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Answers
to ALL Case Questions
1. Symptoms include pallor,
bone tenderness, enlarged spleen and lymph nodes, bruising,
bleeding (nosebleeds).
2.
Symptoms are not consistent with a Strep infection.
3.
Clinical Laboratory Scientist
4. Elevated WBC count,
decreased RBC, Hct, and platelet count. Decrease in normal
White Blood Cells; elevated abnormal White Blood Cells (blasts).
5.
Pediatric oncologist.
6.
Leukemia is a cancer of the blood. A large number of
abnormal blood cells are produced which do not function properly.
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
increases rapidly, and the disease gets worse quickly. In chronic
leukemia, some blast
cells are present, but in general, these cells are more mature
and can carry out some of their normal functions. Also, the
number of blasts increases less rapidly than in acute leukemia.
As a result, chronic leukemia gets worse gradually.
In
acute leukemia, symptoms appear and get worse quickly. People
with this disease go to their doctor because 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
worse gradually. Doctors often find chronic leukemia during a
routine checkup--before there are any symptoms.
8. Acute lymphocytic
leukemia (ALL) is the
most common type of leukemia in young children. This disease also
affects adults, especially those age 65 and older.
Acute myeloid leukemia
(AML) occurs in both adults and children.
Chronic lymphocytic
leukemia (CLL) most
often affects adults over the age of 55. It sometimes occurs in
younger adults, but it almost never affects children.
Chronic myeloid leukemia
(CML) occurs mainly in adults. A very small number of children
also develop this disease.
9.
Symptoms include:
Fever, chills, and other flu-like
symptoms;
Weakness
and fatigue;
Frequent
infections;
Loss
of appetite and/or weight;
Swollen
or tender lymph nodes,
liver,
or spleen;
Easy
bleeding or bruising;
Tiny
red spots (called petechiae)
under the skin;
Swollen
or bleeding gums;
Sweating,
especially at night; and/or
Bone
or joint pain
10. CBC, bone marrow smear
11. A bone marrow procedure (commonly
referred to as a bone marrow or bone marrow aspiration) is a
technique used to obtain the blood-forming portion (marrow) of
the inner core of bone for examination in the laboratory or for
transplantation. The bone marrow consists of inserting a special
needle into a bone that contains marrow and withdrawing the
marrow by suction or coring out a sample of the marrow.
12.
A preponderance of one cell line, blasts.
13. A
lumbar puncture (an LP) is the insertion of a needle into the
fluid within the spinal canal. It is termed a "lumbar
puncture" because the needle goes into the lumbar portion
(the "small") of the back.
14.
Diagnostic purposes: obtain a sample of spinal fluid for
examination.
Therapeutic
purposes: administer antibiotics, cancer drugs or
anesthetic agents.
15.
The CSF circulates around the brain and spinal cord (the central
nervous system). This "water bath" acts as a support of
buoyancy for the brain and spinal cord. The support of the CSF
helps to protect the brain from injury.
16.
Protein, glucose, cell count and pressure.
17.
Chemotherapy is treatment with drugs to kill cancer cells.
Drugs are generally administered through an I.V. (intravenously)
and given in cycles. Side effects differ depending upon the
drugs used and the patient. Side effects may include
fatigue, bleeding or bruising, loss of appetite, nausea and
vomiting, hair loss, or mouth sores.
18.
A fever is a symptom of a possible infection.
19.
The physician suspects a pneumonia, which can be detected on a
chest x-ray.
20.
A chest x-ray is a radiology test that involves exposing the
chest briefly to radiation to produce an image of the chest and
the internal organs of the chest.
21.
Abnormalities of the lungs including: pneumonia,
bronchitis, asthma, cysts, and cancers.
Abnormalities of the heart including: fluid around the
heart, enlarged heart, heart failure, abnormal anatomy.
Broken chest bones.
22.
Clinical Laboratory Scientist
23.
Gram positive and gram negative bacteria.
24.
An immunocompromised patient has a depressed immune system, and
is unable to mount a response to disease.
25.
An infection that occurs when fluid and cells collect in the
lungs. Pneumonia can be caused by bacteria, viruses, and
other pathogenic organisms. It can also be caused by
chemicals or other irritants.
26.
Noah's initial chest x-ray showed infiltrates (a cloudy area)
indicative of a pneumonia. His final chest x-ray was clear
indicating a clearing of the infection.
27.
A nurse or respiratory therapist collected a sputum sample for
culture. A clinical laboratory scientist performed the gram
stain and culture on the sample and issued a report. A radiology
technician performed a chest x-ray. A radiologist read the
x-ray and issued a report. The physician ordered
antibiotics to treat the pneumonia based on the x-ray and culture
reports. Respiratory therapists administered and monitored
oxygen, monitored blood gas levels, and administered chest
physiotherapy.
28.
Different cell lines are represented in the CBC and Bone Marrow
smear instead of just one abnormal one. This indicates that
progress is being made.
29.
Radiation in high doses is aimed at tumors or specific areas of
the body containing disease.
30.
Normal cell values and normal cell lines are present.
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