Acute Lymphocytic Leukemia
Ca #7
Leukemia is a cancer of white blood cells. In an acute leukemia, the abnormal cells divide rapidly, quickly overtaking functional white and red blood cells. The most common form of cancer in children 0-14 years of age is acute lymphocytic leukemia (ALL). The survival rate in children has improved more than 50% in the last half century. Currently there is a 65.3% overall survival rate; in children under 5 the survival rate increas to 90.4%. Come experience the cancer journey with 6-year-old Noah.
Ca Objectives
1)After reviewing the blood unit of the cardiovascular system in the text, and completing thehealthy的比较级
Acute Lymphocytic Leukemia ca, the student should be able to:
a.Define hemopoiesis.
b.Describe the origin and development of blood cells.
c.Define the tissue where blood cells are formed before and after birth.英语翻译字典
d.List the 5 types of circulating leukocytes and describe their microscopic appearance and
function.
2)After reviewing the medical terminology links in the ca study, the student should be able to
define the following terms: anemia, leukopenia, leukocytosis, lymphoblast, thrombocyte,
blasts, blood-brain barrier, hypercellularity, meninges, pneumonia, pus, petechiae, remission, upper-lobe infiltrate, transfusion, cytochemical stains, immunologic marker studies.
3)After reviewing the CBC diagnostic testing site, the student shoud be able to:
a.Define CBC, WBC, RBC, Hb, Hct, and platelets.
b.List 5 pathological conditions that may cau an elevation in the WBC count.
4)After reviewing the diagnostic testing in the ca to include throat culture, bone marrow
aspirate, lumbar puncture, and chest x-ray, the student should be able to:
a.Define the principle of the test.
b.Describe when the test is indicated.
c.Describe how the test is performe
d.
d.Summarize the dias that can be diagnod by the test.
5)Review the gram stain link and:
a.Define the two groups of bacteria differentiated by a gram stain.
b.Discuss why the gram stain is an important first step in the identification of a pathogen.
6)After reviewing the leukemia link, the student should be able to:
a.List the 4 major types of leukemia.
b.Define the predominant age group of each type of leukemia.
c.Describe the difference between a lymphocytic and a myeloid leukemia.
d.Describe the difference between an acute and chronic leukemia.
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e.Describe how an acute leukemia is treated differently than a chronic leukemia.
f.List possible risk factors of leukemia.
g.Describe the clinical symptoms of leukemia.
h.Describe the procedures ud to diagno leukemia.
7)Review the following treatments for leukemia: chemotherapy, radiation, bone marrow
transplant.
a.Define the principle of the treatment.
rallyb.Describe how the treatment is given.
c.Discuss the benefits and side effects of treatment.
8)After reviewing the health professional links and the ca study, discuss the role of the
following health care professionals in diagnosing and/or treating a patient with leukemia:
a.physician to include the following physician specialties: pediatrician, oncologist,
radiation oncologist, pathologist, and radiologist.
b.clinical laboratory scientist
d.radiology technician
Noah, 6 years old, was brought back to his pediatrician three weeks following a streptococcal throat infection. His mother was worried that the Strep infection had not cleared up as the child was still complaining of a sore throat and had been very lethargic.
The physician noted that the child looked quite pale. The child's throat was still red, although the pus and petechiae previously noted with the Strep infection were abnt. Ears and chest appeared to be clear although the child cried and emed to be in pain when the doctor presd on the sternum. Upon further examination, the physician noted that the child's spleen felt slightly enlarged, as did the lymph nodes. He noted that the child had multiple bruis over his lower extremities. Upon questioning, the mother commented that the child had been experiencing excessive nobleeds. The physician ordered a CBC,and a throat culture.
1)What symptoms did Noah exhibit?
2) Are Noah's symptoms consistent with a Strep infection?
The results of the laboratory tests were returned the following day.
Preliminary Throat Culture Report
CBC Results
3)Which health professional is responsible for performing Noah's laboratory tests?
排放英语4)What abnormalities were prent in the laboratory tests?
5)Which health professional would Noah's pediatrician be most likely to consult with?
Upon receiving the results, the physician informed the stunned mother that her child had leukemia and would need to be admitted to the hospital for further testing and treatment.
6)Define leukemia.
7)What is the difference between a chronic and acute leukemia? How do the symptoms differ?
8)What are the four most common types of leukemia? In which age groups is each most predominantly
found?
9)What are the common symptoms of leukemia?
10)What tests help a physician diagno a leukemia?
After admission to the hospital, Noah was referred to a pediatric oncologist, a doctor who specializes in pediatric dias of the blood. The oncologist ordered a bone marrow aspirate.
