In an adult man older than 50 who presents with new-onset iron deficiency anemia and gastrointestinal bleeding, what is the most likely cause?
Celiac disease
Malignancy
Parasitic infestation
Increased systemic requirements for iron
The Correct Answer is B
Choice A reason: Celiac disease can cause iron deficiency anemia due to malabsorption, but it is less likely to present with overt gastrointestinal bleeding, especially in older adults. While it should be considered in chronic anemia, it is not the most likely cause in this context.
Choice B reason: Malignancy, particularly colorectal cancer, is a leading cause of iron deficiency anemia and gastrointestinal bleeding in men over 50. Occult or overt bleeding from a tumor can lead to chronic iron loss, and this presentation warrants urgent investigation for gastrointestinal malignancy.
Choice C reason: Parasitic infestation is a more common cause of iron deficiency anemia in children or individuals in endemic areas. It is less likely to be the cause in an older adult in a non-endemic setting, especially when gastrointestinal bleeding is present.
Choice D reason: Increased systemic requirements for iron are typically seen in growth phases, pregnancy, or chronic blood loss. In older men, this is not a common cause of iron deficiency anemia and does not explain gastrointestinal bleeding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: NSAIDs are commonly used to relieve pain and inflammation in RA, but they do not alter the disease course or prevent joint damage. They are considered adjunctive therapy rather than first-line disease-modifying treatment.
Choice B reason: Methotrexate is the cornerstone and first-line disease-modifying antirheumatic drug (DMARD) for RA. It reduces inflammation, slows disease progression, and prevents joint damage. It has a well-established efficacy and safety profile and is recommended by major rheumatology guidelines as the initial treatment for most patients with RA.
Choice C reason: Corticosteroid injections may be used for localized joint inflammation or as a bridge therapy while waiting for DMARDs to take effect. However, they are not considered first-line long-term treatment due to potential systemic side effects and lack of disease-modifying properties.
Choice D reason: Opioids are not recommended for RA management due to their risk of dependence and lack of anti-inflammatory or disease-modifying effects. They may be used in exceptional cases for severe pain but are not part of standard RA treatment protocols.
Correct Answer is D
Explanation
Choice A reason: This description applies to osteoarthritis, not osteoporosis. Osteoarthritis involves degeneration of joint cartilage and synovial structures, whereas osteoporosis affects bone density and strength.
Choice B reason: While this statement touches on bone remodeling, it inaccurately suggests that compensatory osteoblastic activity leads to structurally inferior bone. In osteoporosis, the imbalance favors osteoclastic resorption over osteoblastic formation, resulting in net bone loss.
Choice C reason: This description is characteristic of autoimmune diseases like rheumatoid arthritis. Osteoporosis is not autoimmune in nature and does not involve synovial inflammation.
Choice D reason: Osteoporosis is defined by decreased bone mass and microarchitectural deterioration due to an imbalance between bone resorption and formation. Risk factors include smoking, low BMI, Asian ethnicity, and postmenopausal status, all of which apply to this patient. The disease increases fracture risk due to weakened bone structure.
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