Pancytopenia Flashcards

1
Q

What is pancytopenia

A

A deficiency of blood cells of all lineages

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2
Q

Name one inherited cause of pancytopenia

A

Fanconi anaemia

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3
Q

Primary acquired causes of pancytopenia

A

Idiopathic aplastic anaemia
Myelodysplastic syndromes
Acute leukaemia

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4
Q

Secondary acquired causes of pancytopenia

A

Drug induced aplasia
Vitamin deficiency (B12/folate)
Infections
Metastatic cancer
Storage disorders

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5
Q

What are the 2 main mechanisms that cause pancytopenia

A

Reduced production
Increased destruction / sequestration

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6
Q

What causes increased destruction of cells in pancytopenia

A

Hypersplenism

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7
Q

What causes reduced production of cells in pancytopenia

A

Bone marrow failure

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8
Q

Why does fanconis anaemia cause pancytopenia

A

Patients are unable to correct inter-strand cross links (DNA damage)

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9
Q

Why does idiopathic aplastic anaemia cause pancytopenia

A

Autoreactive T cells target haemopoiesis

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10
Q

Why do myelodysplastic syndromes cause pancytopenia

A

Increased apoptosis of progenitor and mature cells

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11
Q

What are the 3 main causes of hypersplenism

A

Splenic congestion
Systemic disease
Haematological disease

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12
Q

Name one cause of splenic congestion

A

Portal hypertension

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13
Q

Name one systemic disease that can cause hypersplenism

A

Rheumatoid arthritis

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14
Q

Name one haematological disease that can cause hypersplenism

A

Splenic lymphoma

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15
Q

General symptoms of anaemia

A

Fatigue
SOB
Cardiovascular compromise

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16
Q

General symptoms of neutropenia

A

Increased severity and duration of infections
Opportunistic infections

17
Q

Infections with what type of bacteria are the most dangerous

A

Gram negative

18
Q

Neutropenia

A

Low white cell count (neutrophils)

19
Q

Thrombocytopenia

A

Low platelet count

20
Q

General symptom of thrombocytopenia

A

Bleeding

21
Q

General investigations for pancytopenia (3)

A

FBC
blood film
Bone marrow examination

22
Q

Supportive management of pancytopenia

A

Transfusions
Antibiotic prophylaxis if needed

23
Q

What causes hypocellular marrow in pancytopenia

A

Aplastic anaemia

24
Q

What causes hypercellular marrow in pancytopenia (3)

A

Myelodysplastic syndromes
B12/folate deficiency
Hypersplenism

25
Q

What can be used to confirm aplastic anaemia

A

Bone marrow biopsy

26
Q

Inheritance seen in fanconi anaemia

A

Autosomal recessive

27
Q

What is the most common cause of aplastic anaemia

A

Radiation exposure