Leukopenia Flashcards
What is the first thing to do when presented with a patient who has leukopenia?
Figure out if it is neutropenia, lymphopenia, or monocytopenia
5 common causes of low neutrophil count
Autoimmune disorders, infections, nutritional deficiencies, mediations and hematologic neoplasias.
What is the strongest evidence of causality with cytopenia that we need to always look for?
Starting a new medication
Two infections and 1 autoimmune disorder that can cause low neutrophil counts?
HIV, hepatitis, lupus
6 antibiotics that can cause low neutrophil counts?
Cephalosporins, clindamycin, gentamicin, sulfonamides, tetracyclines, and vancomycin
What 5 infections can cause splenic sequestration and marrow invasion with suppression?
TB, brucellosis, typhoid fever, malaria and kala azar.
A CBC revealing cytopenia of one or more blood cell types should suggest what?
Hyerplenism
What 4 things characterize hypersplenism?
Splenomegaly, cytopenia (s), normal or hyperplastic bone marrow, and response to taking out the spleen.
What actually causes the cytopenia in hyersplenism?
Increased destruction secondary to reduced blood flow through the spleen because of congestion.
What can the morphology of the RBCs be in hypersplenism?
Spherocytosis
How do we define lymphopenia and what are three things are we looking for on physical exam that would lead us down the road of lymphopenia?
Less than 1500 cells
Splenomegaly, adenopathy, evidence of fungal infections, particularly oral candiasis
What infection must be excluded in the lymphopenic patient and what is the most common iatrogenic cause of lymphopenia?
HIV
Glucocorticoids
What is the most notable condition to exclude when a patient has monocytopenia and what are 3 clinical signs/symptoms?
Hairy cell leukemia
Constitutional symptoms, splenomegaly and monocytopenia/neutrophil low as well.
Two cell markers for hairy cell leukemia?
CD11c and CD103
What patient population to think of with lymphopenia?
Alcoholics
