The causes of neutropenia include? (a) Metastatic cancer and lymphoma (b) Cyanotic spell and lymphoma (c) Hypersplenism and chemotherapy (d) Infectious hepatitis and radiation therapy

Appeared in: AIIMS Raipur NO - 2017 (Shift-1)

Explanation

The correct option correctly identifies that metastatic cancer, lymphoma, hypersplenism, chemotherapy, infectious hepatitis, and radiation therapy are all causes of neutropenia.
Metastatic cancer and lymphoma can infiltrate the bone marrow, displacing normal hematopoietic tissue and reducing neutrophil production.
Hypersplenism leads to increased sequestration and destruction of neutrophils in the spleen.
Chemotherapy and radiation therapy are common iatrogenic causes, as they are cytotoxic to rapidly dividing cells in the bone marrow, including neutrophil precursors.
Infections such as viral hepatitis can cause neutropenia through direct bone marrow suppression.

Option A: This option is incorrect because it includes statement (b).
Option B: This option is incorrect because it includes statement (b) and omits the correct statement (a).
Option C: This option is incorrect because it includes statement (b) and omits the correct statement (c).

Visual 1: Flowchart: Categorization of Neutropenia Causes. This visual would branch into three main categories: 1) Decreased Production, 2) Increased Destruction, and 3) Sequestration, with specific examples like chemotherapy, autoimmune disorders, and hypersplenism listed under each.

Clinical Relevance

Nursing practice connection: Knowing Etiology of Neutropenia helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Neutropenia is a critical finding as it places patients at a high risk for severe, life-threatening infections. Fever in a neutropenic patient is considered a medical emergency.
Nurses must implement 'neutropenic precautions' for these patients, which include strict hand hygiene, placing the patient in a private room, avoiding fresh flowers or raw foods, and limiting visitors who are ill.
What if? If a patient on chemotherapy develops a fever of 38.3°C (101°F), the nurse's priority action is to notify the physician immediately and prepare for blood cultures and administration of broad-spectrum antibiotics, even before the infection is confirmed, as delays can lead to sepsis.

How to Approach the Question

First, understand the core concept: Neutropenia is a decrease in neutrophils.
Evaluate each statement (a, b, c, d) individually to determine if the conditions listed are known causes of neutropenia.
Recall or deduce the pathophysiology. For example, chemotherapy and radiation target rapidly dividing cells, including bone marrow cells, leading to decreased production.
Identify the incorrect statement. In this case, 'cyanotic spell' is not a cause; it's associated with hypoxia, which can cause polycythemia.
Eliminate all options that include the incorrect statement (b).
Select the option that contains all the correct statements (a, c, and d).

Concept Tested & Keywords

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Practise the full AIIMS Raipur NO - 2017 (Shift-1)

Attempt every question from this paper in a timed mock, then review the full solution for each one.