Hematology Case 1 .


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Hematology Case
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Hematology Case # 1 History of Present Illness The patient was a 47-year-old white male who was found in the facility, with the grievance of shortcoming and weariness. He had loss of craving. He had lost 10 pounds in the previous month, felt feeble and was confined to bed. The patient was wooziness on standing. His Temp was 36.8 degrees.

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Hematology Case # 1 Lab Data

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Hematology Case # 1 Questions Interpret the research facility and morphologic discoveries? List 4 conceivable basic illnesses? What extra tests would you do?

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Hematology Case # 1 Question 1 Interpret the research facility and morphologic discoveries? Macrocytic pallor with hypersegmented neutrophils, nucleated RBC, marginal neutropenia and stomatocytosis

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List 4 conceivable hidden infections? liquor admission. liver ailment strange DNA combination (megaloblastic) because of B12 or folate lack Drugs, for example, methotrexate Hypothyroidism Myelodysplastic disorder

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Hematology Case # 1 What extra tests would you do? Serum B12 Serum and red cell Folic corrosive Liver Enzymes Gamma GT ALT TSH Bone Marrow

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Hematology Case # 2 History 21 year old female who is a University understudy noted over the previous week expanding exhaustion, sore throat, cerebral pains, and fever. Physical Exam She has erythematous throat and tonsils, Swollen cervical lymph hubs and hepatosplenomegaly

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Hematology Case # 2 CBC with infinitesimal differential RBC 5.25 x 10 12/L HGB 154 g/L MCV 87.9 fL RDW 12.2 PLT 150 x 10 9/L WBC 11.9 x 10 9/L

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Hematology Case # 2 Questions What morphologic changes are found in this blood spread field? What is the supreme lymphocyte number? What is the differential analysis? What different tests would you arrange?

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Hematology Case # 2 Questions What morphologic modifications are found in this blood spread field? Atypical lymphocytes What is the outright lymphocyte check? 8.4 x 10 9/L What is the differential determination? viral diseases Infectious mononucleosis, CMV Pertussis Toxoplasmosis What different tests would you arrange? Monospot test Serology for toxoplasma Serology or sub-atomic for CMV

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Hematology Case # 3 A 15-year-old young lady grumbled of exhaustion and loss of stamina. Her hunger was poor. Her month to month menstrual stream was overwhelming. Here CBC was as per the following:

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Case 3 CBC

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Case 3 questions What is your conclusion? List 4 conceivable fundamental malady? What extra tests would you do? Clarify the platelet number?

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Case 3 questions What is your conclusion? Microcytic hypochromic pallor List 4 conceivable fundamental malady? (Fe insufficiency) thalassemia weakness of perpetual infection Sideroblastic iron deficiency Pb poisonous quality

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Case 3 questions What extra tests would you do? Serum Ferritin Serum Iron, TIBC Hemoglobin Electrophoresis Bone marrow examination Lead level Explain the platelet number? Commonly found in patients who are effectively draining Increased in erythropoietin levels Bone marrow hyperplasia

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Hematology Case # 4 While looking at your own blood you discover: WBC 9 x 10 9/L Segmented neuts 30% groups 5% Eos 7% Basos 3% Monos 5% Lymphs half

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Hematology Case # 4 Questions Is this typical? Do you have excessively couple of neutrophils? An excessive number of lymphocytes, eosinophils and basophils?

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Hematology Case # 4 Questions Is this ordinary? Yes Do you have excessively couple of neutrophils? (< 1.5 X 10 9/L) 2.7 x 10 9/L Too numerous lymphocytes? (> 4.0 X 10 9/L) 4.5 x 10 9/L eosinophils (> 0.35 X 10 9/L) 0.63 x 10 9/L Basophils (> 0.2 X 10 9/L) 0.27 x 10 9/L

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Hematology Case # 5 49 year old male patient gave exhaustion. There was splenomegaly present CBC WBC 30. Hgb 120 and plt 400

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Hematology Case # 5 Diff

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Case 5 Questions What is the differential conclusion? Responsive disease, irritation, putrefaction, physical specialists, passionate boosts, drugs, poisons, other neoplasia, metabolic, hormonal, and endocrine unsettling influences, Neoplastic Chronic myeloproliferative issue Chronic myeloid leukemia Essential thrombocythemia Chronic idiopathic myelofibrosis Polycythemia Vera List 3 key analytic tests Repeat CBC Bone Marrow examination Molecular for BCR/ABL Cytogenetic Study

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Case 5 Questions cont What is the Prognosis? This a gradually dynamic malady Median survival 5-7 years List 2 treatment choices Targeted treatment tyrosine kinase inhibitors, for example, Imatinib Bone marrow transplant

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Hematology Case # 6 Your second patient is a 37-year-old man grumbled of shortcoming. He is pale and gave a background marked by petechiae and hematuria. He is drained.

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Hematology Case # 6 CBC Hgb 70 g/L, WBC 2.2 x10 9/L, Plt 30 x10 9/L Diff % Neut 23, Lymph 70 Mono 3 Eos 3 Baso 1 The PB spread demonstrated normocytic/normochromic RBCs.

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Hematology Case # 6 Questions Calculate the total neutrophil number. _______________ x 109/L What is your conclusion? A. aplastic iron deficiency B. sedate instigated neutropenia C. quickened demolition of neutrophils

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Hematology Case # 6 Questions Calculate the total neutrophil tally. 0.5 x 10 9/L What is your determination? A. aplastic iron deficiency

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Normal reference ranges WBC 10 9/L (4.5 – 11.0) HGB g/L (120 - 160) Female HGB g/L (140 - 180) male RBC 10 12/L (3.8 – 5.8) Female RBC 10 12/L (4.5 – 6.5) male MCV fL (80.0 – 97.0) RDW % (11.5 – 14.5) PLT 10 9/L (150 - 350)

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