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Old 10-19-2011
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Question A mutiple choice question: acute myelogenous leukaemia

Appologies for the typo in the title: it should be ALL not AML (since I cannot edit the title).

Tod, 15 years old, plays quarterback in his school football team. He was diagnosed with acute lymphoblastic leukaemia 4 months ago and has completed a course of triple chemotherapy containing mercaptopurine, vincristine, and cyclophosphamide. His blood films show no cancer cells, but his FBC shows a severely reduced platelet level. In his follow-up, his treating doctor warned against strenuous exercise due to the risk of bleeding or tissue damage. However, Tod went back to a 2 weeks intense training program in his football team against medical advice. He did not develop any severe bleedings during his training as his doctor predicated. What was the reason?
(A) The rate of platelets production is higher in teens than in adults
(B) Dehydration from strenuous exercise thickens blood flow
(C) Strenuous exercise increases the platelet count.
(D) Athlete’s adrenalin level is likely to increase to a higher level in intensive sports and adrenalin functions as a peripheral vessel constrictor.
(E) Increased extrinsic coagulation pathway activity to compensate for thrombocytopenia.
(F) Increased intrinsic coagulation pathway activity to compensate for thrombocytopenia

Last edited by HaipengWang; 10-19-2011 at 12:48 AM.
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c) increase pl.count as a result of exercise
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Old 10-19-2011
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Yes you are correct. During exercise, ATP is consumed and ADP is increased. ADP activates platelet. Also strenuous exercise may release collagen-like substance from micro-tears of tissues fibres. This provides signalling pathways to activate platelet. Exercise only temporarily increases platelet levels, (with exercise-induced increases becoming less pronounced with age); It should not be viewed as a potential treatment for chronic thrombocytopenia.
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