pls solve on the patient with leukemia many or t When DIC develo infection, or o
ID: 280091 • Letter: P
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pls solve
on the patient with leukemia many or t When DIC develo infection, or othe blood clotting o clotting factors, rhage. The b hemorrhage va underlying pro combination Myelodyspla of condition CASE STUDY A Acute Lymphocytic Leukemia P.M., aged 4 years, returned of a unusual listlessness and anorexia. The physicia ruises on her legs and arms and one on her back. S, has returned to the family physician because mentions ces several The physician st cate a low hemoglobin level, thrombocytopenia, h lymphocyte count, with abnormally high numbers recurrent sore throat and cough. Her mother n noti orders blood tests and a course of antibacterial drugs. le and a higExplanation / Answer
Acute lymphocytic leukemia is a malignancy of bone marrow in which there is rapid proliferation of early lymphoid precursors, without getting matured, and replace the normal hemopoietic cells. In simple words, it can be said as cancer of the white blood cells of lymphoid lineage. The most common risk factor for ALL is exposure to radiation. The common mode of exposure is radiation therapy for cancers, radiation from imaging studies, exposure of an unborn baby within the first few months of development, exposure to chemical carcinogens and chemotherapy drugs, exposure to benzene containing solvents, and cigarette smoking. Some virus like HTLV (human T cell leukemia virus-1) is also responsible for ALL.
ALL is thought to occur when proto-oncogenes are converted to oncogenes or when tumor suppressor genes lose their function, both of which can occur due to mutations or virus infection.
The recurrent sore throat and cough are due to the shortage of effective immune response. Since the lymphocytes produced are immature, they cannot lodge an immune response against a pathogen. Therefore, the person becomes immunocompromized due to deficiency of T-cell and B-cell responses. As a result, even certain normal flora can become pathogenic. The Streptococci, which are normal flora of the upper respiratory tract, can become pathogenic and cause sore throat in ALL individuals. Cough also is due to the same reason, the lack of efficient immune responses.
General debility and anorexia result from shortage of normal blood cells. The cancer cells build up in the liver and spleen, causing them to enlarge. Hepatomegaly and spleenomegalo causes feeling full after eating even small amount. Therefore, a person doesnot eat sufficiently and hence, is affected my malnutrition, and its associated symptoms like feeling tiresome and anorexia.
Bruising and bleeding is common during ALL due to shortage of blood platelets. Since the immune cells are not mature, the immature cells does not deal with the blood clotting effectively. A low platelet count is also responsible for clotting issues.
Since the bone marrow is over crowded by leukemia cells, normal red blood cells cannot be produced. This leads to anemia, and the affected becomes easily tired, take more naps, look pale, and have tachycardia. For the same reason, megakaryocytes, which are precursors for the platelets, are also not synthesized. The person suffers from thrombocytopenia and clotting related issues.
Blast cells are immature blood-forming cells that are not normally found in the blood. If the count of the blast cells is more than 10% of the total cell count, it indicates leukemia. Hypermetabolism is commonly seen in ALL. Since the patient is malnourished, there is progressive skeletal muscle mass to meet the protein and energy needs of the body. Reduced food intake and hypermetabolism leads to cachexia. The effects of hypermetabolism include wasting of muscles, fever, sleeplessness during nights, night sweating, and weakness.
Chemotherapy and radiation therapy can both aggravate the ALL as both of them can be carcinogenic. The may cause new mutations and ALL with a new mutation can arise. The drugs used in chemotherapy act against cells that are dividing quickly. However, the drugs can also act on cells lining the mouth and intestines, hair follicles, which also divide quickly. As a result, these cells are also afftected by the drugs. Hairfall and inflammation of mouth and intestines is a common side effect, along with mouth sores, loss of appetite, diarrhea, and fatigue.
If leukemic cells infiltrate the brain, headache, visual disturbances, drowsiness, and vomiting may occur. The cells divide and exert pressure on the surrounding brain tissue, which causes respective symptoms.
Since the bone becomes over crowded with leukemic cells, bone or joint pain may occur. Certain drugs and radiation therapy given during leukemia treatment may damage nerves and cause neuropathic pain.
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