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10 Cards in this Set
- Front
- Back
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descr
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BM failure due to
aplastic process( failure of stem cells to undergo differentiation) 2 myelophthisic process- destr of BM environment by invaders or inflamattory tissues) may be isolated deficiency( pure red cell aplasia-- PRSA) agranulocytosis thrombocytopenia |
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how does BM look
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empty without precursor cells
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etiology
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radiation toxins-- bensen and alcohol
drugs- chloramphenicol and alkylating agents sulpha drugs carbamasepine chemotherapy infection- HIV CMV EBV TB PV 19 in immunocmpromised cr infiltration SLE PNH B12 and folate def thyroid inhibiting medications such as propylthiouracil and methimazole |
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clinical
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fatique of anemia
infect from lo WBC bleeding from low platelets |
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how to confirm
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exclude all caused pancytopenia
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most accurate test
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BM biopsy
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immunology
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autoi im disorder in wish T cells attack the patient own marrow, tx is based on medication like cyclosporine that inhibit T cells
this could bring the marrow back to life |
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ds
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pancytopenia
bone marrow biopsy ham test or sucrose ( rule out PNH) serum immunoglobulins( hypoglobulinemia) CT chest( thymoms) rule out leukemia myelofibrosis myelodysplasia |
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febrile neuropenia-
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febrile neuropenia- medical emergency
T > 38.3C( 101.3F) or sustained T > 38(100.4) for more than 1 hour in patients after chemo admit, blood culture and start empiric Ab that will cover gram negative00 Pseudomonas especially cefrixidime cefepine( 4 generation) they are covering pseudo. enterococc and others |
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tx
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Bm transplant
antilymphotic globulin high doses of steroid immunosupressive therapy anderogenes read cell and platelet transfusion |
