Larry, a 9-year-old male, was brought to his dentist for a regular preschool che

Question

Larry, a 9-year-old male, was brought to his dentist for a regular preschool check-up. The dentist and mother were having a chatty conversation when Larry's mother stated that her son recently had stopped showing interest in sports and com­plained of fatigue. During the dental examination, the dentist noted gingival bleeding whenever the tissue was lightly probed. Three nontender lymph nodes were palpable in the submandibular nodes. No other abnormalities were noted. The dentist advised the mother to take Larry to the medical clinic next door. The physical examination showed Larry’s skin to be pale with ecchymoses and petechiae of the trunk. The spleen and liver were not palpable, and the remaining examination was unremarkable. A sample of blood was withdrawn.

Explanation / Answer

Larry could be suffering from leukemia. The petechiae and gingivitis indicate a low platelet count, which is brought about by high WBC count. Any infection results in lymphadenopathy. The paleness of skin indicates less RBC.

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