The symptoms of congenital aplastic anaemia include? a. Purpura b. Petechia c. Neutropenia d. Thalassemia - AIIMS Raipur - 2017 (shift-2)

AIIMS Raipur - 2017 (shift-2)

Child Health Nursing (Pediatrics)

Easy

Appeared in: AIIMS Raipur - 2017 (shift-2)

Explanation

Congenital aplastic anemia is defined by bone marrow failure, leading to pancytopenia—a deficiency of all three major blood cell lines.
A key component of pancytopenia is thrombocytopenia (low platelets), which directly causes bleeding symptoms like petechiae (pinpoint hemorrhages) and purpura (larger bruises).
Another critical component is neutropenia (low neutrophils/white blood cells), which results from the bone marrow's inability to produce immune cells, leading to a high risk of infection.
Therefore, purpura, petechiae, and neutropenia are all direct consequences and characteristic symptoms of aplastic anemia.

Option B: This option incorrectly includes Thalassemia (d). Thalassemia is a genetic disorder of hemoglobin synthesis, not a bone marrow failure syndrome like aplastic anemia.
Option C: This option incorrectly includes Thalassemia (d) and excludes Petechiae (b). Petechiae are a classic sign of the thrombocytopenia seen in aplastic anemia.
Option D: This option incorrectly includes Thalassemia (d). While a, b, and c are correct symptoms, the inclusion of 'd' makes the entire group incorrect.

Visual 1: Image - Photograph showing petechiae and purpura on a patient's skin. This helps learners visually differentiate these key signs of thrombocytopenia.
Visual 2: Diagram - A flowchart illustrating how bone marrow failure in aplastic anemia leads to pancytopenia (thrombocytopenia, neutropenia, anemia) and their resulting clinical symptoms. This connects the pathophysiology to the patient's presentation.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical manifestations of congenital aplastic anemia as background academic context rather than a clinical decision trigger.
Recognizing the triad of symptoms (bleeding, infection, anemia) is critical for nurses to suspect bone marrow failure. Early identification of petechiae, purpura, unexplained fever, or severe fatigue can lead to prompt diagnosis.
Nursing care for patients with aplastic anemia centers on managing pancytopenia: implementing bleeding precautions (e.g., no razors, soft toothbrush) for thrombocytopenia and infection precautions (neutropenic precautions, reverse isolation) for neutropenia.
What if? If a patient with known aplastic anemia develops a fever of 38°C (100.4°F), it is considered a medical emergency. The nurse's priority action is to initiate sepsis protocols, obtain blood cultures, and prepare for the administration of broad-spectrum antibiotics immediately, as neutropenia severely compromises the ability to fight infection.

How to Approach the Question

First, identify the core concept of the question: 'symptoms of congenital aplastic anaemia'.
Recall the pathophysiology of aplastic anemia: it is a failure of the bone marrow.
Connect bone marrow failure to its consequence: pancytopenia, meaning a lack of red cells, white cells, and platelets.
Analyze each listed item (a, b, c, d) to see if it results from pancytopenia.
a. Purpura (bleeding) -> caused by low platelets (thrombocytopenia). Correct.
b. Petechiae (bleeding) -> caused by low platelets (thrombocytopenia). Correct.

Concept Tested & Keywords

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