A 45-year-old female presented with a lump in her right neck for one week. She has had a cough with white sputum for one month. She also had a low-grade fever, night sweats, and a 5 kg weight loss (from 45 kg to 40 kg) in one month. The patient looked well. There were four lymph node enlargements in her posterior cervical right neck with a 1-2 cm diameter, matted, tender, and no sign of erythema, edema, or pain. Which histology description in the spleen is correct and related to the case?

A 25-year-old woman suffered wheels on her arms, trunk, and chest two hours after she ate a prawn. She feels severe itching & stinging. The clinical manifestation is more severe when she scratches the lesion. The doctor diagnosed her with having an allergy. Which of the following cells is most likely involved and increased?

A 17-year-old junior high school student experiences blood lancet for anemia screening. Capillary blood succeeded to be drawn, and bleeding stop in less than 1 minute. Which platelet events in sequential order are the most correctly involved in this process?

A real-time microscope showed a new dirty tearing wound that had accumulated erythrocytes, fibrin, and immune cells. The predominant accumulation was neutrophils. What substance or structure is most likely to attract neutrophils related to the case?

A one-month-old baby has to experience thymus removal because of his thymus malignant enlargement. Which immune cells are mostly depleted in the vascular?

A differential white blood cell count from a 2-year-old boy, suspected with Cytomegalo virus infection, showed that monocytes is 7%. What is the best description for the nucleus of this cells?

A 6 year old boy admitted to the hospital for pallor and easy bruising. Physical examination showed pallor, widespread petechiae, ecchymosis, bleeding gums and fever. No hepatosplenomegaly, no lymphadenopathy. Laboratory data revealed CBC and reticulocyte lower than normal, MCV, MCH, MCHC within normal limits. A bone marrow aspirate was markedly hypocellular with less than 25% cellularity. Which of the following is most likely the cause of this patient's condition?

An 18-year-old woman presents with increasing fatigue, dizziness, and shortness of breath over the past few months. She reports a vegetarian diet for the past three years and has a history of prolonged, heavy menstrual periods lasting 7-10 days. She also notes frequent headaches and difficulty concentrating. There is no history of gastrointestinal bleeding or significant weight loss. General examination revealed pale, pallor skin, brittle nails, and no jaundice. BP 110/70 mmHg, HR 95 bpm, Temp 36.8°C. Which of the following pathophysiology is the most likely to be found in that case?

A differential cell count from a patient showed increased cells with the following characteristics: size almost twice that of a red blood cell, NC ratio = 1:3; 2 distinct nuclear lobes; eccentric or central nucleus; deep-blue purple coarsely granular chromatin; pink cytoplasm and red inform granules in cytoplasm. Which of the following accumulating cells reflects the patient's condition?

A 7-year-old boy is admitted to the pediatric ward for routine blood transfusions due to his chronic anemia. This transfusion is the 12th time since this patient was found to have a very low hemoglobin level and the results of his blood genetic examination revealed a mutation in the beta-globin coding gene for hemoglobin. Physical examination at admission to the ward showed dark and dull skin color, anemic conjunctiva, and the abdominal surface appeared convex and there was a "filling effect" (dull) in the Traube Abdomen Room. Blood laboratory tests (before blood transfusion) showed a Hb level of 5 g/dL and leukocyte and platelet levels within normal limits. What is the most appropriate anemia process that occurs in this case?

You see a 25 year-old female patient who reports a history of heavy periods since menarche. She reports bruising easily as well for most of her life. She had tonsillectomy at age 6 and was told by her mom that she needed to stay in hospital for longer due to bleeding. You organize laboratory investigations and are able to confirm von Willebrand's disease in this patient. What is the most likely correct etiology about the coagulation mechanism of the case?

The mother of an eight-month-old boy brought him to the pediatrician for recurrent throat infections. The child had a high fever and was extremely irritable. Bacterial cultures grew beta-hemolytic Streptococcus pyogenes. Laboratory examination reveals that his serum's IgG, IgA, and IgM were abnormally low. Which of the following most likely explains the mechanism etiology?

A 7-year-old boy was brought to the Health Center with complaints of paleness for 6 months. Complaints were accompanied by weakness and palpitations. The patient often had mucous and bloody stools. The physical examination revealed anemic conjunctivae and atrophy of the tongue papillae. The results of peripheral blood smear examination showed hypochromic microcytic anisopoikilocytosis erythrocytes with cigar cells. The erythrocyte index was found to be low, characterized by a low MCV and MCHC.

The thymus is a primary lymphoid organ that supplies other lymphoid organs and tissues. It is encircled by a thin connective tissue capsule. The thymus plays a pivotal role in the development of B cells. Which of the following statement is the most CORRECT for the function for immunological organ above?

A 25-year-old male came with gum bleeding 1 week ago. The bleeding was accompanied by unspecified bone pain, weakness, fatigue, and fever. Physical examination revealed pallor, multiple skin petechiae, non-tender lymph node enlargement at the regio colli/neck region, and splenomegaly. Laboratory investigations showed hemoglobin 6.0 g/dL, increased WBC number 23000 mm3, and low platelet 10,000 mm3. The doctor hypothesizes leukemia. Which of the following is the most likely morphology finding seen in the peripheral blood smear?

The thymus is a primary lymphoid organ that supplies other lymphoid organs and tissues. A thin connective tissue capsule encircles it and plays a pivotal role in the development of immune cells, particularly the Main resident cells in the germinal center of secondary lymphoid tissue. What is the most likely immune cells mentioned?

You are called to see a 45 year-old woman who has become unwell 15 minutes after starting a blood transfusion. She started a red cell transfusion for post operative haemorrhage (after vaginal hysterectomy) 15 minutes earlier. She complains of loin pain. On examination her blood pressure is 80/48 mmHg, pulse 120/min, respiratory rate 20/min, temperature 37.4°C. You stop the transfusion and check the blood group of the patient and the bag. The patient is blood group O RhD pos.

