Which of the following is a primary treatment modality for individuals with severe forms of thalassemia?
Blood transfusion
Antibiotic therapy
Physical therapy
High-dose vitamin supplementation
The Correct Answer is A
A. Blood transfusion is the cornerstone of management for severe thalassemia, such as beta-thalassemia major, to maintain adequate hemoglobin levels. Regular transfusions suppress ineffective erythropoiesis and prevent the severe skeletal deformities and organomegaly associated with the disease. This life-sustaining therapy provides the functional red blood cells that the patient’s bone marrow cannot produce.
B. While patients with thalassemia may be at an increased risk for infections, especially if they have undergone a splenectomy, antibiotic therapy is not a primary treatment for the anemia itself. Antibiotics are used adjunctively to manage complications rather than as a definitive therapy for the underlying genetic hemoglobinopathy. The core issue is hematologic, not infectious.
C. Physical therapy may be useful for managing some secondary complications, such as osteoporosis or pain, but it has no effect on the primary pathophysiological defect of thalassemia. The disease is characterized by a genetic deficiency in the synthesis of globin chains. No amount of physical exercise or therapy can correct the underlying cellular production of defective hemoglobin.
D. High-dose vitamin supplementation is not a primary treatment for thalassemia and can sometimes be dangerous. For instance, vitamin C can increase iron absorption and mobilize iron stores, potentially worsening iron overload in transfusion-dependent patients. While folate may be supplemented to support erythropoiesis, it does not address the fundamental need for functional red cell replacement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Expansion of the alveoli occurs during inspiration, but an increase in surface tension would actually resist expansion and promote alveolar collapse. Surfactant naturally decreases surface tension to ensure that the small air sacs can inflate easily. High surface tension is a pathological state that inhibits the effective entry of air into the distal pulmonary structures.
B. Inhalation requires the active contraction of the external intercostal muscles to elevate the ribs and sternum. Relaxation of these muscles and a decrease in ribcage volume are characteristics of expiration, not inspiration. For air to enter, the thoracic volume must increase to create the negative pressure gradient necessary for atmospheric air to flow inward.
C. The trachea is a rigid structure supported by C-shaped cartilaginous rings designed to maintain patency throughout the respiratory cycle. It does not contract or significantly decrease in diameter during normal inhalation. Any narrowing of the primary airway would increase resistance to airflow, which would be counterproductive to the goal of facilitating rapid air entry.
D. Contraction of the diaphragm causes it to flatten and move inferiorly, which increases the vertical dimension and overall volume of the thoracic cavity. This volume expansion leads to a drop in intrapleural pressure, following Boyle's Law, which pulls air into the lungs. This active muscular process is the primary driver of quiet inspiration in healthy human physiology.
Correct Answer is C
Explanation
A. Inspiratory crackles over the lung bases are clinical findings often associated with restrictive lung diseases or heart failure involving pulmonary edema. In chronic bronchitis, the primary issue is airway obstruction rather than alveolar fluid or interstitial fibrosis. While some secretions may cause coarse rales, fine basal crackles are not the defining feature of this condition.
B. Increased resonance, or hyperresonance, upon percussion is a classic finding in emphysema due to alveolar destruction and subsequent air trapping. In chronic bronchitis, the lung parenchyma often remains intact, and percussion notes may be normal. Hyperresonance indicates a loss of lung density that is specifically characteristic of the hyperinflated state of emphysema patients.
C. A prolonged expiratory phase is a hallmark physical finding of obstructive lung diseases, including chronic bronchitis. This occurs because inflammatory narrowing of the bronchioles increases airway resistance, making it more difficult and time-consuming for air to exit the lungs. This physiological delay is a compensatory mechanism to maintain airway pressure and facilitate more complete exhalation.
D. Decreased tactile fremitus occurs when there is an increase in the air-to-tissue ratio, such as in emphysema or a pneumothorax. In chronic bronchitis, the presence of excessive mucus and bronchial wall thickening may actually maintain or slightly increase the transmission of vocal vibrations. Decreased fremitus is not a sensitive or specific diagnostic sign for simple chronic bronchitis.
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