A 15-year-old male patient is suspected to have Von Willebrand disease (VWD). Which of the following statements about the characteristics of VWD is incorrect?
Von Willebrand disease is a hereditary deficiency of von Willebrand factor
Von Willebrand factor functions independently of factor VIII
Von Willebrand factor allows adhesion of platelets to a glycoprotein Ib-IX
Although VWD causes platelet dysfunction, bleeding tendencies are usually mild
The Correct Answer is B
Choice A reason: Von Willebrand disease is indeed a hereditary bleeding disorder caused by a deficiency or dysfunction of von Willebrand factor (vWF), which plays a crucial role in platelet adhesion and stabilization of factor VIII. This statement is accurate.
Choice B reason: This statement is incorrect. Von Willebrand factor does not function independently of factor VIII. In fact, vWF serves as a carrier protein for factor VIII, protecting it from degradation in circulation. A deficiency in vWF can lead to secondary reductions in factor VIII levels, contributing to bleeding symptoms.
Choice C reason: vWF mediates platelet adhesion to the subendothelial matrix by binding to glycoprotein Ib-IX on the platelet surface. This interaction is essential for the initial steps of hemostasis. The statement is correct.
Choice D reason: VWD typically causes mild to moderate bleeding symptoms, such as easy bruising, nosebleeds, and prolonged bleeding after minor injuries. Severe bleeding is less common, especially in type 1 VWD. This statement is accurate.
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Related Questions
Correct Answer is C
Explanation
Choice A reason: Advanced sleep phase type is characterized by falling asleep and waking up earlier than desired. Individuals with this disorder tend to feel sleepy in the early evening and wake up very early in the morning, which is the opposite of the scenario described.
Choice B reason: Irregular sleep-wake type involves a lack of a clearly defined sleep-wake cycle. People with this disorder have fragmented sleep patterns with multiple naps throughout the 24-hour period, not a consistent delay in sleep and wake times.
Choice C reason: Delayed sleep phase type is defined by a consistent pattern of falling asleep and waking up later than desired. This disorder is common in adolescents and young adults and matches the client’s report of delayed sleep onset and waking.
Choice D reason: Non-24 sleep-wake type is typically seen in individuals who are blind and lack light perception. Their circadian rhythm does not align with the 24-hour day, leading to progressively shifting sleep times. This does not match the client’s stable but delayed sleep pattern.
Correct Answer is B
Explanation
Choice A reason: While untreated streptococcal infections can lead to rheumatic fever or glomerulonephritis, they are not implicated in the pathogenesis of SLE. SLE is an autoimmune disease, not a post-infectious sequela of strep or scarlet fever.
Choice B reason: SLE arises from a complex interplay of genetic susceptibility and environmental triggers (e.g., UV light, infections, medications). These factors activate the innate immune system, leading to autoantibody production, immune complex deposition, and systemic inflammation. ANA positivity reflects this autoimmune activity.
Choice C reason: Epstein-Barr virus has been studied as a potential environmental trigger in autoimmune diseases, including SLE, but it is not the primary cause. Its role is contributory rather than causative.
Choice D reason: HPV is associated with cervical dysplasia and cancer, not autoimmune diseases like SLE. There is no established link between HPV infection and the pathogenesis of lupus.
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