A boy with leukemia screams whenever he needs to be turned or moved. Which is the most probable cause of this pain?
a. Edema
b. Bone involvement
c. Petechial hemorrhages
d. Changes within the muscles
ANS: B
The invasion of the bone marrow with leukemic cells gradually causes a weakening of the bone and a tendency toward fractures. As leukemic cells invade the periosteum, increasing pressure causes severe pain. Edema, petechial hemorrhages, and changes within the muscles would not cause severe pain.
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