Hematological Van Meter and Hubert (2014) describe symptoms

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Hematological Disorder: Pernicious AnemiaPatient by the name of Mr. X, age 57, has presented manifestations that conclude his health status of having a deficit in Vitamin B12. A further break down of all three  major present symptoms and signs through a pathophysiological explanation aid in supporting diagnosis of pernicious anemia. Van Meter and Hubert (2014) describe symptoms of nausea and diarrhea to correlate to a vitamin B12 deficiency in hand with a decrease of gastric acid production. (VanMeter & Hubert, 2014). The cause of pernicious anemia is yet to be clarified, yet according to the National Organization of Rare Diseases  it is an autoimmune condition possibly caused by an autosomal recessive gene that affects the production of intrinsic factor (Anemia, Pernicious, n.d.). The National Heart, Lung, and Blood Institute states that antibodies are thought to attack the parietal cells that produce intrinsic factor causing chronic gastritis (.  In turn, at the age of 57 Mr. X’s lack of intrinsic factor reduces his ability to absorb ingested Vitamin B12, leading up to his current anemic state.  VanMeter and Hubert (2014) states that vitamin B12 deficiency interferes in DNA synthesis of erythrocyte maturation, resulting in large nucleated megablast visible during a complete blood count. The megablast are recognized and tagged for destruction and filtration prompting a low RBC. The swollen tongue and soreness  is caused by lactic acid, a byproduct of  anaerobic state. Lastly neurological symptoms that Mr. X is experiencing, such as the tingling sensation in his toes and overall clumsiness, are due to demyelination in the peripheral system from the lack of vitamin B12 (VanMeter & Hubert, 2014).Mr. X was diagnosed through complete blood count and serum results which are two of three methods that are stated in our textbook. VanMeter & Hubert (2014) also claims that detection of achlorhydria may be done (VanMeter & Hubert, 2014). I would suspect that since proteins aren’t being digest that a stool analysis for proteins could be done as well. Treatments for pernicious anemia include management for the vitamin B12 deficiency. VanMeter and Hubert (2014) listed oral supplements or injections of vitamin B12 (VanMeter & Hubert, 2014) . As mentioned before pernicious anemia is a progressive and inherited disease that will chronically be with Mr. X. I think that transfusions could also be given to the patient if need be but for the most part management seems to be the best suited treatment.Lymphatic Disease: Hodgkin’s LymphomaVanMeter and Hubert (2014) describe two types of proliferation within lymph nodes as non-Hodgkin or Hodgkin Lymphoma. Non-Hodgkins lyphoma presents scattered swollen lymph nodes throughout the body at once in which at an early stage it affects organ and intestinal lymph nodes. Tumor treatments for non-Hodgkins are available yet encounter difficulties managing the dispersed malignancy. On the other hand treatments for Hodgkin Lymphoma have a better chance of managing localized lymph node tumors (VanMeter & Hubert, 2014).Ms. Y has exhibited manifestations that lead to believe that she has stage II Hodgkin’s Lymphoma. For example she has medically presented a painless firm lymph node on her neck. Upon examination several other affected lymphs in the local area were discovered indicating a spread of the malignant cells through the lymph system and thus categorizing her as stage II. According to VanMeter and Hubert (2014) stage I is only when one lymph node is affected. Cancer spreading to lymph nodes of the diaphragm and spleen would be considered stage III and stage IV would have been if the malignant cells had spread to organs other than those in the lymphatic system (VanMeter & Hubert, 2014) The night sweats, fatigue and weight loss are telltale symptoms of cancer. The abnormal lymph node cells are called Reed Sternberg cells. Dr. Lash and Dr. Argiris, authors for online health media website Medscape (2017), wrote that the malignant cells of Hodgkin’s Lymphoma are derived from B lymphocyte cells  and do not express normal antibodies. Instead they express CD30 and CD15, activators for lymphocyte proliferation (Lash & Argiris, 2017). The excessive lymphocytes in the nodes result in their palpable swelling. As metastasis of malignant cells occurs in the lymphatic system it will travel one way affecting down-the-line lymph nodes. Typical cancer treatments such as surgery, chemotherapy, radiation and combination drugs are provided. According to VanMeter and Hubert (2014) in the case of Ms. Y’s stage II she would receive a total of three chemotherapy sessions intervaled every four weeks (VanMeter & Hubert, 2014) ReferencesAnemia, Pernicious. (n.d.). Retrieved from https://rarediseases.org/rare-diseases/anemia-pernicious/Pernicious Anemia. (n.d.). Retrieved from https://www.nhlbi.nih.gov/health-topics/pernicious-anemiaVanMeter, K., Hubert, R. J., & Gould, B. E. (2014). Gould’s pathophysiology for the health professions. St. Louis, MO: Elsevier/Saunders.Lash, B. W., MD, & Argiris, A., MD. (2017, December 01). Hodgkin Lymphoma (E. C. Besa MD & M. L. Windle PharmD, Eds.). Retrieved January 26, 2018, from https://emedicine.medscape.com/article/201886-overview#a3

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