Presentation is loading. Please wait.

Presentation is loading. Please wait.

This is a 55 year old woman who has fatigue. Her only

Published byDerrick Rose Modified over 9 years ago

Similar presentations

Presentation on theme: "This is a 55 year old woman who has fatigue. Her only"— Presentation transcript:

1 This is a 55 year old woman who has fatigue. Her only
other symptom is a craving for chewing ice cubes. Apart from being pale her examination is normal. Test results Hgb g/L MCV 66f/L RBC x1012/L WBC x106/L Plat x109/L Blood film

2

3 Which one of the following tests would best define the type of anemia she has ?
A. Hgb electropheresis B. Serum iron and iron-binding capacity C. Serum ferritin D. Serum transferrin E. Bone marrow iron

4 A 44 year old executive is sent to you for an insurance
examination. He is fit, but on examination he has mild hypertension. Test results Hgb g/L MCV fL  RBC x1012/L WBC x106/L Plat x109/L Blood film

5

6 A 44 year old executive is sent to you for an insurance
examination. He is fit, but on examination he has mild hypertension. Test results Hgb g/L MCV 65 fL RBC x1012/L WBC 6.5 x106/L Plat x109/L Blood film microcytosis hypochromia target teardrop basophilic stippling

7 Which test is likely to give a diagnosis in this case ?
A. Serum ferritin B. Serum transferrin C. Sickle Cell screen D. Hgb electropheresis E. Liver function tests

8 This is an 18 year old boy who you are investigating for
Jaundice. He has this intermittently for some time. His family are Christian Scientists. Physical exam shows jaundice and splenomegaly Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L Retic count: elevated bili 35 mol/L

9

10 Which of the following would be most helpful in identifying this young man’s problem ?
A. Reticulocyte count B. Osmotic fragility test C. DAT (Coomb’s test) D. Bone marrow test E. Family studies

11 This is an 18 year old boy who you are investigating for
Jaundice. He has this intermittently for some time. His family are Christian Scientists. Physical exam shows jaundice and splenomegaly bili 35 mol/L blood film polychromasia spherocytes Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L

12 A 46 year old diplomat is referred to you because of
abnormal blood results. On review of these you suspect the cause and order appropriate blood tests. Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L Blood Film

13

14 A 46 year old diplomat is referred to you because of
abnormal blood results. On review of these you suspect the cause and order appropriate blood tests. Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L Blood Film Macrocytosis Target cells stomatocytes

15 What tests would you order on receiving these results ?
A. Serum B12 and folate B. Bone marrow aspirate C. Serum lipid studies D. Liver function tests E. Thyroid function tests

16 A 65 year old woman is referred to you because of memory
loss. Her family physician had received tests which included bilirubin of 28  mol/L and an LDH of U/L. He was puzzled by these results. Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L Retic count low

17

18 A 65 year old woman is referred to you because of memory
loss. Her family physician had received tests which included bilirubin of 28  mol/L and an LDH of U/L. He was puzzled by these results. Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L Blood Film Macrocytosis oval macroytes hypersegmented neutrophils

19 Which one of the following tests is most appropriate ?
A. Liver function B. Thyroid function C. RBC folate D. Serum B12 E. Bone marrow aspirate

20 A 65 year old woman complains of back pain. Her X-rays
show diffuse osteoporosis. She also complains of increased thirst and drowsiness. Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L Retic ‘normal’

21

22 A 65 year old woman complains of back pain. Her X-rays
show diffuse osteoporosis. She also complains of increased thirst and drowsiness. Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L Blood Film rouleaux background staining

23 Which one of these tests would most likely lead to the diagnosis ?
A. Serum osmolarity B. Serum viscosity C. Serum protein electrophersis D. Serum TSH E. Serum PTH

24 You admit a 36 year old woman with pneumonia. She has
fever, shortness of breath and requires oxygen. She is also noted to be anemic. Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L Retic count: elevated

25

26 You admit a 36 year old woman with pneumonia. She has
fever, shortness of breath and requires oxygen. She is also noted to be anemic. Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L Blood Film RBC agglutination

27 These test results would help you choose which one of these antibiotics ?
A. Cephalexin B. Penicillin G C. Azithromycin D. Sulfamethoxazole E. Ciprofloxacin

28 An 18 year old woman has symptoms of cystitis. After urine
cultures are taken she is given Sulfamethoxazole. Her urinary symptoms improve but she becomes short of breath. A week later on follow-up her investigation shows. Test results Hgb g/L MCV 107fL RBC x1012/L WBC x106/L Plat x109/L Blood Film

29

30 An 18 year old woman has symptoms of cystitis. After urine
cultures are taken she is given Sulfamethoxazole. Her urinary symptoms improve but she becomes short of breath. A week later on follow-up her investigation shows. Test results Hgb g/L MCV 107fL RBC x1012/L WBC x106/L Plat x109/L Blood Film polyychromasia blister bite cells

31 What type of anemia is causing this problem ?
A. An idiosyncratic drug reaction B. An allergic drug reaction C. Marrow suppressive effect D. Immune hemolysis E. Oxidative hemolysis

