Manifestations

of

Non- Hodgkin's Lymphoma

• Painless, enlarged cervical lymph nodes
• Fever
• Susceptibility to Infection
• Anemia
• Fatigue
• Weight Loss ; Anorexia
• Pruritus
• Malaise

Medical Management

for

Non-Hodgkin's Lymphoma

• Accurate staging of the disease
• Radiation
• Bone Marrow Transplant
• Chemotherapy
• Tumor Necrosis Factor

Non- Hodgkin's Lyphoma

A group of malignant neoplasms of the immune system.

Cause is Unknown.

Tumors usually start in lymph nodes and spread to lymphoid tissue in the spleen, liver GI tract, and bone marrow

Hodgkin's Disease

Inflammatory or infectious process that develops into a neoplasm

 Characterized by Reed-Sternberg Cells

Affects males twice as frequently as females

Manifestations

of

Hodgkin's Disease

• Enlargement of the cervical lymph nodes
• Weight Loss ; Anorexia
• Low-Grade Fever
• Anemia
• Pruritus
• Night Sweats
• Leukocytosis

Medical Management

of

Hodgkin's Disease

Stage I or II (Localized)

• Radiation

Stage III or IV (Generalized)

• Chemotherapy
• Combination

Lymphedema

• An abnormal accumulation of lymph in the soft tissue commonly caused by obstruction of lymphatic flow
• Primary or Secondary

Manifestations

of

Lymphedema

• Massive edema and tightness of affected extremity that progresses toward the trunk and is aggravated by standing

• Pain

Medical Management

of

Lymphedema

Pharmacological Management

Lymphangitis

Inflammation of one or more lymphatic vessels or channels

Usually result of acute streptococcal or staphylococcal infection in an extremity 

Manifestations

of

Lymphangitis

• Fine, Red Streaks on the affected area
• Edema
• Local Pain
• Fever and Chills
• Headache
• Myalgia

Medical Management

of

Lymphangitis

• Penicillin
• Moist Heat
• Elevate Affected Extremity

Multiple Myeloma

Also known as Plasma Cell Myeloma

A malignant neoplastic immunodeficiency disease of the bone marrow

Destroys osseous tissue, causing pain, fractures, and skeletal deformities

Manifestations

of

Multiple Myeloma

• Bone pain ; Pathological Fractures
• Anemia
• Renal Failure
• Risk for Infection
• Hypercalcemia
• Pain with movement
• Bleeding tendency

Medical Management

for

Multiple Myeloma

• Symptomatic ; Not Curable
• IV Fluids
• Radiation
• Chemotherapy

Pharmacological Management

• Corticosteroids
• Analgesics

Disseminated Intravascular

Coagulation (DIC)

Manifestations

of

DIC

• Bleeding generally from all orifices
• Hemoptysis
• Dyspnea
• Diaphoresis with Cold, Mottled Digits
• Purpura on the Chest and Abdomen
• Petechiae
• Hematuria

Medical Management

of

DIC

• Treat Underlying Cause
• Cryoprecipitate
• Protection from Bleeding and/or Trauma

Pharmacological Management

von WilleBrand's Disease

An inherited bleeding disorder

Characterized by abnormally slow coagulation of blood and spontaneous episodes of GI bleeding, epistaxis, and gingival bleeding

Caused by a mild deficency of antihemophilic factor VIII

Similar to hemophilia, but not limited to males

Medical Management

of

von Willebrand's

Disease

• Cryoprecipitate containing Factor VIII
• Fibrinogen
• Fresh Plasma
• Desmopressin (DDAVP)
• Minimize bleeding - avoid trauma
• Relieve pain (no Aspirin)

Hemophilia

A hereditary coagulation disorder (Hemophilia A or B)

X-linked hereditary trait that affects males; females are

 carriers

Involves the absence of Factor VIII or deficiency of

Factor IX

Manifestations

of

Hemophilia

• Internal and External Bleeding
• Hemarthrosis
• Excessive blood loss from small cuts and dental procedures
• Ecchymoses and hemorrhage from the slightest trauma

Medical Management

of

Hemophilia

• Minimize bleeding- avoid trauma
• Relieve pain (no Aspirin)

Transfusions

• Manufactured Factor VIII or IX
• Cryoprecipitate
• Factor VIII or IX concentrate

Thrombocytopenia

An abnormal hematological condition in which the number of platelets is fewer than 150,000

Occurrs in aplastic anemia, leukemia, tumors and chemotherapy 

Manifestations

of

Thrombocytopenia

• Petechiae
• Ecchymosis
• Platelets below 150,000
• Bleeding from mucous membranes
• Signs of increased ICP

Medical Management

of

Thrombocytopenia

• Avoid Trauma
• Platelet transfusion

Pharmacological Management

• Corticosteroids

Leukemia

A malignant disorder of the hematopoietic system in which an excess of leukocytes accumulates in the bone marrow and lymph nodes; a proliferation of cells

Cause unknown

Acute or Chronic

Manifestations

of

Leukemia

• Varies depending on type
• Painless Splenomegaly
• Oral Lesions
• Enlarged lymph nodes
• Thrombocytopenia
• Anemia
• Bone pain
• Meningeal Irritation

Medical Management

for Leukemia

• Chemotherapy
• Radiation
• Bone Marrow Transplant

Pharmacological Management

Agranulocytosis

A potentially fatal condition of the blood

Characterized by a severe reduction in the number of granulocytes

Neutrophil count is less than 200/mm3

Causes may be neoplastic disease, chemotherapy, radiation therapy, viral/bacterial infections, or congenital

Polycythemia

(Erythrocytosis)

Primary (Polycythemia Vera) - characterized by excessive bone marrow production ; a stem cell abnormality of unknown cause

Secondary - caused by hypoxia

Manifestations

of

Polycythemia

• Hypertension; Angina Pectoris; Heart Failure; Thrombophlebitis ( Increased blood volume and viscosity)
• Venous Distention
• Epistaxis; GI bleeding; petechiae
• Elevated WBC count
• Hepatomegaly ; Splenomegaly
• Generalized pruritus ; Dermatologic changes

Medical Management

of

Polycythemia

• Reduce viscosity
• Assessment of nutritional status
• Adequate oxygenation
• Intake and Output

Pharmacological Management

• Myelosuppressive Agents
• Radioactive phosphorus