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Acute Lymphocytic Leukemia - Answers

1. Symptoms include pallor, bone tenderness, enlarged spleen and lymph nodes, bruising, bleeding (nosebleeds).

2. Symptoms are not consistent with a Strep infection.

3. Medical Laboratory Scientist

4. Elevated WBC count, decreased RBC, Hct, and platelet count. A 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. Cancer of the stem cells in the bone marrow that produce lymphocytes.

14. Cancer cells multiply rapidly crowding out normal cells in blood and bone marrow.

15. Persistent fever, fatigue, bleeding, easy bruising, swollen lymph nodes.

16. Radiation therapy, biologic therapy, a bone marrow transplant.

17. 80%

18. 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.

19. Diagnostic purposes: obtain a sample of spinal fluid for examination.

Therapeutic purposes: administer antibiotics, cancer drugs or anesthetic agents.

20. 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.

21. Protein, glucose, cell count and pressure.

22. 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.

23. A fever is a symptom of a possible infection.

24. The physician suspects pneumonia, which can be detected on a chest x-ray.

25. 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.

26. 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.

27. Medical Laboratory Scientist

28. Gram-positive and gram-negative bacteria.

29. An immunocompromised patient has a depressed immune system and is unable to mount a response to disease.

30. 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.

31. Noah's initial chest x-ray showed infiltrates (a cloudy area) indicative of pneumonia. His final chest x-ray was clear indicating a clearing of the infection.

32. A nurse or respiratory therapist collected a sputum sample for culture. A medical 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 pneumonia based on the x-ray and culture reports. Respiratory therapists administered and monitored oxygen monitored blood gas levels and administered chest physiotherapy.

33. 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.

34. Radiation in high doses is aimed at tumors or specific areas of the body containing the disease.

35. Normal cell values and normal cell lines are present.

36. The spongy tissue inside some of the bones. Its purpose is to make blood cells.

37. Blood stem cells (immature cells that can grow into red blood cells, white blood cells, and platelets) are transfused into the bloodstream.

a. Healthy individuals can donate marrow from the iliac crest (hip bone).

b. Healthy individuals can donate blood stem cells.

c. The patient can use stem cells from their own blood if they're healthy enough to donate.

d. (From the website) Umbilical cord blood may also be used.