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In: Anatomy and Physiology

O. M. is a 6-year-old child at a freestanding emergency room. Per the mother, O.M. is...

O. M. is a 6-year-old child at a freestanding emergency room. Per the mother, O.M. is complaining of being tired, sleeping at night with several naps in the day, and her appetite is decreasing. The mother reports an uneventful pregnancy and delivery; O.M. has met her milestones, and immunizations are up to date. Her parents and younger brother are healthy. Paternal grandfather died of colorectal cancer in his 70s. She has no medical history and has no medication.  

All vital signs are normal except for an elevated heart rate and she is minimally underweight.

All assessment findings are normal with the exception of:

·        Skin pale but warm and dry

·        Bruising over the buttocks and left flank

·        Noted oral mucous membranes with petechiae

·         Mild enlarged, cervical, submaxillary, inguinal nodes

·        Presence of hepatosplenomegaly

Blood work:

Hemoglobin decreased

Hematocrit decreased

RBC count decreased

WBC 13,100/mm3

Neutrophils 58%

WBC differential identifies 11% are blast cells

Platelet count 30,000/mm3

PT/PTT normal

Later results:

Bone marrow aspirate: 94% blast cells, 3% erythroblasts, 3% all other cells.

Reverse Transcriptase - Polymerase Chain Reaction: positive TEL-AMI fusion gene. No other abnormality.

Chest x-ray: Normal

Lumbar puncture: Cerebral spinal fluid normal

Immunology: positive for cytoplasmic µ heavy chain protein

  1. Explain the genetic implications and risk factors in the development of Acute Lymphoblastic leukemia
  2. Explain the pathophysiologic or physiologic response leading to O.M. being tired, sleepy, and decreased appetite.
  3. What other patient information would you have wanted to have a clearer understanding of the patient?
  4. Provide examples of chemical exposures, environmental hazards, or antigens that may lead to leukemia
  5. What is the prevalence of childhood ALL?

Solutions

Expert Solution

I have answered all the answers and some extra points regarding the types of ALL.If you have any further doubt please comment.If you are clear about the topic please give a positive review.Thanking you

Sydney Mullin answered 1 year ago
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