NBME Bone marrow question

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NBME Bone marrow question

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DrVirgo
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05/13/06 - 01:48 PM

I hope you all can see the picture and question. smiling face

I'm confused between aplastic anemia and myelofibrosis?
The bone marrow looks empty, and all cell lines are decreased, so aplastic anemia?
But then it looks like fibrosis occuring in the marrow... so myelofibrosis?

How can we differentiate? Or is the answer something else?

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BoneMarrowQuestion.jpg (38 KB, 127 downloads)

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robin082006
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05/13/06 - 02:53 PM

symptoms are classic of Aplastic anemia

In myelofibrosis, there is extramedullary hematopoiesis (splenomegaly)

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vallia
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05/13/06 - 03:13 PM

this is a classic aspect of aplastic anemia.

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DrVirgo
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05/13/06 - 07:45 PM

ok. What is the red structure in the picture?

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vallia
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05/14/06 - 07:12 AM

this is portion from bone trabeculae.

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DrVirgo
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05/14/06 - 01:57 PM

Ok, thanks. smiling face

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vallia
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05/14/06 - 02:14 PM

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vallia
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05/14/06 - 02:15 PM

this is myelofibrosis, it's very rare in children

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05/18/06 - 06:21 AM

vallia, you went from saying:

vallia wrote:
this is a classic aspect of aplastic anemia.

to:

vallia wrote:
this is myelofibrosis, it's very rare in children

i think it's aplastic anemia...is there a reason why you chose myelofibrosis?

DrVirgo
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05/20/06 - 07:02 PM

#10

The answer to MY question is aplastic anemia.

The slide the VALIA put is myelofibrosis. (I think thats what valia was trying to say).

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docarchana
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09/01/06 - 05:06 PM

#11

u got it right Drvirgo..

fongch
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10/23/06 - 07:24 PM

#12

I vote for myelofibrosis - despite that RBC and WBC counts are both low, the platelet count seems to be OK - if this is aplastic anemia, it should also be low. Also, if I remember correctly, myelofibrosis is caused by expansion of megakaryocyte.
Correct me if I am wrong.

ManuNastai

10/25/06 - 07:20 AM

#13

it's aplastic anemia

@ fongh:

the plattelet number is 12.000/mm3 that's a lot less than 150.000/mm3 which is considered the inferior limit of normal..

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