Blood cells and clinical values

Question 1

list some causes of neutropenia

Answer 1

• aplastic anaemia
• immunosuppression
• *chemo
• HIV
• bone marrow infiltration
• neoplastic disease
• infections

Question 2

define neutropenic sepsis - management?

Answer 2

T > 38.5 or 2x >38 an hr apart, plus neutrophils <0.5 + hypotension.

Rx - sepsis 6 with tazocin + fluid challenge + G-CSF (SC injection, stimulates neutrophil production)

Question 3

Give 3 causes of neutrophilia.

Answer 3

1. Infection.
2. Inflammation.
3. CML.
4. Cancer.

Question 4

What is lymphocytosis?

Answer 4

Too many lymphocytes.

Question 5

Give 3 causes of lymphocytosis.

Answer 5

1. Viral infections.
2. Inflammation.
3. Malignancy.
4. CLL.

Question 6

What is thrombocytosis?

Answer 6

Too many platelets.

Question 7

What is neutropenia?

Answer 7

Not enough neutrophils.

Question 8

What is the major risk associated with being neutropenic?

Answer 8

Susceptible to infection.

Question 9

Give 3 causes of neutropenia.

Answer 9

1. Marrow failure.
2. Marrow infiltration.
3. Marrow toxicity.

Question 10

What is the definition of febrile neutropenia.

Answer 10

Temperature >38°C in a patient with neutrophil count <1x10^9/L.

Question 11

Give 4 risk factors for febrile neutropenia.

Answer 11

1. If the patient had chemotherapy <6 weeks ago.
2. Any patient who has had a stem cell transplant <1 year ago.
3. Any haematological condition causing neutropenia.
4. Bone marrow infiltration.

Question 12

What is the presentation of febrile neutropenia?

Answer 12

1. Pyrexia, 38°C.
2. Generally unwell.
3. Confusion.
4. Hypotensive.
5. Tachycardic.

Question 13

Describe the management of febrile neutropenia.

Answer 13

1. Thorough history and examination.
2. Bloods.
3. Antibiotics within 1 hour!