14152483
Descripción
Fichas por Averil Tam, actualizado hace más de 1 año
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Creado por Averil Tam
hace más de 6 años
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| Pregunta | Respuesta |
| 1. YES/NO: The following is concerning and requires further Ix/review: A) 4 month old girl with a neutrophil count of 0.9 x 10^9/L | No, within normal limits |
| 1. YES/NO: The following is concerning and requires further Ix/review: B) 2 year old boy with recurrent otitis media and a neutrophil count varying between 0.2–1.0 x 10^9/L | Yes, may have autoimmune neutropaenia or cyclic neutropaenia |
| 1. YES/NO: The following is concerning and requires further Ix/review: C) 10 year old girl from Sudan with a neutrophil count of 1.0 x 10^9/L | No, consistent with benign ethnic neutropaenia |
| 1. YES/NO: The following is concerning and requires further Ix/review: D) 15 year old boy with neutrophil count of 0.6 x 10^9/L after rituximab for renal disease | Yes, may be late onset drug induced neutropaenia |
| 2. 11 month old twins, previously well and thriving. 6 weeks of recurrent skin infections now growing pseudomonas. Apart from the skin lesions, exam normal. Both neutropenic (0.1 x 10^9/L). Bone marrow examination: normocellularity with increased myeloid activity with a left-shift and with reduction in mature forms; small amount of neutrophil phagocytosis; normal erythroid and megakaryocytic activity, no evidence of leukaemia. Most likely Dx: A. Severe congenital neutropenia B. Alloimmune neutropenia C. Autoimmune neutropenia of infancy D. Hypersplenism | C, most likely diagnosis is autoimmune neutropenia. The bone marrow findings of good myelopoiesis are against a diagnosis of SCN. Too old to have alloimmune neutropenia (usually resolves by 3-4 months). BM findings are typical of autoimmune neutropenia (including neutrophil phagocytosis). No evidence of splenomegaly to support hypersplenism. |
| 3. Which of the following features is most consistent with a diagnosis of ITP A) Absence of dysmorphic features B) Elevated MCV for age C) History of easy bruising since infancy D) Reduced Hb for age E) Presence of hepatosplenomegaly | A, all the rest are wrong. Since ITP is a diagnosis of exclusion the presence of any of these features suggest alternative diagnoses that must be looked for. |
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