not tolerated. Removal of the spleen (D) may be considered in refractory cases but is not usually the initial treatment choice.

Correct Answer: C

Rationale: The Schilling test assesses the client's ability to absorb vitamin B12, as it evaluates the absorption of an orally administered radioactive B12. First, the client is given a dose of radioactive B12 orally, and urine samples are collected to measure how much of the radioactive B12 is excreted. If the client is unable to absorb vitamin B12 properly, a second test is performed with intrinsic factor to determine the cause. Choices A, B, and D are incorrect as the Schilling test specifically focuses on the absorption, not storage, digestion, or production of vitamin B12.

Correct Answer: A

Rationale: The iliac crest is the best source for active bone marrow in a 20-year-old because it contains a high concentration of hematopoietic stem cells responsible for blood cell production. It is easily accessible, minimizing risks associated with harvesting. The femur, distal radius, and tibia have lower concentrations of active bone marrow and are less commonly used for bone marrow aspiration. Therefore, the iliac crest is the optimal choice for obtaining active bone marrow in this scenario.

Correct Answer: B

Rationale: Step 1: Decitabine is a DNA methyltransferase inhibitor, NOT an inducer. Step 2: Fetal hemoglobin production is regulated by gene expression, not DNA methylation. Step 3: The switch from gamma to beta-globin production is primarily controlled by transcription factors. Step 4: Therefore, the statement that decitabine prevents the switch by inducing DNA methylation is FALSE. Summary: Choice B is correct because decitabine does not induce DNA methylation to increase fetal hemoglobin production. Choices A, C, and D are incorrect due to the lack of evidence supporting them.

Correct Answer: B

Rationale: The correct answer is B: FALSE. Homan's sign is actually classified as pain in the calf upon passive dorsiflexion of the foot, not behind the knee. This test is used to assess for deep vein thrombosis (DVT). The other choices are incorrect: A is incorrect as Homan's sign is not associated with pain behind the knee, C is incorrect as the sign is consistent in its presentation, and D is incorrect because Homan's sign is not exclusive to DVT.