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PBL > Unit 2 Case 3 > Flashcards

Unit 2 Case 3 Flashcards

1
Q

What is Unit 2 Case 3 about?

A

Young male patient 5 years old develops acute lymphoid leukemia (ALL). The boy shows signs of pallor, lymphadenopathy, and dyspnoea which raises suspicion of if anemia is involved.
Blood tests show too many white blood cells that require a bone marrow aspirate to confirm the diagnosis.
The boy is treated with oral iron supplements and a blood transfusion in the short term before being put on induction chemotherapy for the next 3 years without relapse

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2
Q

What are immature white blood cells?

A

Immature white blood cells are white blood cells that have not fully developed before being released from the bone marrow into the blood

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3
Q

How would a full blood count differ in patients with anemia?

A

Red blood cell counts, haemoglobin, hematocrit or mean corpuscular volume would be lower than normal, suggesting anemia

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4
Q

How would a full blood test indicate liver or kidney damage?

A

If levels of c-reactive protein are abnormal, levels of alkaline phosphatase (ALP) are high or levels of blood urea are high this can indicate liver or kidney

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5
Q

How does the translocation of chromosome 9 to 22 link to ALL?

A

As the transolcation of chromosome 9 to 22 contains the BCR-ABL fusion gene which is repsonsible for the overproduction of white blood cells

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6
Q

What is ALL?

A

Acute Lymphoid Leukemia

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7
Q

What are the types of chromosome translocation?

A

Reciprocal translocation

Robertsonian translocation

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8
Q

What is reciprocal translocation?

A

When 2 different chromosomes exchange segments with each other

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9
Q

What is Robertsonian translocation?

A

When an entire chromosome attaches to another chromosome at the centromere

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10
Q

What are the main types of leukemia?

A

Acute myeloid leukemia (AML)
Chronic myeloid leukemia (CML)
Acute lymphoid leukemia (ALL)
Chronic lymphoid leukemia (CLL)

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11
Q

What is a relapse in ALL and what causes it?

A

A relapse in ALL is the return of ALL in patients who have already undergone treatment and reached complete remission
Relapse happens if the cancer doesn’t respond well to the first treatment tried, and possibly spread to other areas of the body the test didn’t pick up

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12
Q

What is anemia?

A

A condition in which you don’t have enough healthy red blood cells to carry adequate oxygen to your body’s tissues

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13
Q

What is iron-deficiency anemia?

A

A common type of anemia

-the body doesnt have enough iron to produce adequate levels of hemoglobin, and therefore healthy blood cells

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14
Q

What is PCR?

A

Polymerase Chain Reaction (PCR) is a method of amplifying and making many copies of a small section of DNA or a gene

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15
Q

What is lymphadenopathy?

A

Swollen lymph nodes

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16
Q

How is PCR used in medicine?

A

You can copy and make the segment of DNA that is of interest for studying, rather than the whole genome

17
Q

What are oral iron supplements and when are they prescribed?

A

They are ferrous fumerate- an easily absorbed form of iron

-used to treat iron deficiency anemia by increasing iron levels so adequate haemoglobin can be produced

18
Q

What is dexamethasone and what is it’s mechanism of action?

A

Is a corticosteriod which works as an anti-inflammatory and immunosuppressant agent. It binds with high affinity to the glucocorticoid receptors, inhibiting cytokine production and causing cell death

19
Q

What is asparaginase and what is it’s mechanism of action?

A

It is an enzyme that breaks down the amino acid asparagine. ALL cells are unable to produce their own asparagine but need it to make functional proteins. This helps stop cancer growth

20
Q

What is vincristine and what is it’s mechanism of action?

A

Part of a class of drugs known as vinca alkaloids and works by interfering with microtubule polymerisation to prevent mitosis. As well as blocking the utilisation of glutamic acid to interrupt protein synthesis - stopping cell growth

21
Q

What is Mercaptopurine and what is it’s mechanism of action?

