Unit 2 Case 3 Flashcards
What is Unit 2 Case 3 about?
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
What are immature white blood cells?
Immature white blood cells are white blood cells that have not fully developed before being released from the bone marrow into the blood
How would a full blood count differ in patients with anemia?
Red blood cell counts, haemoglobin, hematocrit or mean corpuscular volume would be lower than normal, suggesting anemia
How would a full blood test indicate liver or kidney damage?
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
How does the translocation of chromosome 9 to 22 link to ALL?
As the transolcation of chromosome 9 to 22 contains the BCR-ABL fusion gene which is repsonsible for the overproduction of white blood cells
What is ALL?
Acute Lymphoid Leukemia
What are the types of chromosome translocation?
Reciprocal translocation
Robertsonian translocation
What is reciprocal translocation?
When 2 different chromosomes exchange segments with each other
What is Robertsonian translocation?
When an entire chromosome attaches to another chromosome at the centromere
What are the main types of leukemia?
Acute myeloid leukemia (AML)
Chronic myeloid leukemia (CML)
Acute lymphoid leukemia (ALL)
Chronic lymphoid leukemia (CLL)
What is a relapse in ALL and what causes it?
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
What is anemia?
A condition in which you don’t have enough healthy red blood cells to carry adequate oxygen to your body’s tissues
What is iron-deficiency anemia?
A common type of anemia
-the body doesnt have enough iron to produce adequate levels of hemoglobin, and therefore healthy blood cells
What is PCR?
Polymerase Chain Reaction (PCR) is a method of amplifying and making many copies of a small section of DNA or a gene
What is lymphadenopathy?
Swollen lymph nodes
How is PCR used in medicine?
You can copy and make the segment of DNA that is of interest for studying, rather than the whole genome
What are oral iron supplements and when are they prescribed?
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
What is dexamethasone and what is it’s mechanism of action?
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
What is asparaginase and what is it’s mechanism of action?
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
What is vincristine and what is it’s mechanism of action?
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
What is Mercaptopurine and what is it’s mechanism of action?
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
What is an antineoplastic?
A drug acting to prevent, inhibit or halt the development of a neoplasm (a tumour).
What is methotrexate and what is it’s mechansim of action?
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
How does chemotherapy lead to hair loss?
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