A 29-year-old man comes to the primary health clinic to receive a newly tested influenza virus vaccine as he meets the intranasal attenuated influenza virus vaccine criteria. This vaccine produces antibodies that work on the surface of the nasal epithelial barrier, preventing the virus from entering the body. Which immunoglobulin class is most likely to be produced?

A 12-year-old girl presents for a routine check-up following her first dose of the HPV vaccine. She received it three months ago through a school program. She reports mild soreness at the injection site, which has improved, and expresses an increased understanding of HPV and its associated risks. Her medical history is unremarkable, and she has completed her childhood vaccinations. Physical examination shows normal growth and development, with only mild tenderness at the vaccination site. She is doing well, and the importance of completing the vaccination series was emphasized, with her second dose scheduled for the upcoming months. Which of the following is the most likely significant effector related to the case above?

A 30 years old male patient was hospitalized with a severe anemia in District Hospital. The patient had fatigue, pale and dizziness for one month and approximately 12 kg weight lost for four months previous to admission. Severe iron deficiency anemia was diagnosed in the patient by laboratory analyses. The stool examination revealed numerous eggs of hookworm. Which of the following best describes the immune response related to the case above?

A previous healthy baby becomes unconscious on the 3rd day of life. CT scan shows intracranial bleeding. The laboratory findings show: Hb 11 g/dl, WBC 6,000/mm3, thrombocyte: 175,000/mm3, bleeding time was normal, while PT and aPTT were prolonged. What is the most likely cause of bleeding?

A 40-year-old man came to the hospital polyclinic with complaints of headache and weakness. In addition, the patient also felt like there was something protruding in the upper left abdomen. On physical examination, BP was found: 160/100, Oxygen saturation: 98%. Spleen felt enlarged. The results of a complete blood examination showed Hb 19.9 g/dL, Hct 59.6%, leukocytes 15,000/mm3, platelets 500,000/mm3. What is the most likely diagnosis?

A three month-old boy is brought to his GP by his mother for his 2nd immunisation. His 2 year old sister has leukaemia and is receiving high-dose chemotherapy. What is the most appropriate action?

A 5-year-old boy was brought to the hospital's emergency room by his mother because of bluish swelling in both of his knees. The swelling was caused by the patient falling while playing. The patient has a history of bleeding that is difficult to stop. On physical examination, the child was conscious, appeared to be in pain, had a pulse of 90 beats per minute, a respiratory rate of 20 breaths per minute, a temperature of 37.2°C, and swelling and redness in both knees. What is most likely diagnosis?

A 45-year-old woman came to the emergency room of the hospital with complaints of a pale face and lightheadedness for 1 month. Complaints accompanied by fatigue, headache, and heart palpitations in the past week. On physical examination, blood pressure was 80/60 mmHg, respiratory rate 26 breaths per minute, pulse rate 104 beats per minute, and afebrile temperature. On physical examination, a pale inferior palpebral conjunctiva was found. Routine blood laboratory examination found Hb 5 gr / dL, leukocytes 5500 / mm3, platelets 205,000 / mm3, Ht 17.6%, MCV 71 fl, MCH 25 pg. On morphological examination of peripheral blood, the impression of microcytic hypochromic anemia, low serum iron levels, normal serum ferritin, normal TIBC, and slightly increased reticulocyte count. What is the most appropriate initial therapy to be given?

A 90-year-old man who lives alone at home. He is physically frail due to several medical illnesses and has dementia. He has been housebound for many months, has lost weight, and his diet has been suboptimal. His family says he has mainly eaten soup, bread, and biscuits. Blood tests show that he is anemic and has a raised MCV, and the blood film shows macrocytosis. Which of the following would be the most relevant test or tests to order next?

A 28-year-old woman presents with a 6-month history of symmetrical joint pain in the hands, knees, and wrists, accompanied by a red, butterfly-shaped malar rash across her cheeks and nose, worsened by sun exposure. She also reports fatigue, mild hair loss, and occasional low-grade fever. Physical examination reveals tenderness and mild swelling in the affected joints, with no significant systemic findings beyond the skin rash. Which of the following pathophysiologies is the most likely related?

A 14-year-old girl presents with fever and increasing lethargy over the previous 3 weeks. This mainly happened after sunbathing. On physical examination, she has raised red tender lesions over her cheeks. The appearance almost describes a butterfly pattern. Vascular lesions are also depicted over the soles of her feet. The table below was the result of the investigation: Parameter | Value | Normal range Haemoglobin (g/l) | 85 | 130-180 Urea (mmol/l) | 15.3 | 2.1-8.9 Creatinine (µmol/l) | 210 | 55-133 Autoimmune screen: - Antinuclear antibody | 1:320 | - Anti-Sm | Positive | C3 (g/l) | 0.650 | 0.7-1.7 C4 (g/l) | 0.11 | 0.13-0.43 Erythrocyte sedimentation rate (mm/h) | 87 | 0-10 C-reactive protein (mg/l) | 12.0 | 0-10

A 21-year-old woman presented to the hospital's general clinic with complaints of recurrent nosebleeds for the past year. Complaints were accompanied by fatigue and frequent fevers with red spots on the chest and legs. There was no history of the same disease in the parents. The physical examination revealed anemic conjunctivae, petechiae, and ecchymosis on the thighs and legs, with no lymphadenopathy or hepatosplenomegaly. Laboratory examination found Hb 5.2 g/dL, leukocytes 1,200/mm3, platelets 5,000/dL, reticulocytes <1%. What is the most appropriate further supporting examination?