32 You are called to see this 29 year old primip in the case
room. The obstetrician is concerned about her platelet count. She is well but a bit hypertensive. Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L

33

34 You are called to see this 29 year old primip in the case
room. The obstetrician is concerned about her platelet count. She is well but a bit hypertensive. Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L Blood Film polychromasia rbc fragments thrombocytopenia

35 What diagnosis is most likely ?
A. ITP ( immune thrombocytopenia ) B. TTP ( thrombotic thrombocytopenic purpura) C. PIH (pre-eclampsia) D. Benign thrombocytopenia of pregnancy E. DIC (disseminated intravascular coagopathy)

36 This 35 year old man is sent to you because of unusual
blood results. His complaints are of fatigue and an episodic itchy rash. Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L Blood Film

37 You are asked to asses a 72 year old woman for anemia
and splenomegaly. She has been losing weight for 1 year. She has had 2 episodes of gout. Test results Hgb g/L MCV fl RBC x1012/L WBC x106/L Plat x109/L Retic: low

38

39 You are asked to asses a 72 year old woman for anemia
and splenomegaly. She has been losing weight for 1 year. She has had 2 episodes of gout. Test results Hgb g/L MCV fl RBC x1012/L WBC x106/L Plat x109/L Blood Film thromboytosis tear drop cells leukoerythroblstic

40 What test would give a definitive diagnosis ?
A. LAP score B. Osmotic fragility C. Hgb electropheresis D. Bone scan E. Bone marrow biopsy

41 …splenomegaly Hematologic conditions Myelofibrosis
Some hemolytic anemias Myeloproliferative conditions leukemia Lymphomas Non-hematologic Congestive (cirrhosis) Infiltrative: malignant, non-malignant Infectious (mono) Inflammatory:

42

43

44 Lymphadenopathy Abnormal in size, consistency, number Generalized
Localized

45 uptodate

46

47 This 24 year old man has acute abdominal pain. He has not
been feeling well for 5 days. After a baseball game he had acute upper abdominal pain and was quite tender in the upper abdomen. The surgeon asks you to see the patient. Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L Blood Film

48

49 This 24 year old man has acute abdominal pain. He has not
been feeling well for 5 days. After a baseball game he had acute upper abdominal pain and was quite tender in the upper abdomen. The surgeon asks you to see the patient. Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L Blood Film variant lymphocytes atypical reactive

50 What is the disorder most likely responsible for his condition ?
A. Acute leukemia B. Pancreatitis C. Malaria D. Infectious mononucleosis E. Liver abcess

51 This 55 year old man is referred for unexplained elevated
White cell count. He feels well. Examination is normal. Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L Blood Film

52

53 This 55 year old man is referred for unexplained elevated
White cell count. He feels well. Examination is normal. Test results Hgb g/L MCV fL RBC x1012/L WBC x106/L Plat x109/L Blood Film Lymphocytosis Smudge cells

54 What test would confirm your diagnosis ?
A. Mono spot test B. LAP score C. Bone marrow biopsy D. Immunophenotyping E. Skeletal survey

55 This 36 year old man is admitted to hospital with generalized
bruising and bleeding. He is febrile. There are many bruises and petichia present. Test results Hgb g/L MCV fL RBC x1012/L WBC 5.2 x106/L Plat x109/L Blood Film

56

57 This 36 year old man is admitted to hospital with generalized
bruising and bleeding. He is febrile. There are many bruises and petichia present. Test results Hgb g/L MCV fL RBC x1012/L WBC 5.2 x106/L Plat x109/L Blood Film Cytopenias Blasts

58 What disease is most responsible for his condition ?
A. Septicemia B. Drug reaction C. Infectious mononucleosis D. Chronic leukemia E. Acute leukemia

59 This is a 35 year old male who is found to have persistent leukocytosis. His family physician wants you to rule out a Chronic leukemia. Test Results HGB g/L MCV fL RBC x1012/L WBC 25X106/L Plat x109/L Blood Film

60

61 This is a 35 year old male who is found to have persistent leukocytosis. His family physician wants you to rule out a Chronic leukemia. Test Results HGB g/L MCV fL RBC x1012/L WBC 25X106/L Plat x109/L Blood Film Normocytic Normochromic Neutrophilia Metamyelocyte

62 What test would be most cost effective in helping to establish a diagnosis ?
A. Immunophenotyping B. Leukocyte alkaline phosphatase C. Bone marrow aspirate D. Cytogenetics E. Blood cultures

63 A 25 year old female university student is found to have a very low hemoglobin. She in fact feels fairly well. Physical exam shows pallor only. Test Results HGB g/L MCV 80 fL RBC 2.7x1012/L WBC 6.3x106/L Plat x109/L Blood Film

64

65 A 25 year old female university student is found to have a very low hemoglobin. She in fact feels fairly well. Physical exam shows pallor only. Test Results HGB g/L MCV 80 fL RBC 2.7x1012/L WBC 6.3x106/L Plat x109/L Blood Film Irreg contracted Burr cells

66 Which test do you think will give the diagnosis ?
A. Iron studies B. Reticulocyte count C. Endocrine studies D. Liver function E. Renal function

67 A 50 y.o male presents with an elevated hematocrit, splenomegaly, and pruritus following shower
Test results Hb 195, HCT 0.60 Platelets 500 WBC 7.0

68 Which test is indicated?
A. iron studies B. B12 levels C. Serum epo D. Jak 2 mutation testing E. BCR-ABL testing

Download ppt "This is a 55 year old woman who has fatigue. Her only"

Similar presentations

RBC Morphology and Cases

RBC Morphology and Cases
Hematopathology Lab December 12, 2013. Case 1 . Normal Peripheral Blood Smear.

