General Pathophysiology (CLS 323)

2nd Semester 2021-2022

Case Study 1
A routine mammogram showed a large mass in the right breast of Mrs. Norah., age 42. A biopsy
confirmed the presence of a malignant tumor. Mrs. H. was concerned because her mother and an
aunt had breast cancer. No metastases were detected at this time. A mastectomy was performed
and a number of axillary and mediastinal lymph nodes were removed. Pathologic examination
showed several nodes from each area contained malignant cells. Given this case was considered
to be stage III, it was recommended that Mrs. Norah has chemotherapy and radiation treatment
following surgery and later have her ovaries removed to reduce her estrogen levels.
Discussion Questions (2.5 marks each)
1. Discuss the differences between a malignant and benign tumor and how they may be used in
diagnosing the cancer. (See: Characteristics of Malignant and Benign Tumors)
2. Discuss what other signs and symptoms Mrs. Norah may expect to experience if the tumor
returns. (See: Pathophysiology, Local Effects of Malignant Tumors, Systemic Effects of
Malignant Tumors)
3. Other than the biopsy used in this case, discuss what other diagnostic tests could have been
used to diagnose the cancer. (See: Diagnostic Tests)
4. Discuss the reasons why the axillary lymph nodes were removed and it was recommended
that the patient continue with chemotherapy and radiation. (See: Spread of Malignant
Tumors)

Case Study 2
Mr. Ali., age 57, presented to his physician with marked fatigue; nausea with occasional
diarrhea; and a sore, swollen tongue. Lately he also has been experiencing a tingling feeling in
his toes and a feeling of clumsiness. Microscopic examination of a blood sample indicated a
reduced number of erythrocytes, many of which are megaloblasts and a reduced number of
leukocytes including many large, hypersegmented cells. Hemoglobin and serum levels of vitamin
B12 were below normal. Additional tests confirm pernicious anemia.
Discussion Questions (2.5 marks each)
1. Relate the pathophysiology of pernicious anemia to the manifestations listed above. (See:
Pernicious Anemia)
2. Discuss how the gastric abnormalities contribute to vitamin B 12 deficiency and to iron
deficiency and how vitamin B12 deficiency causes complications associated with pernicious
anemia. (See: Pernicious Anemia—Pathophysiology, Etiology)
3. Discuss other tests that could be performed to diagnose this type of anemia. (See: Pernicious
Anemia—Diagnostic Tests)
4. Discuss the treatment available and the limitations.

Notes:
 Make sure to discuss all questions in your own words, each in a paragraph format, not as
a list).
 Copied answers from the internet or others sources will result in a ZERO grade on the
assignment in addition to the disciplinary actions, as per KSU rules and regulations.
 Provide references for your answers and make sure to include a reference page.

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 Follow APA format