Practical Diagnosis of Hematologic Disorders - Essay Example

? HEAMATOLOGY al Affiliation) Key words: Heamatology Question One Full blood counts are tests that check on status and number of the various blood cells. Hemoglobin is a compound that contains iron which is normally found in the red blood cells. The red blood cells are responsible for the transportation of oxygen in the body. Normal levels for an average male are between 130 to 170 g/l. The patient has a level of 10.4 g/l which is far below the expected threshold. This means that there is difficulty in the transportation of oxygen in the body which is manifested by constant fatigue in the patient. The MCV test was supposed to get an estimation of the volume of the red blood cells. The normal levels for an adult male are between 83-101 fl. The patient’s levels are found to lie between the normal levels as a count of 83.5 was recorded. Nucleated red blood cells are normally found in newborns only. Any appearance beyond that may be an indication of a disorder in the blood production apparatus. The lack of platelets is responsible for the easy bruising and bleeding in the patient. The blast cells are immature red blood cells and their presence in the blood sample may be a precursor to leukemia disorder which is in order with the described symptoms of fatigue, excessive bleeding by the patient upon cleaning of the teeth (Saha, 2011). Question Two The blood film allowed for further examination of the physical characteristics of the blood cells in the blood. From the blood sample there is impaired staining of the red blood cells. This is a common occurrence in iron deficient patients. There is the presence of large, spherical, purple cells with prominent nucleoli excluding blastic MCL. Over the recent duration of time advancements that have been made in the method used in the identification of diseases has led to the adoption of the 2001 World Health Organization (WHO) classification. The classification lays emphases on the usage of a multiparametic system in order to diagnose and set forth the genotypic, morphologic and immunophenotypic characteristics of every single disease. There are several steps that should be undertaken in application and the interpretation of the immunophenotypic information 1) The identification of cells and determination if they are mature or immature 2) To check for abnormal cells by checking for any differences from those samples taken from a normal person 3) The documentation of the abnormal cell populations 4) Evaluation of whether the information acquired can be used to come up with a diagnosis 5) Provision of information that can be directed towards the application of a specific diagnosis. The age of the patient plays an important role in the diagnosis process as malignancies tend to take place in older patients. Based on the WHO guidelines the morphologic features that include the presence of huge blast cells which have basophilic cytoplasm coupled with the reduced levels of monocytes in the blood then we can come to the conclusion that the patient is suffering from leukemia specifically the acute myeloid type (Kjeldsberg, 2006) Question Three A physical examination can be done where the doctor checks for pale skin in the patient. Further tests that can be done include doing a background check on the patients past history which also includes investigation of the family history of such diseases. The doctor can also check the lymph nodes of the patient for any enlargement that may have occurred. The doctor can also check for enlarged liver in the patient (Schneider & Szanto, 2009). A bone marrow aspiration and biopsy can also be conducted for further investigations. The bone marrow sample is usually obtained from the hipbone and is usually obtained through the use of a long needle. A cytogenetic test can be carried out which is basically a test that looks for changes in the chromosomes of the cell from a sample taken from the bone marrow. X-rays of the chest can also be carried out in order to find out whether the infection is the cause of respiratory problems such as incessant coughing, difficulty in breathing or even chest pains. A CT scan of the head can also be carried out on various parts of the body such as the head, torso and the chest in order to check whether the infection has spread to such areas. Question Four Over the past years or so there has been great advances in the field of cancer and cytogenetic, the application of cytogenetic methodologies which have led to the establishment of prognostic and diagnostic indexes for a myriad of chronic leukemia’s (“Lymphedema understanding and managing lymphedema after cancer treatment” 2006). Such information has helped the physician to make more favorable diagnosis and to formulate a follow up plan. An important implication that has been brought about by the improvements in methodologies is that now more patients are more involved in decisions about their treatment. The patients and their carers can now be taught how to conduct part of their treatment at home through directions that are delivered over different medium such as the telephone. Some of the implications brought about by the improvements are not necessarily positive. For example the treatment procedures for most hematological cancers can have some long lasting effects on the patients. These include the increased risk of acquiring secondary primary cancers. There have also been some tumors that have been linked to the chemotherapy treatment such as breast and lung cancer. However these tendencies have been mostly noted in long term survivors that are of a significantly younger age than other patients that are generally more advanced in age. Also some patients are rendered infertile by the treatment procedures. The treatment procedures for the various forms of hematological malignancies can result in the patient feeling fatigued, pain, and loss of muscle and reduced mobility (Jones & Wickramasinghe, 2006). Therefore it is normally advised for the patient to have access to a physiotherapist who has adequate understanding about such conditions in order to reduce the discomforts and pains that come along with the treatment plans. Due to the improvements in the sector of hematological cancers the doctors now have more information on what exactly is ailing the patient. The availability of such information is that it reduces anxiety among the patients, it also enhances the capability of the patient to cope with the punishing treatment regime and it also facilitates the self- care of the patients. The improved integration of palliative care with the treatment services during the duration of treatment has led to the improvement of the quality of life to the patients. REFERENCES Jones, N. C., & Wickramasinghe, S. N. 2006. Lecture notes on hematology 7th ed. Malden: Blackwell Pub. Kjeldsberg, C. R. 2006. Practical diagnosis of hematologic disorders 4th ed. Chicago, Ill.: ASCP Press. Lymphedema understanding and managing lymphedema after cancer treatment. 2006. Atlanta, Ga.: American Cancer Society. Saha, V. 2011. New agents for the treatment of acute lymphoblastic leukemia. New York: Springer. Schneider, A. S., & Szanto, P. A. 2009.Pathology 4th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Read More