Scenario 1: Acute Lymphoblastic Leukemia (ALL)

APA 7th. One source for each question. A paragraph for each question.
QUESTION 1
Scenario 1: Acute Lymphoblastic Leukemia (ALL)
4 points
SAVE ANSWER
An 11-year-old boy is brought to the clinic by his parents who states that the boy has not been eating and listless. The mother also notes that he has been easily
bruising without trauma as he says he is too tired to go out and play. He says his bones hurt sometimes. Mother states the child has had intermittent fevers that
respond to acetaminophen.
Maternal history negative for pre intra, or post-partum problems
MH: Negative. Easily reached developmental milestones
PE: reveals a thin, very pale child who has bruises on his arms and legs in no particular pattern
LABS: CBC revealed Hemoglobin of 6.9/dl, hematocrit of 19% and platelet count of 80 000/mm3 The CMP demonstrated a blood urea nitrogen (BUN) of 34m
g/di and creatinine of 2 9 mg/dl.
DIAGNOSIS: acute leukemia and renal failure and immediately refers the patient to the Emergency Room where a pediatric hematologist has been consulted
and is waiting for the boy and his parents.
CONFIRMED DX: acute lymphoblastic leukemia (ALL) was made after extensive testing.
Question
Explain what ALL is?
Scenario 1: Acute Lymphoblastic Leukemia (ALL)
An 11-year-old boy is brought to the clinic by his parents who states that the boy has not been eating and listless. The mother also notes that he has been easily
bruising without trauma as he says he is too tired to go out and play. He says his bones hurt sometimes. Mother states the child has had intermittent fevers that
respond to acetaminophen.
Maternal history negative for pre, intra, or post-partum problems.
MH: Negative. Easilv reached developmental milestones
PE: reveals a thin. very pale child who has bruises on his arms and legs in no particular pattern.
LABS: CBC revealed Hemoglobin of 6.9/dl, hematocrit of 19%, and platelet count of 80,000/mm? The CMP demonstrated a blood urea nitrogen (BUN) of 34m
g/di and creatinine of 2.9 mg/dl.
DIAGNOSIS: acute leukemia and renal failure and immediately refers the patient to the Emergency Room where a pediatric hematologist has been consulted
and is waiting for the boy and his parents.
CONEIRMED DX: acute Ivmphoblastic leukemia (ALL) was made after extensive testing
?
Question
Why does ARF occur in some patients with ALL?
QUESTION 3
4 points
SAVE ANSWER
Scenario 2: Sickle Cell Disease (SCD)
A 15-year-old male with known sickle cell disease (SCD) present to the ER in sickle cell crisis. The patient is crying with pain and states this is the third acute
episode he has had in the last 10-months. Both parents are present and appear very anxious and teary eyed A diagnosis of acute sickle cell crisis was made
Question
Explain the pathophysiology of acute SCD crisis. Why is pain the predominate feature of acute crises?
QUESTION 4
Scenario 2: Sickle Cell Disease (SCD)
A 15-vear-old male with known sickle cell disease (SCD) present to the ER in sickle cell crisis. The patient is crying with pain and states this is the third acute
episode he has had in the last 10-months. Both parents are present and appear very anxious and teary eyed. A diagnosis of acute sickle cell crisis was made.
Question
Discuss the genetic basis for SCD.
QUESTION 5
4 points SAVE ANSWER
Scenario 3: Hemophilia
8-month infant is brought into the office due to a swollen right knee and excessive bruising. The parents have noticed bruising about a month ago but thought the
bruising was due to the attempts to crawl. They became concerned when the baby woke up with a swollen knee. Infant up to date on all immunizations, has not
had any medical problems since birth and has met all developmental milestones.
H: negative for any history of bleeding disorders or other major genetic diseases
PE: within normal limits except for obvious bruising on the extremities and right knee. Knee is swollen but no warmth appreciated. Range of motion of knee
limited due to the swelling.
DIAGNOSIS: hemophilia A.
Question
What is the pathophysiology of Hemophilia