Anemias
Anemias 100 — Identify the most likely diagnosis for a patient presenting with glossitis, pallor, fatigue, and koilonychia (spoon-shaped nails).
Anemias 100 → What is Iron deficiency anemia?
100 — Which population in the U.S. has the highest prevalence of sickle cell disease and why is this distribution historically explained?
100 → What is Black/African American population? (higher prevalence due to selective pressure from malaria in ancestral regions).
100 — Which leukemia is the most common malignancy in children, and what cell line does it arise from?
100 → What is Acute lymphocytic leukemia (ALL)? arises from lymphoid (lymphoblast) precursors.
100 — Cancer cells lack which normal cellular mechanism that halts growth when cells contact one another? Define it.
100 → What is Contact inhibition? (loss allows uncontrolled growth when cells touch).
100 — According to the provided content, what is the most common cancer in women?
100 → What is Breast cancer? (most common cancer in women accounts for 30% of all new cancers).
200 — Which laboratory value, when low, confirms iron deficiency anemia and what is the physiologic role of this biomarker?
200 → What is Low serum ferritin?
Ferritin reflects stored iron and low levels indicate depleted iron stores.
200 — Name two major physiologic or environmental triggers of vaso-occlusive crisis and briefly describe how each contributes to sickling.
200 → Triggers: What are dehydration and infection? (others include cold, high altitude, pregnancy); dehydration increases blood viscosity, infection/inflammation promotes sickling and vaso-occlusion
200 — Identify a hallmark bleeding-related sign of leukemia that results from thrombocytopenia and explain the underlying hematologic deficit.
200 → What is Bruising, petechiae, or bleeding gums? — due to thrombocytopenia from marrow replacement.
200 — What is the term for “loss of normal cell function and structure,” and how does it relate to tumor grade?
200 → What is Anaplasia? (lack of differentiation; correlates with higher tumor grade and aggressive behavior).
200 — Identify the classic skin change described as “orange peel skin” in breast cancer and explain the underlying pathologic process.
200 → What is Peau d’orange? (caused by lymphatic obstruction in the dermis leading to edema and skin tethering).
300 — A patient presents with paresthesias, gait instability, and cognitive changes. Which deficiency explains these neurologic findings and what is the pathophysiology behind them?
300 → What is Vitamin B12 (cobalamin) deficiency? B12 is required for myelin maintenance and methylation reactions—deficiency causes demyelination and neuronal dysfunction.
300 — Identify the disease-modifying medication that reduces vaso-occlusive episodes and state one important administration or safety instruction.
300 → What is Hydroxyurea? (oral; must NOT be chewed — follow swallow/administration instructions and counsel on cytopenia monitoring).
300 — Specify the infection-control nursing precautions required for a patient with neutropenia and the rationale for these measures.
300 → What is Neutropenic precautions? (e.g., protective isolation, strict hand hygiene, limit exposures), no fresh flowers, fruit, to reduce infection risk from low neutrophils.
300 — Interpret the staging shorthand T1N0M0: what does it indicate about tumor size, nodal involvement, and metastasis?
300 → What is Stage I? (localized tumor, no nodal involvement, no metastasis).
300 — Caused by tumor erosion into bronchial blood vessels or tumor-induced inflammation/necrosis. An early indicator of lung cancer.
300 → What is Hemoptysis?
400 — Name the laboratory test that is elevated in true vitamin B12 deficiency and explain why it rises.
400 → What is Methylmalonic acid (MMA)? (elevated in B12 deficiency because B12 is a cofactor for methylmalonyl-CoA mutase).
400 — Describe a common cerebrovascular complication of sickle cell disease and the typical mechanism leading to it.
400 → What is Stroke? (ischemic stroke from vaso-occlusion of cerebral vessels).
400 — State the diagnostic procedure that confirms leukemia by direct examination of hematopoietic stem cells and outline what key findings on that test support the diagnosis.
400 → What is Bone marrow biopsy? (examination of marrow/stem cells showing blasts, cytogenetic/molecular abnormalities).
400 — Name one carcinogen associated with lung cancer and briefly describe the exposure source.
400 → What is tobacco? (cigarette smoke), asbestos, radon; tobacco exposure is primary from cigarette smoking.
400 — Name one breast cancer risk factor related to reproductive history listed in the source and explain the hormonal link.
400 → What is not breastfeeding? (also early menarche, late menopause, not caring baby before age 30 years.) — prolonged lifetime estrogen exposure increases risk.
500 — List two dietary sources high in bioavailable iron and discuss one factor that enhances and one that inhibits iron absorption.
500 → Examples: What are red meat and spinach? (also broccoli, peas, beans, fortified cereals). Enhancer: vitamin C increases nonheme iron absorption. Inhibitor: phytates or calcium reduce absorption.
500 — Provide three assessment findings you would expect during an acute sickle cell crisis and explain how each finding relates to the underlying pathophysiology.
500 → What is Pain (from ischemia), jaundice (hemolysis), fever (infection or inflammatory response)/shortness of breath/fatigue? — reflecting hemolysis, anemia, and end-organ stress.
500 — Name two central nervous system symptoms that can be seen in leukemia and explain two possible mechanisms for CNS involvement.
500 → What is Headache and vomiting? (also irritability, papilledema, seizures) — due to increased intracranial pressure from leukemic infiltration, hemorrhage, or CNS involvement.
500 — The prompt states all hematologic cancers are automatically classified as which stage—explain the rationale or reasoning behind universal classification, if any.
500 → What is Stage IV? (the document states hematologic cancers are automatically classified as Stage IV).
500 — List two diagnostic tests used for breast cancer and give one advantage of each.
500 → What are Mammogram and MRI? (also breast biopsy). Mammogram: effective population screening and detects microcalcifications; MRI: higher sensitivity for dense breasts or high-risk patients; biopsy: definitive histologic diagnosis.