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Pathophysiology

Predisposing Factors: Age Gender Race Family HIstory Precipitating Factors: ex


posure to radiation and certain chemicals having a sibling with leukemia HTL
V-1 virus genetic abnormalities chromosomal translocations
ETIOLOGY: Unknown
Somatic mutations in the DNA
Activate oncogene/ deactivate tumorsupppresor gene
Malignant transformation of lymphoid stem cells s/sx: bone pain joint pain
Uncontrolled proliferation of lymphoblast in the bone marrow Diagnostic Test: BM
aspiration BM biopsy
Treatment: Analgesic
Lymphoblast replace the normal marrow elements
Treatment: Remission Induction Therapy Consolidation and Maintenance Therapy
BM Transplantation
Diagnostic Test: CBC
Leukopenia (↓4.36 x 10 /L)
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Decreased production of normal blood cells Decreased production of normal blood
cells Spillage of lymphoblast into the bloodstream
s/sx: fever, chills seizure
Infection
s/sx: presence of petechiae bruise & bleed easily anemia fatigue dizzi
ness palpitations dyspnea
Treatment: Blood transfusion Epoetin and hemapoetic stimulants
Organ infiltration If treated: Antibiotic Ig Leukapheresis If not treated
Septicemia
Prevention of complications
Death
Kidneys

Renal failure
s/sx: Little/ no UO ↑RR Flank pain Restless n/v legs and feet swelling
Diagnostic Test: MRI Treatment: Intrathecal chemotherapy
CNS s/sx: h/a, weakness, blurred vision, balance difficulty, vomiting, lethargy
Liver / Spleen Diagnostic Test: Ultrasonography
leukocyte cells impairs the circulation of CSF
s/sx: ↑ CSF leukocytes s/sx: cranial nerve palsies confusional states optic neur
opathy cerebellar dysfunction papilledema
Extra cells cause the liver/spleen to rupture
Diagnostic Test: Spinal Tap
leukocyte cells compresses spinal/ cranial nerves
bleeding Hypovolemic shock
s/sx: hepatomegal y splenomegaly elevated ALT (81 u/L) s/sx: hypotension tachypn
ea tachychardia
Progress to coma
Overgrown thymus
Compress the Superior Vena Cava
s/sx: shortness of breath cough suffocation
Physical Exam Diagnostic test: Lymph node biopsy
Lymph nodes
Mediastinal lymphadenopathy
s/sx: lymphadenopathy SVC syndrome s/sx: swelling of head, neck and arms obs
truction of blood flow Treatment: O2 administration Bronchodilator s s/sx: c
ough, wheezes, respiratory tract obstruction
Bronchial/tracheal obstruction Esophageal compression
s/sx: dysphagia
Erosion of node into a bronchus/ trachea
s/sx: hemoptysis
Severe hypoxia
DEATH