Question

Case Scenario: A 16-year-old female presents at the clinic with extreme fatigue and shortness of breath while playing volleyball. She has been in good health until about six months ago. During these six months, she has had several colds and flu events where she was unable to do normal activities. Her mother reports she spends a great deal of time sleeping, sometimes twelve hours, and complains of fatigue when she awakens. She is pale and appears to have little energy. The doctor suspects iron deficiency anemia (IDA).

1. Question: Explain the pathophysiology of iron deficiency anemia (IDA)

Case Scenario: A 35-year-old woman presents with an enlargement of her neck. She has been experiencing intermittent fevers and no other symptoms of infection, drenching night sweats, itchy skin, and fatigue. She has no prior health problems. She also reports to have lost 20 pounds in the last month, that was not an intentional loss. The doctor fears Hodgkin lymphoma. There is no family history.

2. Question: Compare Stage 1 of Hodgkin’s disease to Stage 3 for symptoms and efficacy of treatment.

Answer 1

ANSWER- Pathophysiology of iron deficiency anemia (IDA)

Initial Stage- Iron stores are reduced without reducing serum iron level and can be assessed with serum ferritin measurement.

Once iron stores are depleted, there still is adequate iron from daily RBC turnover for Hb synthesis.

Second Stage -Iron deficiency occurs ;Hb falls just above the lower limit normal

Third Stage - considered as IDA and occurs because of Hb falls to less than normal values.

ANSWER- comparison of stages of hodgkin's disease on the basis of symptoms-

Stage I- The cancer is limited to one lymph node region or a single organ.

Stage II - In this stage, the cancer is in two lymph node regions or the cancer has invaded one organ and the nearby lymph nodes . But the cancer is still limited to a section of body either above or below the diaphragm.

Stage III - when the cancer moves to lymph nodes both above and below the diaphragm, it is considered stage III . Cancer may also be in one portion of tissue or an organ near the lymph node groups or in the spleen.

Stage IV - This is the most advanced stage of hodgkin's lymphoma . Cancer cells are in several portions of one or more organs and tissues. Stage IV hodgkin's lymphoma affects not only the lymph nodes but also other parts of the body , such as liver, lungs or bones.

Comparison of stages of hodgkin's disease on the basis of treatment-

Stage I -Short course of chemotherapy if disease is in limited condition. Doctor can recommend radiotherapy to the affected lymph nodes .

Stage II - Radiation therapy alone or modified radiation therapy and chemotherapy.Patients with unfavorable prognostic factors should receive chemotherapy and radiation therapy as initial treatment.

Stage III - chemotherapy

Stage IV- multiple cycles of chemotherapy and bone marrow transplantation in severe condition.