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CASE STUDY 12-2A 3-year-old girl was admitted with a diagnosis ofacute lymphocytic leukemia. Her admitting labora-tory data are shown in Case Study Table 12-2.1.After admission, she was treated by administration ofpacked red cells, 2 units of platelets, IV fluids, andallopurinol. On the second hospital day, chemother-apy was begun, using IV vincristine and prednisoneand intrathecal injections of methotrexate, predni-sone, and cytosine arabinoside. She was dischargedfor home care 5 days later. She was continued onprednisone and allopurinol at home. She receivedadditional chemotherapy 1 month later (11/1)and again on 11/14. On 12/6, she was readmittedbecause she had painful sores in her mouth and wasunable to eat.Questions1. How would you explain the significant elevationsof uric acid on admission?2. Which two factors are responsible for the normalconcentrations of uric acid seen in subsequentadmissions?3. Which is the most likely cause of the abnormallylow concentration of urea nitrogen observed on12/6? Which other laboratory test would confirmyour suspicions?CASE STUDY TABLE 12-2.1LABORATORY RESULTS10/1 10/2 10/3 10/4 11/14 12/6 6/20Urea N(mg/dL)12.0154.02.0Creatinine(mg/dL)0.71.00.70.7Uric acid(mg/dL)12.0 9.2 4.0 1.92.33.1WBC(mm³)56,300 •• 3,700 2,800 3,700"Indicates test not performed.None
1 Approved Answer
Subhash P
3Ratings (18 Votes)
Leukemia is a type of cancer that involves white blood cells. The most common type of cancer in the age group of 0-14 years...
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