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Blood Cancers and NeutropeniaMedical Surgical Nursing

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What are the primary methods for diagnosing leukemia?
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Peripheral blood examination and bone marrow studies
Whih two types of leukemias require cytogenic studies in order to identify the subtype?
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AML and ALL
When there is no evidence of disease, the bone marrow and peripheral blood appear normal, this is called...
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Complete remission
The term for when tumor cells cannot be detected by morphological examination but are detected via molecular testing...
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Minimal residual
The term used when the patient has a lack of symptoms and a normal peripheral blood smear, but there is still evidence of the disease in the bone marrow....
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Partial remission
Term used when a patient that has had leukemia has less than 1 in 10,000 blasts in the bone marrow...
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Molecular remission
In some cases, a patient has a high WBC count (greater than 100,000) which places them at high risk for thromboses. To prevent this, patients are treated with...
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Patients are treated with leukapheresis and hydroxyurea which reduces WBC counts.
What are the traditional stages of leukemia treatment?
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Induction, Intensification, Consolidation and Maintenance
Which stage of leukemia treatment? Aggressive treatment to destroy leukemic cells in the tissues, peripheral blood and marrow. There is a risk of the patient becoming critically ill. During this stage, the nurse focuses on monitoring for neutropenia, thrombocytopenia or anemia and provides psychological support.
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Induction
Which stage of leukemia treatment? High doses of the drugs given for several months, other drugs that work differently may be added.
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Intensification
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Which stage of leukemia treatment? Occurs once remission is achieved. Purpose is to eliminate any remaining leukemic cells that may have survived the other stages.
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Consolidation
Which stage of leukemia treatment? Lower doses of the induction drugs given every 3-4 weeks over a prolonged period of time.
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Maintenance
Which type of leukemia doesn't respond well to maintenance therapy?
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AML, it is rarely administered if the patient has this type
Hematopoietic Stem Cell Transplantation (HSCT) involves the eradication of the patient's stem cells which are then replaced with a donor's. Explain the following terms to describe donor sources: Allogeneic- Autologous- Syngeneic-
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Allogeneic-HLA matched sibling or volunteer donor Autologous-self donated via harvest prior to eradication Syngeneic-identical twin donation
Malignant neoplasms originating in the bone marrow and lymphatic strutures, the fifth most common form of cancer in the US...
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Lymphoma
A malignant condition characterized by abnormal, giant, multinucleated cells called Reed-Sternberg cells...
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Hodgkin's Lymphoma
When does Hodgkin's Lymphoma peak in incidence?
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It is considered bimodal, it peaks between 15-30, then again after age 50
Where are the Reed-Sternberg cells associated with Hodgkin's lymphoma located?
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In the lymph nodes
What are the three key factors for development of Hodgkin's Lymphoma?
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Infection with the Epstein-Barr virus, genetic predisposition and exposure to environmental toxins
What organs are the most common sites of infiltration from Hodgkin's lymphoma (3)?
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Spleen, liver and lungs
Which lymph nodes are the most common sites of Hodgkin's Lymphoma's initial development?
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Cervical, axillary or inguinal lymph nodes. A mediastinal mass is the second most common area.
  
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