Mohd Hairy Bin Ramli Mohd Erwan Bin Ahmad Superi Nor Azizah Bt Jaafar

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12 nucleoli Acute Leukemia . more cytoplasm.(AML Acute Myeloid Leukemia and Acute Lymphoblastic Leukemia ALL) •Excess myeloblasts or lymphoblasts •short clinical course (weeks to months) • A clonal. •Accumulation of leukemic blast cells results in marrow replacement. minimal cytoplasm. organ infiltration and metabolic effects •Adults . 2-5 nucleoli •ALL: no cytoplasmic granules. molecular abnormality of hematopoietic blast cells resulting in a failure of differentiation & uncontrolled cell proliferation. Auer rods.85% of acute leukemia is AML •Children-85% of acute leukemia is ALL •Leukemic Blast morphology •AML: cytoplasmic granules.

ALL naïve B-lymphocytes Plasma cells T-lymphocytes Lymphoid progenitor AML Hematopoietic stem cell Myeloid progenitor Neutrophils Eosinophils Basophils Monocytes Platelets Red cells .

Myeloid maturation myeloblast promyelocyte myelocyte metamyelocyte band neutrophil MATURATION Adapted and modified from U Va website .

Acute Leukemia • accumulation of blasts in the marrow .

Gingival. Lymphadenopathy. Blasts on peripheral blood smear (often) and Hypercellular bone marrow with 20% or more blasts (normal is < 5%) . Fever. hypertrophy. chemicals. Hematology Laboratory Findings •Decreased. underlying hematologic disorders. Hyperuricemia • Marrow replacement. Leukemic meningitis. drugs • ionizing radiation. viruses (HTLV I). Thrombocytopenia. organ infiltration & metabolic effects Marrow replacement •Neutropenia: infection •Anemia: pallor. Anemia. Hepatosplenomegaly. Hyperkalemia.Causes of acute leukemias • idiopathic (most).hereditary/genetic conditions Clinical Manifestations • Constitutional & Metabolic effects: – Weight loss. fatigue. dyspnea •Thrombocytopenia: abnormal bruising and bleeding Organ infiltration •Bone pain. normal or elevated WBC.

Treatment of acute leukemias Choice of Rx is influenced by: • type (AML vs ALL). age. antibiotics. curative vs palliative intent Principles of treatment combination chemotherapy •first goal is complete remission •further Rx to prevent relapse supportive medical care •transfusions. CNS prophylaxis. nutrition psychosocial support •patient and family Leukemia Cutis Chemotherapy for acute leukemias Phases of ALL treatment •Induction. maintenance Phases of AML treatment •Induction. intensification. consolidation (post-remission therapy) Gingival Hyperplasia .

What is Asthma?  Chronic inflammatory disorder of the airway. Can be fatal. Not the same as allergies What are Allergies?  An unusual reaction to something. like a food or a plant. Breathing can be difficult. but not yet curable. Not contagious. What Happens During an Asthma Episode? Warning Signs of an Asthma Episode • Breathing tubes swell up  Coughing • Muscles around these tubes tighten • Tubes make large amounts of a thick fluid called mucus    Wheezing Chest tightness Shortness of Breath . 40 to 50 million people have allergies. making breathing difficult. which is normally harmless. Usually reversible.

Colds .When Having a Severe Asthma Episode  Go to the emergency room right away  Signs of a severe episode  Rescue or inhaler medicine doesn’t help within 15 minutes  Person’s lips or fingernails are blue  Person has trouble walking or talking due to shortness of breath • • • • • Asthma Triggers Pollen Dander Mold Dust Secondhand Tobacco Smoke •Cleaning products like furniture polish or dusting sprays •Personal care products like hair spray or perfume •Flu.

Some Other Common Allergens Foods Medicine Insect Stings and bites Contact allergens . Many of the asthma triggers can also cause allergic .Common Signs of Allergies • Stuffy or runny nose • Itching • A rash Common Allergens An allergen is something that causes allergy signs or allergic reaction. reactions in people who don’t have allergies.

Controlling Asthma & Allergies  Know your triggers  Healthy Housekeeping  Keep Down Dust Mites  Pets  Check Appliances  Smoking  Mold  Control Other Pests .

•The body makes antibodies that are directed towards the body’s own tissues .auto antibodies • The auto antibodies attack the normal cells by mistake .AUTOIMMUNE DISEASE • Autoimmune disorders occur when the body fails to tell the difference between self and non-self.

CAUSES OF AUTOIMMUNE • The cause of autoimmune disease is unknown. • There are many theories about what triggers autoimmune diseases. including  bacteria or virus  drugs  chemical irritants  environmental irritants • Happen when regulatory T cells fail their function .

which attack the nuclei of cells in your body – autoantibody tests—any of several tests that look for specific antibodies to your own tissues – complete blood count (CBC)—measures the numbers of red and white cells in your blood.HOW ARE AUTOIMMUNE DIAGNOSED? • Depending on the type of the disorder • tests are used to diagnose an autoimmune disease: – antinuclear antibody tests—a type of autoantibody test that looks for antinuclear antibodies. these numbers will vary from the norm – C-reactive protein (CRP)—elevated CRP is an indication of inflammation throughout your body . When your immune system is actively fighting something.

if blood is affected take anti-inflammatory medication. if necessary get blood transfusions. • to alleviate the symptoms of an autoimmune disease: – eat a balanced and healthy diet – – – – – – – – – – – exercise regularly get plenty of rest take vitamin supplements take hormone replacement. if joints are affected take pain medication take immunosuppressive medication get physical therapy decrease stress limit sun exposure .TREATMENT OF AUTOIMMUNE • Treatment involves attempts to control the process of the disease and to decrease the symptoms. especially during flare-ups.