5 Written Questions
5 Matching Questions
- Pernicious Anemia
- 1) Acute Lymphoblastic Leukemia (aka Lymphocytic) "ALL"
2) Acute Non-Lymphoblastic Leukemia (aka myeloblastic...older term) "AML" or "ANLL"
3) Chronic Lymphocytic Leukemia "CLL"
4) Chronic Myelocytic Leukemia "CML"
- Leukemia (Acute and Chronic)
p. 1105 Merck
- Hematocrit (HTC)
- Folate Deficiency
- a CAUSE: Risks include exposure to ionizing radiation or chemicals (post A-bomb, benzene), prior treatments with certain amnioplastic drugs, exposure to Epstein-Barr virus.
PATHO: malignant transformations usually occurs at the pluripotent stem cell level. Abnormal proliferation, clonal expansion, and diminished apoptosis lead to replacement of normal blood elements with malignant cells.
S/SX: Manifestations are due to suppression of normal blood cell formation and organ infiltration be leukemic cells. Enlargement of Liver, Spleen and lymph nodes, with occasional Kidney and gonadal involvement.
Occurs when a hematopoietic stem cell undergoes malignant transformation into a primitave, undifferentiated cell with abnormal longevity. These cells proliferate abnormally , replacing normal marrow tissue and hematopoietic cells and inducing anemia, thrombocytopenia, and granulocytopenia. They are bloodborne.
Usually presents as abnormal leukocytosis with or without cytopenia in an otherwise asymptomatic person.
- b 4 Major Leukemias
-these are all common leukemias
- c This is a chronic illness caused by impaired absorption of vitamin B-12 because of a lack of intrinsic factor (IF) in gastric secretions. It occurs as a relatively common adult form of anemia that is associated with gastric atrophy and a loss of IF production and as a rare congenital autosomal recessive form in which IF production is lacking without gastric atrophy.
-seen in people of N. American decent, chronic alcoholics, seen in people with gastric bypass or stomach staple surgeries.
SX: Very pronounced fatigue (feeling run down)... can be tired from hours to days to all of the time, dyspnea comes and goes regardless of exertion, glossitis, brittle nails, sudden explosive diarrhea with possible weight loss, mental fog, decreased concentration and confusion, common in people of the 60yr age range, BURNING PAIN IN FEET or anywhere in body, wtach for an unsteady gait, and think nervous system manifestations. This is the FAR END of VIT B12 deficiency.
DDX: LV disease, Alzheimer's, are they a chronic alcoholic?
LABS: Decreased hematocrit, decreased RBC, decreased MCH
- d - a measurement of the percentage of packed red blood cells in a given volume of blood
- increased could be the result of water deprivation, excess use of diuretics, or gastrointestinal losses
- e GENERAL: Folic acid is required for DNA synthesis and red blood cell maturation. It is found in vegetables, leafy greens, fruits, cereals, and meats. Megaloblastic anemia (enlarged red blood cells).
CAUSE: Much of the vitamin is lost in cooking. Most causes are malnutrition or dietary lack, especially in the elderly or in association with alcoholism. Also common in pregnancy, as bearing women require 5-10x the normal daily amount of 50ug.
PATHOPHYSIOLOGY: Dietary lack. Malabsorption of Folic Acid may be due to syndromes such as sprue or other intesinal disorders. Some drugs used to prevent seizures also interfere with folic acid absorption.
S/SX: Similar to Vitamin B12 symptoms, only without neurologic sensations, FATIGUE, DIARRHEA, GENERAL MUSCLE WEAKNESS
DDX: Vit B12 deficiency, Iron def anemia, hypothyroidism, cancer
LABS: increased MCV and MCH, increased homocysteine, slightly increased WBC, decreased RBC, decreased folate
TX: Folic Acid intake
"this is a type of megaloblastic anemia"
5 Multiple Choice Questions
- General timing of chronic leukemias
- -one of most common cancers d/t receiving chemo for a different type of cancer
-chemo suppresses bone marrow fx and effects WBC's
-no CNS or brain involvement
-increased eosinophils and basophils (basophils = histamine)
-70-90% good prognosis
- Standard treatments for all leukemias:
- START OF CLASS NOTES
- Complications for Multiple myeloma
5 True/False Questions
Multiple myeloma → LABS:
-anemia, decreased hematocrit, normo/normo
-presence of BENCE JONES PROTEINURIA
-Increased IgG and IgA
-sheets of plasma cells on bone marrow
Multiple myeloma → LABS: increased eosinophils, basophils, neutrophils
-chemo is mainstay
-stem cell replacement therapy will help but only buys you time (5-7 years) → TREATMENT for Multiple myeloma
Multiple myeloma → malignant neoplasm of blood-forming tissues. Cancers of the WBC's involving bone marow, circulating WBC's and organs such as the Spleen and lymph nodes.
Cytokines → chemicals released by T helper cells that stimulate B cells