Pallor Presentation Case Flashcards
What chemical is used in the manufacturing of products?
benzene
What should you first determine when taking hx?
degree of illness
ROS for a pallor case should be directed towards what?
looking for systemic disorders (chronic renal disease, hypothyroidism, rheumatologic disorders)
(T/F) Family hx of splenomegaly, splenectomy, or early cholecystectomy may point to a hemolytic disorder
TRUE
What should you see in the HEENT exam for a pallor case?
+ conjunctival pallor
lack of red color in palmar creases are associated with?
a hemoglobin value less than 7 gms/dL
If an unusual large and firm spleen is found w/o any scleral icterus, then what’s going on with the RBCs?
They’re being sequestered
Pathogenesis of pallor?
decreased hemoglobin concentration or distribution of blood away from the body’s surface
In a pt w/ pallor, what would the CBC differential show?
normochromic, normocytic anemia, granulocytopenia, thrombocytopenia
What would occur to the reticulocyte count in a pt w/ pallor?
Low (0.4%)
Which 2 diagnostic tests are the first steps to determine if pallor is due to a hematological abnormality?
CBC w/ differential and reticulocyte count
Equation for ANC?
ANC= WBC count x % of PMNs+bands
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?
aplastic anemia
In aplastic anemia, there is a deficiency in what?
hematopoietic stem cells
(T/F) Direct damage can be caused by drugs such as chloramphenicol
TRUE
Clinical manifestations for aplastic anemia:
- fatigue
- pallor
- recurrent infections
- unexplained or easy bruising
What would you see on a peripheral blood smear for a pt with aplastic anemia?
normocytic RBCs
What is required to establish the diagnosis for aplastic anemia?
bone marrow aspiration and biopsy; should see empty, fatty marrow
For someone under 20 y/o, what would be the preferred tx?
hematopoietic cell transplantation (HCT)/bone marrow transplant
For someone over 50 y/o, what would be the preferred tx?
immunosuppressive therapy (IST)
Which medication can you give to stimulate platelet production in order to tx aplastic anemia?
Eltrombopag
Marrow transplantation is curative for ___ of pts younger than 20 y/o
80-90%
Marrow transplantation is curative for ___ of pts b/w 2-40 y/o
70%
Marrow transplantation is curative for ___ of pts older than 40 y/o
50%
A reticulocyte percentage of less than 1% is indicative of?
aplastic erythropoiesis
