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Haematology > Pancytopenia and Bone Marrow Failure > Flashcards

Pancytopenia and Bone Marrow Failure Flashcards

1
Q

What is pancytopenia?

A

This is a reduction in all major cell lines: red cells, white cells and platelets

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2
Q

What are causes of pancytopenia?

A
  • Aplastic anaemia
  • Infiltration
  • Acute leukaemia
  • Myelodysplasia
  • Myeloma
  • Lymphoma
  • Disseminated TB
  • Megaloblastic leukaemia
  • Hypersplenism
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3
Q

What are primary causes of aplastic anaemia?

A
  • Fanconi’s anaemia
  • Idiopathic
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4
Q

What are secondary causes of aplastic anaemia?

A
  • Chemicals
  • Drugs - chemo, antibiotics
  • Insecticides
  • Ionising radiation
  • Infections - HIV, EBV, TB, hepatitis
  • Pregnancy
  • Paroxysmal nocturnal haemoglobinuria
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5
Q

What is aplastic anaemia?

A

Defined as pancytopenia with hypocellularity (aplasia) of the bone marrow; there are no leukaemic, cancerous or other abnormal cells in the peripheral blood or bone marrow. It is usually an acquired condition but may rarely be inherited.

Caused a reduction in the number of pluripotential stem cells together with a fault in those remaining or an immune reaction against them so that they are unable to repopulate the bone marrow. Failure of only one cell line may also occur, resulting in isolated deficiencies such as the absence of red cell precursors in pure red cell aplasia.

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6
Q

How does aplastic anaemia present?

A
  • Anaemia
  • Infection
  • Bleeding
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7
Q

What investigations would you perform if you suspected aplastic anaemia?

A
  • Bloods - FBC
  • Blood Film
  • Bone marrow biopsy
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8
Q

What might you see on bone marrow biopsy in someone with aplastic anaemia?

A

A hypocellular or aplastic bone marrow with increased fat spaces

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9
Q

What would you see on FBC in someone with aplastic anaemia?

A

Pancytopenia

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10
Q

How would you manage someone with aplastic anaemia?

A
  • Supportive management
  • Bone marrow transplant
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11
Q

What is agranulocytosis?

A

Production of granulocytes has stopped (neutrophils, basophils, eosinophils), leaving the individual at risk of severe infection.

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12
Q

What can cause agranulocytosis?

A

Drugs - carbimazole, clozapine, sulfonamides

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13
Q

What is the normal lifespan of a platelet?

A

8 days

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14
Q

What is the average lifespan of neutrophils?

A

1-2 days

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15
Q

What are the most immediate problems in bone marrow failure?

A
  • Thrombocytopenia
  • Neutropenia
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16
Q

At what platelet concentration can traumatic bleeding/bruising occur?

A

<50x109/L

17
Q

At what platelet concentration can spontaneous bleeding occur?

A

<20x109/L

18
Q

What are indications for platelet transfusion?

A
  • <10x109/L
  • Haemorrhage
  • Before invasive procedures

Haematology (34 decks)

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