The correct answer is (D). If this patient has anti-A antibodies, it means that this person has type B blood. Persons with type B blood can receive their own type—in this case B—and type O blood. If this patient received type A blood, the patient’s anti-A antibodies would attack those cells as foreign and cause widespread hemolysis.
The correct answer is (C). The LUQ pain suggests that the spleen is the site of the coagulation, which could lead to swelling of the spleen and increasing pain. Splenic rupture is possible and is suggested by the rebound tenderness resulting from irritation of the peritoneum from internal hemorrhage. Aplastic crisis (A) occurs when the body is no longer manufacturing red blood cells, resulting in anemia. Hemolytic crisis (B) is more likely to present with symptoms of liver failure, particularly jaundice, because of the overdestruction of red blood cells in the liver. Vaso-occlusive crisis (D) is a term for any vessel occlusion anywhere in the body; however, this generally refers to any capillary in the body.
The correct answer is (A). Management of the pain in a person with sickle cell crisis should be the first priority for the paramedic. Online medical direction also is recommended for pain control in these patients because they may require much higher amounts than anticipated. Fluid (B) should be considered but not as a primary treatment. Fentanyl is preferred to morphine (C). Aspirin (D) is never recommended in any child under the age of 20 because of the risk of Reye syndrome, despite this being a coagulopathy problem.