A

This is an antineoplastic and immunosuppresant agent that works by blocking the synthesis of purine nucleotides and blocking DNA synthesis. It also incorperates into DNA as deoxy-thioguanosine and disrupts DNA replication -stopping cell growth

22
Q

What is an antineoplastic?

A

A drug acting to prevent, inhibit or halt the development of a neoplasm (a tumour).

23
Q

What is methotrexate and what is it’s mechansim of action?

A

This is an antineoplastic and immunosuppressant agent which works by inhibiting the enzyme dihydrofolate reductase which prevents the synthesis of purine and pyrimidine nucleotides to interfere with DNA and RNA synthesis- stopping cell growth

24
Q

How does chemotherapy lead to hair loss?

A

Chemotherapy targets all rapidly dividing cells, both healthy and cancerous. Hair follicles are some of the fastest growing cells in the body, and therefore get targeted

25
Q

What is 111 and what is its role?

A

111 is a telephone service by the NHS. It is a number you should call when you need advice or medical treatment quickly, and you cannot wait for an appointment to see your doctor

26
Q

What is the difference between 111 and 999?

A

111 is you need medical advice or help fast but it not an emergancy
999 is for emergencies

27
Q

What is a walk in centre and what is its role?

A

A walk in centre is for treatment of urgent medical matters that are non-life threatening. For example injuries such as minor breaks and minor bleeding

28
Q

When would you go to A&E and not a walk in centre?

A

Go to A&E when the medical matter is life threatening. Reasons to go to A&E include loss of consciousness, fits, chest pain, breathing difficulties, severe bleeding ect.

29
Q

How are patients triaged in the A&E department?

A

There are 5 national codes, patients with code 1 being prioritised and treated first, and pateints with a code 5 being prioritised last

30
Q

What are the 5 national codes in patient triage?

A

Code 1- immediate - need immediate treatment for preservation of life
Code 2- very urgent- seriously ill or injured patients but lives are not in immediate danger
Code 3- Urgent- patients with serious problems but are in a stable condition
Code 4- Standard- standard A&E cases without immediate danger or distress
Code 5- Non-urgent- patients whose conditions are not true accidents or emergencies

31
Q

What are common symptoms of acute lymphoid leukemia (ALL) ?

A

Feeling tired, weak, dizzy and lightheaded, shortness of breath, pale skin, bruises, bleeding such as frequent nosebleeds

32
Q

What is a bone marrow aspiration?

A

A bone marrow aspiration is a procedure that involves taking a sample of the liquid part of the bone marrow. Is often done with a bone marrow biospy

33
Q

Why is bone marrow aspiration and biopsy done?

A

Done to find the reason for many blood disorders and may be used to find out if cancer or infection has spread to the bone marrow.

34
Q

What is a bone marrow biospy?

A

A bone marrow biopsy is a procedure that involves taking a small sample of your solid bone marrow tissue. Is often done with a bone marrow aspiration.

35
Q

What is the difference between induction and maintenace chemotherapy?

A

Induction chemotherapy aims to destroy the leukemia cells. If there is no sign of leukemia after treatment this is called complete remission
Maintenance chemotherapy aims to keep leukemia in remission -low dose of chemotherapy for around 2/3 years

36
Q

What tests are done during chemotherapy for leukemia?

A

Complete blood counts will be done regularly to monitor your blood cell count as the chemotherapy could cause a low red blood cell count- means cells aren’t getting enough oxygen

37
Q

What the social and emotional impacts of chemotherapy?

A

Side effects of chemotherpay can have a big affect on body image and self asteem. This may be coping with hair loss, scars, weight changes etc. This can affect desire for intimacy and social interaction

38
Q

How to explain cancer and conditions to a child?

A

Explain the diagnosis in terms they can understand
Keep them informed
Be truthful
Answer their questions and provide comfort

PBL (12 decks)

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