aplastic aneamia

Question 1

Define Aplastic aneamia

Answer 1

Defined by pancytopenia with hypo cellular marrow and no abnormal cell
most often idiopathic-diagnosis of exclusion

Question 2

Aetiology and risk factors of Aplastic anaemia

Answer 2

Often idiopathic cause,
but can result from toxic drug exposure (NSAID, cholamphenicol), hepatitis
Condition associanted with the development are pregnancy, coeliac, SLE paroxysmal nocturnal heamoglobinura-very linked
fanconi syndrome too-inherited AA
There is often a lag time bwteen exposure and disease

risk factor
biphasic-25 and over 60
East Asian 
PNH
drug exposure
Fhx
recent hepatitis

Question 3

Epidiemology of Aplastic anaemia

Answer 3

rare-about 2 per million

2x more common in east Asia

Question 4

Signs and sx of Aplastic anaemia

Answer 4

Often present resulting from pancytopenia-no hallmark features of AA
it presents often months after initial exposure (if not idiopathic)

Recurrent infection-leukopenia
Aneamia symptoms
Bleeding/bruising from thrombocytopenia

diagnosis needs the FBC

Physical examination should be normal
Spelnomegaly would indicate other cause (AML,other)

congenital AA presents very early on
but rarely in adults-signs of the diseases-
fanconi-

Question 5

Investigation of Aplastic anaemia

Answer 5

FBC-pancytopenia-deficiency in more than 2 cell lines
Hemo <100
Platelets under 50
neutro under 1.5
Reticulocytes low

Bone marrow biopsy should be ordered-all cells should be normal -no weird population or morhphology
only hypocellularity

B12 and other fatigue screen fine
LFT fine