Hematopathology Lab December 12, Case 1 . Normal Peripheral Blood Smear.
HEMATOLOGY WHAT IT IS : Study & measurement of individual elements of Blood. WHAT IT’S COMPOSED OF. SHOW SLIDES FROM PERIPHERAL BLOOD TUTOR CD OR USE PLATE.

HEMATOLOGY WHAT IT IS : Study & measurement of individual elements of Blood. WHAT IT’S COMPOSED OF. SHOW SLIDES FROM PERIPHERAL BLOOD TUTOR CD OR USE PLATE.
This is a 55 year old woman who has fatigue. Her only

This is a 55 year old woman who has fatigue. Her only
Back to Basics - Hematology Objectives LMCC objectives – Anemia fatigue – Jaundice – Lymphadenopathy – Elevated hemoglobin – Splenomegaly – Neck mass.

Back to Basics - Hematology Objectives LMCC objectives – Anemia fatigue – Jaundice – Lymphadenopathy – Elevated hemoglobin – Splenomegaly – Neck mass.
Evaluation of Anemia By Dr. Stephen Szabo.

Evaluation of Anemia By Dr. Stephen Szabo.
Anemia 101- Case Studies Peter A. Kouides MD

Anemia 101- Case Studies Peter A. Kouides MD
Paolo Aquino PGY-I January 2005 VA Hospital

Paolo Aquino PGY-I January 2005 VA Hospital
Approach to Anemia - Summary

Approach to Anemia - Summary
AN APPROACH TO THE ANEMIC PATIENT Martin H. Ellis MD Meir Hospital 2007.

AN APPROACH TO THE ANEMIC PATIENT Martin H. Ellis MD Meir Hospital 2007.
Normocytic Anemia Dr. Fatin Al-Sayes, MD, MSc, MRCPath Consultant Hematology / Assistant Professor King Abdulaziz University Hospital.

Normocytic Anemia Dr. Fatin Al-Sayes, MD, MSc, MRCPath Consultant Hematology / Assistant Professor King Abdulaziz University Hospital.
Hematology Case # 1 History of Present Illness

Hematology Case # 1 History of Present Illness
CLUES TO THE DIAGNOSIS IN ANEMIA PRINCIPLES 4 Anemia is not a disease 4 There is usually a cause 4 investigation should be logical 4 Start with CBC and.

CLUES TO THE DIAGNOSIS IN ANEMIA PRINCIPLES 4 Anemia is not a disease 4 There is usually a cause 4 investigation should be logical 4 Start with CBC and.
Anemia Dr. Meg-angela Christi M. Amores. What is Hematopoeisis? It is the process by which the formed elements of the blood are produced Erythropoeisis:

Anemia Dr. Meg-angela Christi M. Amores. What is Hematopoeisis? It is the process by which the formed elements of the blood are produced Erythropoeisis:
This lecture was conducted during the Nephrology Unit Grand Ground by a Sub-intern under Nephrology Division, Department of Medicine in King Saud University.

This lecture was conducted during the Nephrology Unit Grand Ground by a Sub-intern under Nephrology Division, Department of Medicine in King Saud University.
MLAB Hematology Keri Brophy-Martinez

MLAB Hematology Keri Brophy-Martinez
Hematology RBC/WBC Case Studies

Hematology RBC/WBC Case Studies
A 35 year old woman presents with increasing fatigue, lethargy, and muscle weakness. Her CBC reveals decreased numbers of erythrocytes, leukocytes, and.

A 35 year old woman presents with increasing fatigue, lethargy, and muscle weakness. Her CBC reveals decreased numbers of erythrocytes, leukocytes, and.
General Hematology Slide Review. 15 month old with pallor and hemoglobin 2.5g/dl, MCV 62fl and retic 4% Drinks 48 oz of whole milk/day What is this child’s.

General Hematology Slide Review. 15 month old with pallor and hemoglobin 2.5g/dl, MCV 62fl and retic 4% Drinks 48 oz of whole milk/day What is this child’s.
Interpreting The CBC Francisco F. Lopez, MD The 2005 Advanced Medical Underwriting Course January 14, 2005.

Interpreting The CBC Francisco F. Lopez, MD The 2005 Advanced Medical Underwriting Course January 14, 2005.

Similar presentations

Ads by Google