Reference no: EM133320593

Assignment:

Marlene is an active and otherwise healthy 57-year-old woman who has just undergone a lumpectomy, axillary dissection, and radiation therapy to treat breast cancer. Although Marlene's surgery was performed to cure one medical problem, she will soon realize the impact that inadvertent damage to her lymphatic system can have on her overall health.

Marlene's breast cancer surgery included axillary dissection or the removal of part of her lymphatic system, specifically, her armpit lymph nodes and vessels.

1. What is the normal function of the lymphatic system?

a. the drainage of excess interstitial fluid

b. the transport of dietary lipids from the gastrointestinal tract to the blood

c. protection against pathogen invasion by innate immune responses

d. protection against pathogen invasion by adaptive immune responses

e. All of these choices are functions associated with the lymphatic system.

2. Which lymphatic system function was impaired by her surgery for Marlene to present with this symptom?

a. the drainage of excess interstitial fluid

b. the transport of dietary lipids from the gastrointestinal tract to the blood

c. protection against pathogen invasion by innate immune responses

d. protection against pathogen invasion by adaptive immune responses

e. All of these functions must be impaired to present with this symptom.

Marlene's physician examined several of the excised axillary lymph nodes for the presence of cancer and, fortunately, found none.

3. Based upon your understanding of lymphatic system function, explain why Marlene's doctor followed this protocol.

a. Breast cancer begins in the axillary lymph nodes and impairs immune function.

b. Examining the axillary nodes tells the physician if cancerous cells from the breast have used the transport function of the lymphatic system to spread to other body sites.

c. Impaired lymphatic drainage can lead to breast cancer so examining the nodes can determine the cause of Marlene's cancer.

d. Reduced lymph node function allows pathogens to accumulate rather than draining normally which can trigger healthy cells to become malignant.

e. All of these explanations are reasons for a physician to examine the axillary lymph nodes during a lumpectomy.

During her post-operative recovery, Marlene accidentally cut her hand and self-treated rather than seeking professional medical care.

4. Three days later, she discovered red lines radiating from the injury in her hand up her forearm, a medical condition known as ___________.

a. lymphadenopathy

b. lymphangitis

c. phlebitis

d. anaphylaxis

e. angiopathy

After three days, Marlene's hand injury was oozing pus.

5. What is pus?

a. interstitial fluid

b. degraded plasma

c. dead phagocytic cells plus fluid

d. dead platelets

e. Pus is a mixture of all of these components.

Marlene's hand injury was red, warm to the touch, swollen, and painful after 3 days.

6. These signs indicate Marlene is experiencing __________________.

a. shock

b. sepsis

c. acidosis

d. inflammation

e. anaphylaxis

During Marlene's infection, her temperature rose to 102o F.

7. Explain how Marlene's infected cut could cause this significant fever.

a. Toxins secreted by invading pathogens can trigger fever.

b. The release of specific cytokines during an inflammatory response can elevate temperature.

c. Histamine release from mast cells is responsible for generating a fever.

d. Toxins secreted by invading pathogens and the release of specific cytokines during an inflammatory response can both cause fever.

e. Toxins secreted by invading pathogens, the release of specific cytokines during an inflammatory response, and Histamine release from mast cells can all cause fever.

Marlene was surprised that such a small injury could be so painful.

8. How did the inflammation of Marlene's wound lead to so much pain?

a. The increased edema from altered capillary permeability applies irritating pressure to surrounding nerves.

b. Pain results from neuron injury due to pathogen-secreted toxins.

c. Pain results from direct neuron injury.

d. Pain is a "side effect" of the prostaglandins released during inflammation.

e. All of these choices account for Marlene's pain.

Marlene experienced inflammation following her injury, an innate immune response.

9. What other innate or non-specific immune responses fight infection?

a. Natural killer cells lyse body cells displaying abnormal plasma membrane proteins.

b. Antimicrobial proteins like interferon and complement, protect host cells from viral invasion and lyse invading bacterial cells, respectively.

c. Phagocytosis by neutrophils and macrophages remove invading bacteria.

d. Fever inhibits bacterial growth and also promotes reactions needed for wound repair.

e. All of these choices represent innate immune responses.

Marlene's doctor explained that in adaptive immune responses, the lymphatic vessels carry pathogens to the lymphoid organs and tissues to be presented to B and T cells.

10. What are the primary lymphoid organs/tissues?

a. lymph nodes

b. mucosa-associated lymphoid tissue (MALT)

c. red bone marrow

d. thymus

e. the red bone marrow and the thymus

Marlene demonstrates a classic primary immune response as, with the help of antibiotics, she recovers from her infection

11. How will Marlene's immune system react if she encounters this same pathogen again?

a. Memory B cells will undergo rapid proliferation.

b. Memory B cells will begin immediate antibody secretion.

c. Marlene will be unaware that the pathogen has invaded her system since this rapid secondary response will prevent illness from occurring.

d. Memory B cells will undergo rapid proliferation, begin immediate antibody secretion, and Marlene will be unaware that the pathogen has invaded her system.

e. Memory B cells will undergo rapid proliferation, begin immediate antibody secretion, and Marlene will be unaware that the pathogen has invaded her system, but she will need to continue a prophylactic antibiotic course.

12. Consider the connection between lymph transport and both innate and adaptive immune responses as you answer the following discussion questions. Using your knowledge of infectious disease, consider the following: After taking a high dose penicillin treatment, Marlene complains, "...my throat feels swollen like I'm getting a cold. After all of this, I don't know how anything can survive in my body."

How could Marlene possibly be getting a cold if she has just finished a strong antibiotic treatment?

13. Marlene's doctor suggests her hand is infected with "strep bacteria" that can overwhelm the immune system. There are many species of "strep." Go on-line and investigate the one most commonly associated with skin infections. What is its scientific name? What devastating but sensational infection can it cause?