Bone Marrow Smear Results
11)What is a bone marrow procedure?
12)What abnormality in Noah's bone marrow smear was suggestive of a Leukemia?
Cytochemical stains were ordered as well as immunologic marker studies. Both studies pointed to an acute lymphoblastic leukemia (ALL) type L1.
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Instructor's notes:
Cytochemical stains and immunologic marker studies are advanced testing methods ud to differentiate leukemias. The student is not expected to have an in depth understanding of either testing method but should be expod to both.
A spinal tap was ordered to e if the leukemic cells had crosd the blood/brain barrier. There were many lymphoblasts in the spinal fluid. In ALL the leukemic cells are often harbored in the meninges.
13)What is a spinal tap or lumbar puncture?
14)Why is a lumbar puncture performed?
15)What is cerebral spinal fluid?
16)What chemicals or constituents can be measured from the cerebral spinal fluid?
Noah was started on chemotherapy which would kill as many of the cancer cells as possible. He was also given a transfusion of 2 units of packed red blood cells to help alleviate his anemic condition. Noah was relead from the hospital but continued chemotherapy treatments weekly. After 3 weeks of chemotherapy treatments, Noah developed a fever of 102°F. Examination revealed coar breath sounds in the right anterior chest. An order was nt to the radiology technician for a ries of chest radiographs.
17)What is chemotherapy? How is it given? What are some of the side effects of chemotherapy?
18) Why did Noah develop a fever?
19)Why would the physician order a chest x-ray?
20)What is a chest x-ray?
21)What abnormalities can be detected from a chest x-ray?
Chest x-ray results
A sputum culture was obtained and nt to the lab for gram stain, culture, and nsitivities.
Gram stain and culture report
22)What health care professional is responsible for gram stain and culture testing?
23)A gram stain differentiates bacteria into what two class?
24)Why would an immunocompromid patient be more susceptible to dia?
Noah was again admitted to the hospital and started on antibiotics to treat a gram negative pneumonia. After 10 days of aggressive antibiotic therapy, another t of chest x-rays were ordered Chest x-ray results
广告狂人第四季25)What is pneumonia? What can pneumonia be caud by?
26)What is the difference between Noah's initial and final chest x-ray?权威翻译公司
27)Which health care professionals worked together to diagno and treat Noah's pneumonia? Defi
ne each
role.
CBC and Bone Marrow Aspirate Results
28)Do Noah's CBC and Bone marrow aspirate results indicate he is making progress? Ba your answer
on specific results.
Noah was now in remission. Two weeks after achieving complete remission, Noah visited a radiology oncologist who administered radiation therapy to the spinal column. Radiation therapy was necessary to insure all leukemic cells harbored in the meninges were eradicated.
29)What is radiation therapy?
Noah continued maintenance chemotherapy treatments for two years. A CBC and bone marrow were performed at the end of two years.
CBC Results
Bone Marrow Results
30)What evidence can be noted in the CBC and Bone Marrow results to indicate Noah is in remission?
Eight years later, Noah is free of any signs of leukemia and is living a normal life.
Answers to Ca Questions
Question 1
Symptoms include pallor, bone tenderness, enlarged spleen and lymph nodes, bruising, bleeding (nobleeds).
Question 2
Symptoms are not consistent with a Strep infection.
Question 3
Clinical Laboratory Scientist
Question 4
冲上云霄2所有歌曲Elevated WBC count, decread RBC, Hct, and platelet count. Decrea in normal White Blood Cells; elevated abnormal White Blood Cells (blasts).
Question 5
china sourcingPediatric oncologist.
Question 6
Leukemia is a cancer of the blood. A large number of abnormal blood cells are produced which do not function properly.
Question 7
In acute leukemia, the abnormal blood cells are blasts that remain very immature and cannot carry out their normal functions. The number of blasts increas rapidly, and the dia gets wor quickly. In chronic leukemia, some blast cells are prent, but in general, the cells are more mature and can carry out some of their normal functions. Also, the number of blasts increas less rapidly than in acute leukemia. As a result, chronic leukemia gets wor gradually.
In acute leukemia, symptoms appear and get wor quickly. People with this dia go to their doctor becau they feel sick. In chronic leukemia, symptoms may not appear for a long time; when symptoms do appear, they generally are mild at first and get wor gradually. Doctors often find chronic leukemia during a routine checkup--before there are any symptoms.
Question 8
Acute lymphocytic leukemia (ALL) is the most common type of leukemia in young children. This dia also affects adults, especially tho age 65 and older.
Acute myeloid leukemia (AML) occurs in both adults and children.
