Which of the following subtypes of Hodgkin's lymphoma is common in young women and has good prognosis?

Correct Answer: A

Rationale: The correct answer is A: Nodular sclerosis. This subtype of Hodgkin's lymphoma is more common in young women and has a good prognosis due to its characteristic fibrotic bands dividing the lymph node into nodules. These nodules contain a mixture of inflammatory cells and Reed-Sternberg cells. Choice B: Mixed cellularity is more common in older patients and has a less favorable prognosis due to its heterogeneous cell population with abundant Reed-Sternberg cells. Choice C: Lymphocyte predominance typically affects young adults and has an indolent course with a good prognosis, but it is not as common in young women as nodular sclerosis. Choice D: Lymphocyte depletion is a rare subtype seen in older individuals with a poor prognosis due to the paucity of lymphocytes and an abundance of Reed-Sternberg cells.

Correct Answer: B

Rationale: Rationale for Choice B: Defects in the peripheral proteins are the most likely cause of spherocytosis. Spherocytosis is characterized by spherical-shaped red blood cells due to a deficiency in peripheral membrane proteins like spectrin, leading to reduced cell flexibility and membrane stability. This results in premature destruction of red blood cells in the spleen, causing hemolytic anemia. Summary: A: Abnormal antigenic properties are not the primary cause of spherocytosis; the issue lies in membrane protein defects. C: Increased formation of ropalux is not a known factor in spherocytosis. D: Formation of sickle-shaped cells is characteristic of sickle cell anemia, not spherocytosis.

Correct Answer: D

Rationale: The correct answer is D: RA with excess blasts in transformation. This choice has the poorest prognosis because it represents a progression of RA with excess blasts, indicating a higher percentage of blast cells in the bone marrow. This progression signifies a more aggressive form of the disease with a worse outcome. A: Refractory anemia (RA) is a milder form with a better prognosis compared to the other choices. B: RA with ring sideroblasts is a subtype of RA, and while it may have some adverse features, it generally has a better prognosis than RA with excess blasts. C: RA with excess blasts represents a higher risk group, but it is not as severe as RA with excess blasts in transformation, which indicates a further deterioration of the disease. In summary, D is the correct answer because it signifies the most advanced stage of the disease with the highest risk and poorest prognosis compared to the other choices.

Correct Answer: C

Rationale: The correct answer is C, chronic myelocytic leukemia. The presence of increased numbers of neutrophils at various stages of maturation, along with increased basophils, eosinophils, and platelets, is characteristic of chronic myelocytic leukemia. This condition is marked by a myeloproliferative disorder, leading to an overproduction of myeloid cells in the bone marrow. Acute myeloid leukemia (choice A) typically presents with a high number of blast cells rather than mature neutrophils. Acute lymphoid leukemia (choice B) primarily involves lymphoid cells, not myeloid cells. Chronic lymphocytic leukemia (choice D) is characterized by the accumulation of mature lymphocytes, not myeloid cells as seen in this case.

Correct Answer: A

Rationale: Step 1: Visceral leishmaniasis is transmitted by sand flies. Step 2: In the Asian region, the main vector of visceral leishmaniasis is Phlebotomus species. Step 3: Phlebotomus species are known to transmit the Leishmania parasite in Asia. Step 4: Lutzomyia species are the main vector in the Americas. Step 5: Anopheles species are vectors for malaria, not leishmaniasis. Step 6: Mansonia species are vectors for diseases like filariasis, not leishmaniasis. Summary: Choice A is correct because Phlebotomus species are the main vector of visceral leishmaniasis in the Asian region, while choices B, C, and D are incorrect as they are not the main vectors for this disease in that specific geographical area.