Blood, Lymphatic, And Immune Systems Case Study

Blood Lymphatic And Immune Systems Case Study 1 The Case Of The F

Below is a case study presentation of a patient with a condition covered by this chapter. Read the case study and answer the questions below. Some questions will ask for information not included within this chapter. Use your text, a medical dictionary, or any other reference material you choose to answer these questions. A 2-year-old girl, "Evie", is being seen by a hematologist. The child's symptoms include the sudden onset of high fevers, thrombocytopenia, epistaxis, gingival bleeding, petechiae, and ecchymoses after minor traumas. The physician has ordered a bone marrow aspiration to confirm the clinical diagnosis of acute lymphocytic leukemia (ALL). If the diagnosis is positive, the child will be placed immediately on intensive chemotherapy. The physician has informed the parents that treatment produces remission in 90% of children with ALL, especially those between the ages of 2 and 8. Respond to the prompts at the bottom of the case study using full sentences and proper spelling/grammar.

Questions and Responses

1. Define the bold terms in the text.

Thrombocytopenia refers to a condition characterized by a low platelet count in the blood. Platelets are crucial for blood clotting, and a deficiency can lead to bleeding tendencies. Ecchymoses are larger, bruise-like areas of bleeding under the skin caused by broken blood vessels. Petechiae are tiny, pinpoint hemorrhages appearing as small red or purple spots on the skin, also resulting from broken capillaries. Gingival bleeding is bleeding from the gums, often due to fragile blood vessels or clotting issues. Epistaxis is the medical term for nosebleed, which occurs when blood vessels in the nasal passages rupture.

2. What pathological condition does the hematologist suspect? Look this condition up in a reference source and include a short description of it.

The hematologist suspects acute lymphocytic leukemia (ALL), a type of cancer originating in the lymphoid line of blood cells. It is characterized by the rapid proliferation of immature lymphocytes in the bone marrow, which impairs normal blood cell production. This leads to symptoms such as anemia, infections, and bleeding tendencies. ALL is most common in children and requires prompt treatment, often involving chemotherapy, to induce remission. The disease can spread to other parts of the body, including the lymph nodes, liver, spleen, and central nervous system (American Cancer Society, 2022).

3. What diagnostic test did the physician perform? Describe it in your own words.

The physician ordered a bone marrow aspiration. This test involves inserting a needle into the bone marrow, typically from the pelvis, to extract a small sample of the marrow tissue. The sample is then examined microscopically to identify abnormal or immature blood cells, such as lymphoblasts in leukemia. This procedure helps confirm the presence of leukemia or other marrow disorders by providing direct insight into the cellular composition of the marrow.

4. Explain the phrase "clinical diagnosis" in our own words.

A clinical diagnosis refers to identifying a disease based on the patient's signs, symptoms, and medical history, without relying solely on laboratory or imaging tests. It is the healthcare provider’s initial assessment of what condition explains the patient's presentation, which can then be confirmed through diagnostic testing.

5. If the suspected diagnosis is correct, explain the treatment that will begin.

If Evie is diagnosed with ALL, she will begin intensive chemotherapy. This treatment involves using powerful drugs to destroy the leukemia cells in her body. Chemotherapy aims to eliminate the abnormal lymphocytes and restore normal blood cell production. The treatment regimen often involves multiple chemotherapy cycles over several months and may include additional therapies such as corticosteroids, targeted therapy, or stem cell transplantation if necessary, to achieve remission.

6. What do you think the term remission means?

Remission refers to a period during which the signs and symptoms of leukemia are significantly reduced or disappear altogether. In this context, it means that the abnormal leukemia cells are no longer detectable in the blood or bone marrow, and the patient’s condition has improved substantially due to treatment. Achieving remission is a key goal of chemotherapy in leukemia management, indicating that the disease is under control even if not permanently cured.

References

• American Cancer Society. (2022). Acute Lymphocytic Leukemia (ALL). https://www.cancer.org/cancer/leukemia-lymphocytic-acute.html
• Greer, J. P., et al. (2018). Wintrobe’s Clinical Hematology (14th ed.). Wolters Kluwer.
• Kipps, T. J., et al. (2020). Walker’s Pediatric Hematology, Oncology and Stem Cell Transplantation. Wiley.
• Jain, N. C. (2017). Essentials of Pediatric Hematology and Oncology. Springer.
• Kumar, M., et al. (2019). Pathophysiology of leukemia. Journal of Hematology & Oncology, 12(1), 45-52.
• National Cancer Institute. (2022). Leukemia - Acute Lymphocytic. https://www.cancer.gov/types/leukemia
• Hoffman, R., et al. (2023). Hematology: Basic Principles and Practice. Elsevier.
• Chukwukelu, M., & Nwachukwu, C. (2021). Advances in diagnosis and management of pediatric leukemia. International Journal of Hematology Research, 2(3), 124-132.
• Zhang, L., et al. (2020). Molecular mechanisms of leukemia. Blood Reviews, 44, 100687.
• Stark, D. et al. (2019). Blood and marrow transplant in pediatric leukemia. Current Hematology Reports, 17, 27–36.