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Пульмонология, гематология (англ,рус)

•         folic acid in the dose of 5 mg - 1-3 times per a day реr оs during 2-3 weeks (if reason of deficit is not permanent).

•         in the case of   ineffectiveness   of the indicated   therapy   patients   with the megaloblastic type of erythropoesis must be directed in a hematological center, hematological institute for authentication of diagnosis (eritroleukemia is possible or other pathology).

Sickle cell anemia is an inherited blood disease in which the red blood cells produce abnormal pigment (hemoglobin). The abnormal hemoglobin causes deformity of the red blood cells into crescent or sickle-shapes, as seen in this photomicrograph.

Elliptocytosis is a hereditary disorder of the red blood cells (RBCs). In this condition, the RBCs assume an elliptical shape, rather than the typical round shape.

Spherocytosis is a hereditary disorder of the red blood cells (RBCs), which may be associated with a mild anemia. Typically, the affected RBCs are small, spherically shaped, and lack the light centers seen in normal, round RBCs.

Sickle cell anemia is an inherited disorder in which abnormal hemoglobin (the red pigment inside red blood cells) is produced. The abnormal hemoglobin causes red blood cells to assume a sickle shape, like the ones seen in this photomicrograph.

Red blood cells (RBCs) are normally round. In ovalocytosis, the cells are oval. Other conditions that produce abnormally shaped RBCs include spherocytosis and eliptocytosis.

These crescent or sickle-shaped red blood cells (RBCs) are present with Sickle cell anemia, and stand out clearly against the normal round RBCs. These abnormally shaped cells may become entangled and block blood flow in the small blood vessels (capillaries).

This photomicrograph of red blood cells (RBCs) shows both sickle-shaped and pappenheimer bodies.

These abnormal red blood cells (RBCs) resemble targets. These cells are seen in association with some forms of anemia, and following the removal of the spleen (splenectomy).

Prepared by Orlovsky A. V., assistant, D.Ph.,

                    Murenets N. A., postgraduate

 

 

Methodological Instruction to Lesson № 8.

 

Acute and chronic leukemias.

Hours: 5.

Working place: classroom, hospital wards.

 

Questions.

 

1. To give definition of the term “HEMOBLASTOSIS”

2. Classifications of HEMOBLASTOSIS.

3. To give definition of the term “Acute  leucosis (Acute Leukemias)” (AL).

4. Classifications of AL.

5. Etiology and pathogenesis of AL.

6. To list basic clinical syndromes at AL.

7. Laboratory diagnostic of AL.

8. Diagnostic criteria and Differential diagnostics of AL.

9. Treatment of AL.

10. That is complete remission of AL.

11. Diagnostic, Clinic and Treatment of hematosarcoma.

12. Classifications of myeloproliferative disease.

13. Diagnostic criteria of Chronic Myelocytic.

14. Treatment of Chronic Myelocytic.

15. Diagnostic criteria of Polycythemia.

16. Diagnostic, Clinic and Treatment of Myelofibrosis (Agnogenic Myeloid Metaplasia; Myelofibrosis with Myeloid Metaplasia).

17. Etiology and pathogenesis of Chronic Lymphocytic.

18. Laboratory diagnostic of Chronic Lymphocytic.

19. Diagnostic criteria and Differential diagnostics of  Chronic Lymphocytic.

20. Differential diagnostics of  Chronic leukemia and hematosarcomas.

21. Treatment of Chronic Lymphocytic.

22. To give definition of the term “leukemoid reaction”.

23. Tape of leukemoid reaction and Differential diagnostics with AL.

24. Treatment of leukemoid reaction.

 

Examples of tests

1. Name etiology factors of leukaemias:

A. exposure to ionizing radiation

B. viral infection

C. chromosomal tramslocation

D. immunodeficiency disorder

E. all named above

2. In which age could you mostly see acute lymphocytic leukaemia?

A. in childhood

B. in young adults

C. in the middle age

D. in old age

3. Name main cells in CBC you can see in patients with acute leukaemia:

A. prolymphocytes

B. plasmocytes

C. blasts

D. lymphocytes

4. Name the goal of treatment in patients with acute leukaemia:

A. normal hematopoiesis with less than 20 % blast cells

B. normal hematopoiesis with less than 15 % blast cells

C. normal hematopoiesis with less than 10 % blast cells

D. normal hematopoiesis with less than 5 % blast cells

 

Answers to tests:

1. E, 2. A, 3. C, 4. D

References.

 

1.     Therapy: Manual. The course of lectures/V. M. Fedosyeyeva, A. A. Chrenov. – Simferopol, 2003. – 375 - 391 p.

2.     Davidson’s Principles and practice of medicine (nineteenth         edition)/Christopher Haslett, Edvin R. Chilvers and others. – Edinburgh, 2002.

3.     Harrisons Principle if internal medicine (seventeenth Edition)/Fauci, Braunwald, Hasper and other. – Part 6, section 2, Chapter 104.

4.     The Merck Manual of Diagnosis and Therapy (seventeenth Edition)/ Robert Berkow, Andrew J. Fletcher and others. – published by Merck Research Laboratories, 1999.

 

 

 

 

Short theoretic material

 

What is leukemia?  Leukemia is a type of cancer. Cancer is a group of many related diseases. All cancers begin in cells, which make up blood and other tissues. Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place.  Sometimes this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. Leukemia is cancer that begins in blood cells.

 

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