Pallor Presentation Case

Question 1

What chemical is used in the manufacturing of products?

Answer 1

benzene

Question 2

What should you first determine when taking hx?

Answer 2

degree of illness

Question 3

ROS for a pallor case should be directed towards what?

Answer 3

looking for systemic disorders (chronic renal disease, hypothyroidism, rheumatologic disorders)

Question 4

(T/F) Family hx of splenomegaly, splenectomy, or early cholecystectomy may point to a hemolytic disorder

Answer 4

TRUE

Question 5

What should you see in the HEENT exam for a pallor case?

Answer 5

+ conjunctival pallor

Question 6

lack of red color in palmar creases are associated with?

Answer 6

a hemoglobin value less than 7 gms/dL

Question 7

If an unusual large and firm spleen is found w/o any scleral icterus, then what’s going on with the RBCs?

Answer 7

They’re being sequestered

Question 8

Pathogenesis of pallor?

Answer 8

decreased hemoglobin concentration or distribution of blood away from the body’s surface

Question 9

In a pt w/ pallor, what would the CBC differential show?

Answer 9

normochromic, normocytic anemia, granulocytopenia, thrombocytopenia

Question 10

What would occur to the reticulocyte count in a pt w/ pallor?

Answer 10

Low (0.4%)

Question 11

Which 2 diagnostic tests are the first steps to determine if pallor is due to a hematological abnormality?

Answer 11

CBC w/ differential and reticulocyte count

Question 12

Equation for ANC?

Answer 12

ANC= WBC count x % of PMNs+bands

Question 13

What disease is a life-threatening form of bone marrow failure and is associated with pancytopenia in association w/ BM hypoplasia or aplasia & fatty replacement?

Answer 13

aplastic anemia

Question 14

In aplastic anemia, there is a deficiency in what?

Answer 14

hematopoietic stem cells

Question 15

(T/F) Direct damage can be caused by drugs such as chloramphenicol

Answer 15

TRUE

Question 16

Clinical manifestations for aplastic anemia:

Answer 16

• fatigue
• pallor
• recurrent infections
• unexplained or easy bruising

Question 17

What would you see on a peripheral blood smear for a pt with aplastic anemia?

Answer 17

normocytic RBCs

Question 18

What is required to establish the diagnosis for aplastic anemia?

Answer 18

bone marrow aspiration and biopsy; should see empty, fatty marrow

Question 19

For someone under 20 y/o, what would be the preferred tx?

Answer 19

hematopoietic cell transplantation (HCT)/bone marrow transplant

Question 20

For someone over 50 y/o, what would be the preferred tx?

Answer 20

immunosuppressive therapy (IST)

Question 21

Which medication can you give to stimulate platelet production in order to tx aplastic anemia?

Answer 21

Eltrombopag

Question 22

Marrow transplantation is curative for ___ of pts younger than 20 y/o

Answer 22

80-90%

Question 23

Marrow transplantation is curative for ___ of pts b/w 2-40 y/o

Answer 23

70%

Question 24

Marrow transplantation is curative for ___ of pts older than 40 y/o

Answer 24

50%

Question 25

A reticulocyte percentage of less than 1% is indicative of?

Answer 25

aplastic erythropoiesis