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CASE  MANAGEMENT  Group 1
GENERAL DATA ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
HISTORY OF PRESENT ILLNESS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HPI..cont ,[object Object],[object Object],[object Object]
Past Medical History  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Family History ,[object Object],[object Object],[object Object]
Social, Personal, and Environmental History   ,[object Object],[object Object],[object Object],[object Object]
Review of system ,[object Object],[object Object],[object Object],[object Object]
PHYSICAL EXAMINATION   ,[object Object],[object Object],[object Object]
Vital signs ,[object Object],[object Object],[object Object],[object Object]
Laboratory test
Hematology : Parameter  Result  Normal value  ,[object Object],2.9 4-10 x 10 9 /L SEGMENTERS 0.39 0.40-0.80 LYMPHOCYTES 0.16 0.20-0.40 MONOCYTES 0.04 0.04-0.10 EOSINOPHILS 0.01 0.02-0.06 ,[object Object],0.51 4-6x10 12 /L HEMOGLOBIN 21 140-180g/L HEMATOCRIT 0.06 0.40-0.54 ,[object Object],78 150-450 x 10 9 /L
Blood chem Result  Normal value  Urea nitrogen 4.8 mmol/L 2.2-8.2mmol/L Creatinin 1.9 5-17 Phos  Alk 32.8 10-35 SGPT  50.9 5-47
HBsAg screening  ,[object Object]
What are you impression?
APLASTIC ANEMIA
DIFFERENTIAL  DIAGNOSIS ,[object Object],[object Object],[object Object],[object Object]
APLASTIC  ANEMIA What happens when the bone marrow shuts down?
What is  Aplastic Anemia ? - Aplastic Anemia is a bone marrow failure disease .
APLASTIC ANEMIA ,[object Object],[object Object]
Peripheral blood  Smear  Peripheral  blood  Smear
HYPOCELLULAR  BONE MARROW IN APLASTIC ANEMIA
Aplastic Anemia  patients ,[object Object],[object Object],[object Object]
Functions of Blood Cells ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Manifestations  Symptoms caused by  suppression of any or all bone marrow elements ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PATHOGENESIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathophysiology  of aplastic anemia
Epidemiology ,[object Object],[object Object],[object Object]
Etiology  : Hereditary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Etiology:  Acquired ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Etiology:  Acquired  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
Clinical manifestations of  PNH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical manifestations of  PNH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis  of AA:  Lab findings Peripheral blood Smear  Bone marrow biopsy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CLASSIFICATION Designation Criteria PBS BM biopsy Severe aplastic anemia ,[object Object],[object Object],[object Object],[object Object],-Marked hypocellular < 25% cellularity -Moderate hypocellular <25-50%  -normal cellularity with <30% of remaining cell hematopoietic  Very severe aplastic anemia As above but neutrophils < 200/ ๏ญ L Infection present
Presentation of Anemia, Neutropenia and Thrombocytopenia Hemorrhagic lesion of the gums in a patient with aplastic anemia caused by infection with  Capnocytophaga ochraceus;  such lesions are easily confused with those of herpes simplex.
26-year-old woman with acute aplastic anemia and 1 day of facial pain/swelling. Mouth open involuntarily due to perioral edema. Needle aspirate of small purplish area near right alar revealed  P. aeruginosa.
Aplastic anemia. Oral leukoplakia in dyskeratosis congenita.
Treatment Options Bone Marrow  Transplant Growth Hormones Immune Suppressive Therapy Supportive Care
TREATMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
4.SPLENECTOMY ,[object Object],[object Object],[object Object],[object Object],[object Object]
5.Immunosuppression ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Outcomes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
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Editor's Notes

  1. Aplastic anemia