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Flashcards in Other Deck (10)
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1

What is the definition of aplastic anemia?

Peripheral blood showing Hb < 100g/L, platelets < 50,000 and granulocytes < 1.5, with a bone marrow showing decreasing cellularity in the absence of malignant
infiltration or fibrosis

2

What is the definition of severe aplastic anemia?

Peripheral blood criteria (2/3):
- ANC < 0.5
- Retics < 40
- Platelet < 20,000
Bone marrow criteria (1/2)
- Cellularity < 25%
- Cellularity 25-50% and < 30% hematopoietic cells

3

What is the first line therapy for idiopathic SAA?

HSCT if matched sibling donor available;
Immunosuppressive therapy if no matched sibling donor available

4

What constitutes immunosuppressive therapy for SAA?

- Cyclosporine 12 mg/kg/d
- ATG (equine) daily * 4 days; rabbit can be used in 2nd course to reduce risk of sensitization
- Prednisone, to avoid serum sickness; 2 mg/kg/d * 1 week with tapering over 3 weeks

5

What is the clinical presentation of serum sickness following ATG (7 symptoms)?

1-2 weeks following ATG
- Fever
- Malaise
- Cutaneous eruptions (mostly urticaria)
- Arthritis/arthralgias
- GI Sx: No/Vo/Do
- Headaches, blurred vision
- Dyspnea, wheezing

6

What is the treatment of serum sickness following ATG?

Prednisone 1 mg/kg/dose q 12h
Diphenhydramine
Clinical revory usually takes 1-4 weeks

7

What is the treatment of congenital methemoglobinemia?

Ascorbic acid or methylene blue; only given for cosmetic reasons as patients are usually not or mildly symptomatic

8

What is the treatment of acquired (acute) methemoglobinemia?

**MEDICAL EMERGENCY
- Stop offending agent
- Methylene blue; usually decrease levels in 1-6 h
- For severe cases: transfusion (simple or exchange), hyperbaric chamber

9

Name 5 symptoms of acute methemoglobinemia?

- Headache
- Lightheadness
- Tachycardia
- Dyspnea
- Alteration of consciousness, seizures
- Can lead to death

10

Which infections are associated with splenomegaly?

- Viral infections: EBV, CMV, HIV
- Bacterial endocarditis
- Malaria, i.e. tropical splenomegaly
- Leishmaniasis
- Toxoplasmosis