A 52-year-old female data entry worker complained of bilateral wrist pain. Her physician prescribed a non-steroidal anti-inflammatory drug. Her wrist pain improved; however, over the next 3 months, she noted increasing fatigue and scattered bruises. Past medical history was norm She was taking no other medications and had no recent chemical exposure. Physical examination revealed pallor and scattered ecchymoses (skin coloration) with petechiae on her chest and shoulders with no other abnormalities.

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A 52-year-old female data entry worker complained of bilateral wrist
pain. Her physician prescribed a non-steroidal anti-inflammatory drug.
Her wrist pain improved; however, over the next 3 months, she noted
increasing fatigue and scattered bruises. Past medical history was normal.
She was taking no other medications and had no recent chemical
exposure.
Physical examination revealed pallor and scattered ecchymoses (skin
coloration) with petechiae on her chest and shoulders with no other
abnormalities.
Complete blood count results were as follows:
WBC
2 X10/L
MCV
104FL
8 g/dl
27 X10/L
Hb
Platelets
Reticulocytes
Reticulocytes
Neutrophils
Lymphocytes
Serum B12 and folate levels were normal
0.6%
16 X 10/L
1.1 X 10/1
0.4 X 10/L
Bone marrow aspirate was normocellular with dyserthropoiesis but,
normal myelopoiesis and Megakaryopoiesis. Iron stain shows normal
stores. However, the bone marrow biopsy was moderately Hypocellular
(30%) with a reduction in all three-cell lines. There are no increases in
Reticulin.
Cytogenetic testing shows a normal karyotype and results of flow
cytometry for PNH cells was negative.
1- What term is used to describe a decrease in all cell lines in the
peripheral blood?
2- Which anemia of bone marrow failure should be considered
(Hereditary/ Acquired)? Why you choose this type?
3- In which other diseases would an increase in either Reticulin and
blasts will be noticed?
4- How would the severity of this patient's condition be classified
(Server/ non-severe)? Why?
5- What treatment modality would be considered for this patient?
Transcribed Image Text:A 52-year-old female data entry worker complained of bilateral wrist pain. Her physician prescribed a non-steroidal anti-inflammatory drug. Her wrist pain improved; however, over the next 3 months, she noted increasing fatigue and scattered bruises. Past medical history was normal. She was taking no other medications and had no recent chemical exposure. Physical examination revealed pallor and scattered ecchymoses (skin coloration) with petechiae on her chest and shoulders with no other abnormalities. Complete blood count results were as follows: WBC 2 X10/L MCV 104FL 8 g/dl 27 X10/L Hb Platelets Reticulocytes Reticulocytes Neutrophils Lymphocytes Serum B12 and folate levels were normal 0.6% 16 X 10/L 1.1 X 10/1 0.4 X 10/L Bone marrow aspirate was normocellular with dyserthropoiesis but, normal myelopoiesis and Megakaryopoiesis. Iron stain shows normal stores. However, the bone marrow biopsy was moderately Hypocellular (30%) with a reduction in all three-cell lines. There are no increases in Reticulin. Cytogenetic testing shows a normal karyotype and results of flow cytometry for PNH cells was negative. 1- What term is used to describe a decrease in all cell lines in the peripheral blood? 2- Which anemia of bone marrow failure should be considered (Hereditary/ Acquired)? Why you choose this type? 3- In which other diseases would an increase in either Reticulin and blasts will be noticed? 4- How would the severity of this patient's condition be classified (Server/ non-severe)? Why? 5- What treatment modality would be considered for this patient?
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