In hemodialysis patients, blood is accessed by the surgical attachment of an artery to a vein known as:

Choice A reason: The neck is the most common site where individuals with Hodgkin Lymphoma (HL) present with nontender enlarged lymph nodes. These lymph nodes are typically firm and rubbery in texture. The cervical lymph nodes are often affected first in HL, making the neck a primary area of concern for this type of lymphoma. Early detection and biopsy of these lymph nodes can help in diagnosing HL.

Choice B reason: While the abdomen can be involved in Hodgkin Lymphoma, it is not the most common initial presentation site. Involvement of the abdominal lymph nodes typically occurs at later stages of the disease. Enlarged lymph nodes in the abdomen can be detected through imaging studies but are less accessible for physical examination compared to those in the neck.

Choice C reason: The kidney is not a typical site for lymph node involvement in Hodgkin Lymphoma. HL primarily affects the lymphatic system, including lymph nodes, spleen, and other lymphoid tissues. Direct involvement of the kidney is rare and usually occurs in advanced stages of the disease.

Choice D reason: The spleen is a lymphoid organ that can be involved in Hodgkin Lymphoma, especially in more advanced stages. However, it is not the primary site where nontender enlarged lymph nodes are first detected. Enlargement of the spleen (splenomegaly) can occur due to the spread of HL, but the initial presentation is usually in the lymph nodes of the neck.

Choice A reason: While white blood cells (WBC) are essential for fighting infections, increased WBCs in the blood is not the reason why a minor injury can cause major complications in individuals with diabetes. In fact, diabetes can impair the function of WBCs, making it harder to fight infections.

Choice B reason: Edema, or swelling, can occur in individuals with diabetes, especially in the lower extremities. However, it is not the primary reason why minor injuries can lead to severe complications. Edema can contribute to discomfort and further complications, but it is not the root cause.

Choice C reason: Increased blood flow and oxygen delivery to tissues would generally be beneficial for healing. However, individuals with diabetes often have impaired blood flow, not increased blood flow. This impairment can hinder the healing process and lead to complications.

Choice D reason: The major reason why a minor injury can cause significant complications in individuals with diabetes is due to decreased blood flow to the tissues. Diabetes can cause damage to blood vessels and nerves (peripheral neuropathy), leading to poor circulation and a reduced ability to sense injuries. This decreased blood flow can prevent adequate delivery of oxygen and nutrients to the tissues, leading to slow healing, increased risk of infection, and in severe cases, gangrene (tissue death). Without proper blood flow, even minor injuries can become serious and may require medical intervention, including possible amputation to prevent the spread of infection.