ecchymotic skin lesion

-bruises

-bleeding occur out of BV

cytochemistry study

-deal with detection of cell constituent by biochemical analysis and visualization technique

typical Faggot cells

-promyelocyte found in APL

-presence numerous Auer rods

D-Dimer

-by product in blood protein and breakdown process

disseminated intravascular coagulation (DIC).

-condition that cause abnormal blood clotting through out the body's blood

International normalized ratio (INR)

-standardized measure to monitor and access the effectiveness of oral anti-coagulant therapy

Blood urea serum electrolytes (BUSE)

-test that provide info on renal function especially in excretion and homeostasis

pale with multiple ecchymotic skin lesion

lungs were clear and no organomegaly found on abdominal examination

no evidence of regional lymphadenopathy

abnormal mononuclear showing Auer rods in the cytoplasm with few typical Faggot cells

consistent with the diagnosis of acute myeloid leukaemia (AML)

abnormal blood coagulation tests accompanied by progressive

thrombocytopenia, decreasing fibrinogen, and elevated D-Dimer

levels

evidence of disseminated intravascular coagulation (DIC)

VITAL SIGN:

pulse rate (HIGH)

LABORATORY RESULT:

Hb, Hct, neutrophil, lymphocyte, platelet count, plasma fibrinogen (LOW)

abnormal mononuclear cell , C-reactive protein (HIGH)

Prothrombin time , APTT (PROLONGED)

INR, D-dimer assay (HIGH)

pale

-low production Hb and RBC level

multiple ecchymotic skin lesion

-due to BV ruptured under skin

-primary haemostatic defect ( due to vascular wall and platelet interact to limit blood loss from damage BV)

lungs were clear (palpate) and no organomegaly found on abdominal examination

-no cavitation in lung, no infection

-lung without swelling, blockage and mucous accumulation

-spleen and liver normal (no haemolytic anaemia)

no evidence of regional lymphadenopathy

-(no haemolytic anaemia)

-no cell damage in lymphoid stem cell

abnormal mononuclear showing Auer rods in the cytoplasm with few typical Faggot cells

-presence on faggot cell indicate APL

consistent with the diagnosis of acute myeloid leukaemia (AML)

- presence of Auer rods

abnormal blood coagulation tests accompanied by progressive thrombocytopenia, decreasing fibrinogen, and elevated D-Dimer

levels

- decrease of platelet progressively (lead to bleeding)(indicate cancer specifically leukemia

-activation of coagulation system cause elevated d-dimer level

-elevated d-dimer indicate infection, cancer, pregnancy, venous thromboembolism

-decrease fibrinogen cause defect in secondary haemostasis (in 2nd, stable fibrin clot formation followed by coagulation processes and fibrinogen is converted into fibrin by thrombin due to this clot occur)

-coagulation factor decrease and not activated

evidence of disseminated intravascular coagulation (DIC)

-example of low level platelet and activated coagulation system coexist form micro clot in BV clotting and bleed occur simultaneously

-associate with APL (myelocyte trigger activation of coagulation cascade lead to DIC)

VITAL SIGN:

pulse rate (HIGH)

-deficiency of RBC

LABORATORY RESULT:

Hb, Hct, neutrophil, lymphocyte, platelet count, plasma fibrinogen (LOW)

-Hb, Hct indicate anemia

-platelet (due to overstimulation coagulation process)

-plasma fibrinogen ( due to 2nd hemostasis defect)

abnormal mononuclear cell , C-reactive protein (HIGH)

-leukemia cause abnormal proliferation mononuclear cell

-CRP related to(inflammation due to skin lesion) (marker for AML pt with neutropenia)(irritation of BM)

Prothrombin time , APTT (PROLONGED)

-indicate low level clotting factor

-defect in common clotting pathway

INR, D-dimer assay (HIGH)

-D-dimer due to activation coagulation system

-INR due to low level platelet, takes longer time to blood clot occur

chromosomal translocation t(11;17)

results of fluorescence in situ hybridization (FISH) for the fusion gene was consistent with the diagnosis of acute promyelocytic leukemia (APL)

prompt treatment of the DIC-related bleeding

reatment with specific combination

chemotherapy (all trans-retinoic acid (ATRA), idarubicin, and

arsenic trioxide)

chromosomal translocation t(11;17)(non-accute)

-Rare condition, t(15:17) is common for APL

results of fluorescence in situ hybridization (FISH) for the fusion gene was consistent with the diagnosis of acute promyelocytic leukemia (APL)

-FISH result indicate that genetic abnormalities

prompt treatment of the DIC-related bleeding

-Supportive treatment such as plasma transfusion to replace blood clotting factors