30 Jan Decreased gastrointestinal

QUESTION 1

Jasper is a 7-year-old boy who has had flu-like symptoms for several weeks. It was mild at first, but his parents notice that he has been getting worse. They took him to his pediatrician last week, but he was sent home with suggestions to use OTC medication to treat his symptoms while his body recovered from what appeared to be a mild infection. Jasper appears weak, has lost 3-4 pounds in the last month, and has been complaining of headaches. Jasper’s parents have now brought him back to the clinic and another physician orders a CBC.

What is a CBC? In your own words, briefly describe why it is useful.

QUESTION 2

The physician suspects that Jasper may have leukemia. Which of the lab results most likely lead the physician to this conclusion?

Abnormal WBC count

Normal RBC count

High hemoglobin level

High platelet count

QUESTION 3

Jasper exhibits many symptoms that could relate to a diagnosis of leukemia. List and briefly explain 2 other symptoms of leukemia that are NOT mentioned in this case study.

QUESTION 4

Because of Jasper’s age, which type of leukemia is the most likely?

Acute lymphocytic leukemia

Chronic lymphocytic leukemia

Chronic myelogenous leukemia

Hairy cell leukemia

QUESTION 5

If Jasper has ALL, which of the following lab results is most likely?

High immature lymphocyte count

Low neutrophil count

Low eosinophil count

High platelet count

QUESTION 6

What is the most common type of childhood leukemia? In your own words, briefly describe the pathophysiology of the disease.

QUESTION 7

Which of these tests would NOT be helpful in diagnosing leukemia?

Peripheral blood smear

CT scan

Bone marrow biopsy

Bone density scan

QUESTION 8

In your own words, briefly describe the difference between myelogenous and lymphocytic leukemia.

QUESTION 9

Which of the following is NOT a treatment option for ALL?

Chemotherapy

Surgery

Bone marrow/stem cell transplants

Radiation therapy

QUESTION 10

Assuming that Jasper has the most common type of childhood leukemia, what is his prognosis?

QUESTION 11

Elsa is an 11-month-old girl. Her parents have brought her to her pediatrician because they have noticed she seems lethargic and pale. Both parents have noticed that she appears bloated, doesn’t want to eat as much as she has before, and is tired and “cranky all the time.” They suspected she might be suffering from anemia, since she was being fed a low-iron formula, so they had switched to a high-iron formula. The change made no difference in her symptoms. The pediatrician notes that Elsa’s belly appears swollen. Her vital signs show that her temperature is normal and her heart rate is on the low end of the normal range for her age. She has dropped from the 50th percentile in height and weight (at her last check-up) to the 10th percentile in both height and weight.

Blood test results:

Hemoglobin: 5 g/dl

RBC: 4.6×106 cells/ml

MCV: 65

WBC 15,000 cells/ml

Platelet count: 250,000

Which of Elsa’s symptoms is NOT typical of anemia in infants?

Paleness

Tiredness

Slow heart rate

Loss of appetite

QUESTION 12

In your own words, briefly describe why Elsa’s parents changed her formula to the high-iron baby formula.

QUESTION 13

Which of her blood test results is within normal range?

Hemoglobin

Red blood cell count

Mean corpuscular volume

White blood cell count

QUESTION 14

Elsa’s blood sampled was analyzed under a microscope and it was determined that her red blood cells were “hypochromatic” and “microcytic.” Explain, in your own words, what these terms mean.

QUESTION 15

Elsa’s pediatrician suspects that she has thalassemia. Which of the following statements is true of thalassemia?

Thrombocytes tend to “stick together” and form blood clots.

Thalassemia is always caused by diet and environmental factors, not genetic makeup.

Thalassemia is also known as erythroblastic anemia and involves a reduced amount of hemoglobin in the blood.

Thalassemia is a type of hemophilia and is often hereditary in females.

QUESTION 16

In your own words, explain why hemoglobin is important in hematology.

QUESTION 17

It is determined that Elsa is experiencing beta-thalassemia major. Which of the following statements is NOT true regarding this diagnosis?

The cause of beta-thalassemia is genetic.

Beta-thalassemia major is a grave condition and has a high mortality rate.

Beta-thalassemia major is often treated with blood transfusions.

Because beta-thalassemia is an x-linked trait, it affects males more often than females.

QUESTION 18

Because Elsa has received a confirmed diagnosis of beta-thalassemia major, which of the following statements is true about her parents?

Only her mother carried the gene that caused her blood disorder.

Only her father carried the gene that caused her blood disorder.

If her parents have another child naturally, there is a 100% chance that the second child will be diagnosed with beta-thalassemia major.

If her parents have another child naturally, there is a 25% chance that the second child will be diagnosed with beta-thalassemia major.

QUESTION 19

As Elsa gets older, which of the following choices is NOT a likely complication of her disorder?

Splenomegaly

Gallstones

Cirrhosis

Decreased gastrointestinal iron absorption

QUESTION 20

In your own words, briefly describe how thalassemia is related to Elsa’s failure to thrive.