Page 1 of 1: anaemia

HANNA · Credits: 1064256 My Scrapbook

Theme : Anaemia

A. Acute blood loss
B. Alcoholic liver disease
C. Aplastic anaemia
D. Chronic renal failure
E. Folate deficiency
F. Haemolytic anaemia
G. Hypothyroidism
H. Myelodysplasia
I. Myelofibrosis
J. Vitamin B12 deficiency

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For each of the anaemic patients below, choose the single most likely diagnosis from the above list of options. Each option may be used once, more than once or not at all.

1) A 56 year old woman had terminal ileum resection due to Crohn’s disease and was lost to follow up. She presents on this occasion with difficulty walking. She is anaemic and has lost position sense bilaterally.

2) A 40 year old Afro-Caribbean man is seen with mild bilateral pedal oedema. His blood pressure is 200/130mmHg and his blood film suggests a normocytic, normochromic anaemia.

3) An elderly man is seen with a bleeding diathesis. He is anaemic and has a large palpable spleen. Bone marrow aspirate failed on two occasions. A trephine biopsy showed very few cells and lots of coarse fibres.

4) A man is brought in with haematemesis and melaena. He is anaemic, jaundiced, has spider naevi and gynaecomastia.

5) A young girl of African descent is brought to the emergency room complaining of extreme fatigue and listlessness. She is small for her age, has gnatopathy and is jaundiced. She admits to passing dark coloured urine.

sajida · Credits: 105407 My Scrapbook My Reading List 6 Books

1--j
2--d
3--i
4--a
5--f

archan · Credits: 1276 My Scrapbook

agreed

HANNA · Credits: 1064256 My Scrapbook

4..........i alwasy go for b....................can u exaplain a bit.

uzmagha · Credits: 993 My Scrapbook

i agree e u Hanna!!
but in the answer it was a b/c of haematemesis(acute bld loss from oesophageal varices)

DrDoom · Credits: 151 My Scrapbook

A 40-year-old Afro-Caribbean man is seen with mild bilateral pedal oedema. His blood pressure is 200/130mmHg and his blood film suggests a normocytic, normochromic anaemia.

Chronic renal failure associated with severe hypertension is commoner in the Afro-Caribbean population. They usually present late with hypertension, anaemia, uraemia and bilateral small kidneys on ultrasound scanning.

A 78-year-old man is seen with a bleeding diathesis. He is anaemic and has a large palpable spleen. Bone marrow aspirate failed on two occasions. A trephine biopsy showed very few cells and lots of coarse fibres.

Chronic idiopathic myelofibrosis presents with symptoms of marrow failure, the normal marrow having been replaced by coarse reticulin fibres. It is important to exclude systemic disorders causing secondary myelofibrosis like metastatic carcinomas and irradiation.

A 56-year-old woman had terminal ileum resection due to Crohn’s disease and was lost to follow up. She presents on this occasion with difficulty walking. She is anaemic and has lost position sense bilaterally.

Vitamin B 12 deficiency can present with neurological signs including symmetrical peripheral neuropathy, ataxia and later pyramidal tract signs. Vitamin B12 is absorbed in the terminal ileum. A high mean corpuscular volume, low serum vitamin B12 levels in the absence of intrinsic factor antibodies will establish the diagnosis.

A 55-year-old man is brought in with a six month histroy of deteriorating fatigue and weight gain. He is anaemic, jaundiced, has spider naevi and gynaecomastia.

Anaemia in chronic liver disease can be due to ruptured oesophageal varices (acute blood loss), bleeding peptic ulcers or bleeding gastritis. It can occur chronically, as in this case in association with chronic GI losses and as a consequence of cirrhosis plus alcoholic effects on the marrow.

A 10-year-old girl of African descent is brought to the emergency room complaining of extreme fatigue and listlessness. She is small for her age, has gnatopathy and is jaundiced. She admits to passing dark coloured urine.

Sickle cell disease is common in people of African descent. They usually have a chronic haemolysis but can develop a brisk fatal haemolysis (the hyper haemolytic crises) in response to infections or low oxygenation states.

doc604 · Credits: 435 My Scrapbook

4-b, agree with the last post that it is a better choice

sploop · Credits: 253 My Scrapbook

I saw this on OnExamination and they reckoned it was 4-b

That makes sense to me.

More importantly, what is Gnatopathy?

doc604 · Credits: 435 My Scrapbook

GNATHOPATHY- a term describing malocclusion of jaw, usually a slight protrusion of the upper jaw (in SSD).

sploop · Credits: 253 My Scrapbook

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