Assignment Task: Answer-Please explain you answer
A 12-year-old girl is taken to a walk-in clinic in her neighborhood drug store for a sore throat and fever. The mother states that the child has been just lying around and is having her period. The girl reports that she has had two periods in the past month and has to change her sanitary pad every couple of hours. The clinician notes several bruises, and the girl does not remember how she got them. After speaking with a colleague, the clinician advises the mother to take the girl to a local children's hospital to be evaluated. Later that day, the girl is diagnosed with ALL and begins chemotherapy.
All leukemia's have certain pathophysiologic features in common. These include:
1. Increased function of granulocytic-monocytic cells
2. Increased function of bone marrow to fight the leukemic cells
3. Overcrowding of the bone marrow
4. Decreased response to biologic response modifiers
While undergoing treatment, the girl becomes increasingly neutropenic and is unable to fight off an infection. Overwhelming sepsis occurs, and the girl develops hypotension and shock. As a result, she acquires DIC and multiple organ failure.
DIC is secondary to a wide variety of well-defined clinical conditions, specifically those that activate the clotting cascade. The clotting may result in the consumption of platelets, and clotting factors may lead to severe bleeding that is caused by:
1. Endothelial damage
2. Lack of thrombin production
3. Increased synthesis of thrombomodulin
4. Platelet activation