bone marrow failure syndrome Flashcards

1
Q

what is bone marrow failure ?

A

a reduction in the number of circulating blood cells - pancytopenia , which requires bone marrow examination

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2
Q

what would cause a hypocellular marrow ?

A

aplastic anemia
cytotoxic therapy

cytotoxic therapy

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3
Q

what would cause hypercellular bone marrow ?

A

myelodysplasia
haematological malignancies
secondary cancers

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4
Q

where is the best place to see signs of anemia ?

A

mucous membranes

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5
Q

what are the clinical problems associated with bone marrow failure ?

A

anemia
leucopenia
thrombocytopenia

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6
Q

what infections of the skin may be associated with bone marrow failure patients ?

A

at the site of IV cannula usually due to staph aureus or staph epidermidis

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7
Q

what is the protocol for management in neutropenia/leucopenia ?

A

administration of broad spectrum antibiotics after cultures
non absorbable anti fungals
give prophylactic acyclovir

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8
Q

what are some signs of thrombocytopenia bleeding ?

A

mucosal bleeding
purpura
retinal haemorrhages

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9
Q

what is the management in cases of thrombocytopenia ?

A

in absence of bleeding , prophylactic platelet transfusion

anti-HLA antibodies may develop so HLA matched platelets may be required

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10
Q

how to distinguish purpura ?

A

they dont blanch on pressure

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11
Q

in aplastic anemia what does the BM look like ?

A

hypocellular

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12
Q

what are the causes of aplastic anemia ?

A

congenital fanconi’s anemia

can be acquired such as with autoimmune or acquired aplastic anemia

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13
Q

what are the two major initial presentation of fanconi’s anemia ?

A

anemia
birth defects

birth defects

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14
Q

what are some of the congenital defects in fanconis anemia ?

A

radial ray defects
renal and urinary tract defects
skeletal defects

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15
Q

what do chromosomal breakages predispose the patient to ?

A

developing secondary leukemias

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16
Q

what is the management of aplastic anemia ?

A

remove the cause
supportive measures

supportive (RBC, platelets, antibiotics)

17
Q

if the aplastic anemia is congenital what is the next step in management ?

A

bone marrow transplantation and supportive therapy

18
Q

if the cause of the aplastic anemia is autoimmune what is the next step in management ?

A

anti-thomocyte globulin
along with immunosuppresants (cyclosporine)

other immunosuppressants such as cyclosporine

19
Q

myelodysplastic syndromes ?

A

cytopenia with a hypercellular bone marrow

20
Q

what can these myelodysplastic syndrome transform into ?

A

acute myeloid leukemia

21
Q

what does the prognosis of myelodysplastic syndromes depend on ?

A

depends on :
number of cytopenia in the blood
number of blasts in the marrow
cytogenetic and chromosomal abnormalities

22
Q

what is the managment for myelodysplastic syndromes ?

A

supportive treatment
cytotoxic chemotherapy
demethylating therapy (azacitidine)
allogenic stem cell transplantation

23
Q

what are myelomas commonly preceded by ?

A

monoclonal gammopathy of undetermined significance