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Aplastic Anemia and Bone Marrow Failure Syndromes with Pancytopenia

Fanconi Anemia
Acquired Aplastic Anemia
Dyskeratosis Congenita & Telemore Biology
Aplastic Anemia ... Marrow Failure Syndromes ... Acquired Aplastic ... #Pancytopenia #Syndromes ... #Hematology
Causes of Neutropenia with Pancytopenia - Differential Diagnosis Algorithm
Sequestration:
 • Splenomegaly
Marrow Infiltration:
 • Hematologic and non-hematologic
Infiltration: • Hematologic ... and non-hematologic ... • Toxins • Aplastic ... Anemia • Myelodysplasia ... deficiency: • B12
Aplastic Anemia - Illness Script
Signs and symptoms:
 • Recurrent infections from neutropenia
 • Mucosal bleeding from
Aplastic Anemia ... Illness Script Signs ... Treatment: • Consider ... #management #treatment ... #hematology
Aplastic Anemia - Overview

Who?
• M = F
• 3 peaks:	1) Childhood	2) 15-25 years	3) >60 years

What?
• Aplastic anemia
Aplastic Anemia ... • Aplastic anemia ... - Parvovirus B19 ... anemia Treatment ... #hematology #diagnosis
Causes of Thrombocytopenia - Differential Diagnosis Algorithm
 
Decreased Megakaryopoiesis
 • Aplastic Anemia
 • Toxic Damage (e.g.
Megakaryopoiesis • Aplastic ... Anemia • Toxic ... Megakaryopoiesis • B12 ... Non-lmmune: • HELLP Syndrome ... Algorithm #Causes #Hematology
Algorithmic Approach to Anemia - Differential Diagnosis Framework by MCV

Microcytic (MCV < 80) "TAILS":
 • Thalassemia
Algorithmic Approach to Anemia ... Non-hemolytic: ACD, Aplastic ... anemia, CKD • ... Folate deficiency, B12 ... Differential #Diagnosis #hematology
Overall Approach to Anemia - Differential Diagnosis Algorithm

Blood Loss
 • Acute Bleed - Normocytic / Normochromic
Overall Approach to Anemia ... Deficiency • B12 ... Deficiency • Aplastic ... AnemiaAnemia ... Algorithm #Causes #Hematology
Myelodysplastic Syndrome (MD) - Diagnosis and Management Summary
myelo (marrow) -dys- (abnormal) -plastic (shape) = funny-shaped cells
Myelodysplastic Syndrome ... dys- (abnormal) -plastic ... cytopenias (usually anemia ... only curative treatment ... #hematology #oncology
Clinically Important Vitamins and Vitamin Deficiency States
Fat-soluble Vitamins: 
 • Vitamin A - Xerophthalmia, night blindness,
• Thiamine B1 ... Wernicke-Korsakoff syndrome ... • Riboflavin B2 ... gestation • Vitamin B12 ... differential #diagnosis #signs
Reticulocyte Production Index = (Retic %) x (Hct / 45) / Maturation Factor
The maturation factor is
Index < 2: • Anemia ... loss), Vitamin B12 ... marrow failure: Aplastic ... anemia, Marrow ... Production #Index #hematology