Question

Case Study, Chapter 11, Disorders of White Blood Cells and Lymphoid Tissues Mr.J, aged 38 years, presents to the clinic today for his routine physical. During the review of systems, he offhandedly mentions that he has a "not" in his neck, but he figures it is no big deal since it does not hurt. He also reports occasional fever and chills, and the last several weeks, he has awakened drenched in sweat. He attributes this to the fact that he was around his niece and nephew who were both recovering from the flu. 1. What other questions would be helpful to determine the source of these symptoms? 2. The health care provider (HCP) has ordered a chest x-ray because he is suspicious of Hodgkin lymphoma. What is the rationale for this order? The health care provider (HCP) tells Mr.J that he would like to biopsy the "knot" in his neck to rule out Hodgkin lymphoma. After the HCP leaves the room, Mr.J immediately starts wringing his hands and says, "Oh my goodness. I know I am going to die. My friend had something like this, and he was dead in 6 months. Who will take care of my family?" 3. How will the nurse respond to Mr. I's concerns? 4. What constitutes a definitive diagnosis of Hodgkin lymphoma? 5. What are same manifestations associated with non-Hodgkin lymphoma? 6. The lymph nade biopsy is positive for the Reed-Stemberg cell. What type of treatment is indicated?

Answer 1

1.The other question which can help to determine the source of symptoms are

• Life style like smoking ,alcohol
• Family history of any chronic illness,cancer
• Any recent fever or infection like EBV infection
• Socioeconomic status plays a key role in these symptoms .This infection can occur in higher socioeconomic status

2.The lymphoma cam be seen in the chest X eay if it has spread to lungs and appropriate treatment can be initiated at the earliest

3.Nurse has to provide a psychological support and make him feel comfortable. The disease has a better outcome if treated at the earliest.

4.The definitive diagnosis of hodgkin's lymphoma is a biopsy of the lymph node.

5.The manifestation are

• Extreme tiredness
• Swelling of lymph nodes
• Night sweats are common
• Weight loss
• Fever
• Anorexia
• Itching

6.The treatment are

• Targeted therapy in acting specifically on the cancer cells
• Immunotherapy
• Chemotherapy
• Radiation therapy
• Surgical removal of the lymph node