Flashcards in Other Deck (10)
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
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
What is the first line therapy for idiopathic SAA?
HSCT if matched sibling donor available;
Immunosuppressive therapy if no matched sibling donor available
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
What is the clinical presentation of serum sickness following ATG (7 symptoms)?
1-2 weeks following ATG
- Cutaneous eruptions (mostly urticaria)
- GI Sx: No/Vo/Do
- Headaches, blurred vision
- Dyspnea, wheezing
What is the treatment of serum sickness following ATG?
Prednisone 1 mg/kg/dose q 12h
Clinical revory usually takes 1-4 weeks
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
What is the treatment of acquired (acute) methemoglobinemia?
- Stop offending agent
- Methylene blue; usually decrease levels in 1-6 h
- For severe cases: transfusion (simple or exchange), hyperbaric chamber
Name 5 symptoms of acute methemoglobinemia?
- Alteration of consciousness, seizures
- Can lead to death