D446 Adult Health II - Set 4 - Part 3

Correct Answer: Factor VIII deficient

Hemophilia A lacks factor VIII needed for coagulation cascade; platelets function normally but cannot form stable clots without adequate clotting factors.
Option a is incorrect because hemophilia doesn't involve platelet antibodies; the deficiency is coagulation factor VIII, not platelet destruction or dysfunction.
Option c is incorrect because platelets aren't consumed rapidly in hemophilia; they're present and functional but need factor VIII for clotting.
Option d is incorrect because platelet adhesion is normal in hemophilia; the missing factor VIII prevents coagulation cascade completion despite normal platelets.

Correct Answer: Transmural inflammation occurring

Crohn's disease causes full-thickness bowel wall inflammation that can penetrate through creating abnormal connections to skin, other organs, or between bowel loops.
Option a is incorrect because superficial erosion doesn't create fistulas; Crohn's transmural inflammation penetrates entire wall forming abnormal connections.
Option c is incorrect because while infection may complicate fistulas, transmural inflammation is the primary mechanism creating these abnormal connections.
Option d is incorrect because ischemia causes different pathology; fistulas result from Crohn's characteristic transmural inflammatory process penetrating through tissues.

Correct Answer: Peripheral vasoconstriction compensatory

Sympathetic response to low cardiac output causes peripheral vasoconstriction, shunting blood centrally and reducing skin perfusion, causing cool, clammy skin.
Option a is incorrect because temperature regulation isn't primarily affected; cool skin results from compensatory vasoconstriction reducing peripheral blood flow.
Option c is incorrect because metabolic rate may actually increase from stress; cool skin results from vasoconstriction, not metabolic changes.
Option d is incorrect because sweating occurs from sympathetic activation but skin is cool from vasoconstriction reducing peripheral blood flow.

Correct Answer: Core antibody appearing

IgM anti-HBc appears during acute infection; in fulminant failure, massive hepatocyte destruction may clear HBsAg while IgM anti-HBc remains detectable.
Option a is incorrect because surface antigen clearing alone doesn't indicate fulminant failure; it may clear due to massive hepatocyte destruction.
Option c is incorrect because E antigen indicates replication but doesn't specifically identify fulminant failure versus chronic active infection patterns.
Option d is incorrect because surface antibody indicates recovery or vaccination; fulminant failure is marked by acute phase markers like IgM anti-HBc.

Correct Answer: Reduces calcium release

Dantrolene blocks ryanodine receptors preventing excessive sarcoplasmic calcium release that causes sustained muscle contraction and hyperthermia in susceptible patients.
Option a is incorrect because dantrolene doesn't block anesthetic agents; it interrupts the calcium release causing muscle hypermetabolism after triggering.
Option c is incorrect because dantrolene doesn't directly affect heat loss; it stops heat production by preventing abnormal muscle contraction.
Option d is incorrect because while acidosis improves, dantrolene works by blocking calcium release, not directly correcting acid-base disturbances.

Correct Answer: Histamine release occurring

Increased basophils and mast cells in polycythemia vera release histamine upon temperature changes, causing characteristic itching after hot water exposure.
Option a is incorrect because the itching is specifically triggered by water temperature changes, not dryness, indicating histamine-mediated mechanism.
Option c is incorrect because circulation is actually increased from high blood cell counts; itching results from histamine, not poor circulation.
Option d is incorrect because nerve function is normal; the mechanism is histamine release from increased mast cells, not neuropathy.

Correct Answer: Erythropoietin decreased significantly

Kidneys produce erythropoietin stimulating red cell production; acute injury reduces hormone synthesis causing anemia despite adequate iron and nutrition.
Option a is incorrect because iron stores are usually adequate; anemia results from decreased erythropoietin production, not iron deficiency typically.
Option c is incorrect because hemolysis isn't characteristic of acute kidney injury; decreased erythropoietin production causes the anemia observed.
Option d is incorrect because while nutrition matters long-term, acute anemia in AKI results from lost erythropoietin production, not malnutrition.

Correct Answer: Pressure gradient created

Trapped air creates positive pressure exceeding atmospheric pressure, physically pushing mediastinal structures away from affected side, causing tracheal deviation.
Option a is incorrect because simple lung collapse causes tracheal shift toward affected side; tension pneumothorax pushes structures away from pressure.
Option c is incorrect because blood accumulation causes different pathology; tension pneumothorax involves air pressure, not blood pushing structures.
Option d is incorrect because adhesions pull structures toward pathology; tension pneumothorax pushes structures away through positive pressure mechanics.

Correct Answer: Saponification depletes calcium

Pancreatic lipase causes fat necrosis with calcium soap formation, consuming calcium and potentially causing dangerous hypocalcemia requiring replacement therapy.
Option a is incorrect because while hypercalcemia can cause pancreatitis, monitoring during acute pancreatitis is for hypocalcemia from saponification.
Option c is incorrect because parathyroids aren't affected by pancreatitis; calcium drops from consumption in fat saponification, not hormonal changes.
Option d is incorrect because vitamin D metabolism isn't acutely affected; calcium depletion results from saponification in fat necrosis areas.

Correct Answer: Volume status optimized

Fluid removal during dialysis reduces intravascular volume, often dramatically improving blood pressure control that medications alone cannot achieve effectively.
Option a is incorrect because medication removal would worsen, not improve, blood pressure control; benefit comes from volume reduction primarily.
Option c is incorrect because while uremic toxins affect vasculature, acute blood pressure improvement primarily results from volume removal during dialysis.
Option d is incorrect because dialysis is stressful; blood pressure improvement results from fluid removal optimizing volume status, not stress reduction.