What is the treatment of choice for a patient older than 40 years ...

[lilldybug07]

What is the treatment of choice for a patient older than 40 years old with aplastic anemia?
 
  a. Hematopoietic stem cell transplant
  b. Antibiotic agents
  c. Antithymocyte globulin (ATG)
  d. Erythropoietin

Question 2

Which of the following is most useful for considering the diagnosis of bone marrow failure?
 
  a. A hemoglobin concentration of 11 g/dL
  b. An absolute neutrophil count of less than 0.5  103/dL
  c. A hypercellular bone marrow
  d. Abnormal platelet function tests

[ergserg]

Answer to Question 1

ANS: C
The treatment of choice for patients older than 40 years old with aplastic anemia is
ATG in combination with cyclosporine (CSA). ATG decreases the number of activated T cells, and CSA inhibits their function (thus suppressing the autoimmune suppression of stem cells when this is the cause of the aplasia).

Answer to Question 2

ANS: B
An absolute neutrophil count of less than 0.5  103/dL is found in severe aplastic anemia, although it is not specific for this. The bone marrow will be hypocellular, not hypercellular. A mild anemia of 11 g/dL is found in many different conditions, and platelet function tests are not useful in diagnosing bone marrow failure.