Cases Flashcards
45y/o man with acute onset of pancreatitis, with episodes of epistaxis, is noted as having increasing PT and a decreased platelet count. Further coag. testing reveals decreased fibrinogen levels and positive D-dimers.
DIC
50y/o woman presents approximately 3wks after an URTI with petechiae, easy bruising and gum hypertrophy. No personal or Fox of a bleeding disorder and is currently on no medications. FBC reveals thrombocytopenia.
Immune thrombocytopenia purpura
24y/o woman presents to A&E 8wks postnatal with heavy vaginal bleeding, fatigue and light headedness. She has a PMHx of menorrhagia since menarche and IDA. She had no bleeding symptoms during her pregnancy.
vWF deficiency
6mth old boy presents with fever and painful swelling of he hands and feet. His parents are concerned because he has be inconsolable for 6hrs. The infant has been refusing bottles and has needed fewer nappy changes over the last 2 days.
Sickle-cell disease
18mth old boy presents with left ankle swelling and pain. He has limited range of motion at the ankle and has difficulty walking. Over the last year, he has presented with significant haematomas at immunisation sites.
Haemophilia
8mth old boy of Mediterranean origin presents with pallor and abdominal distension, both of which are progressive. The perinatal history was uneventful, and the boy is noted to be feeding poorly, failure to thrive and decreased activity. Mild bony abnormalities of the skull and hepatosplenomegaly are noted on examination.
Beta-thalassaemia
26y/o black woman presents in her 13th wk of pregnancy with fatigue. She is found to be mildly anaemia with a Hb of 11g/dl and an MCV of 75. She is empirically started on iron sulfate tablets but returns 4 wks later with no improvement in her Hb and is referred haematology.
Alpha-thalassaemia trait
23y/o man of Iranian origin consults his GP with a suspected chest infection. He is noted to be jaundice and complains of fatigue and dizziness.
Glucose-6-phosphate dehydrogenase deficiency
4y/o girl presents with lethargy, dysponoea, fever and bruising. On examination she has hepatosplenomegaly. CXR shows a mediastinal mass and pleural effusion.
Acute lymphoblastic leukaemia
58y/o man presents to his GP care physician with increasing tiredness, accompanied by bruising on his legs. He also complains of aching bones. He has no previous illnesses. On examination he is pyrexial and pale, with bony tenderness over the sternum and tibia.
Acute myeloblastic leukaemia
62y/o man presents to his GP for an annual physical. He denies any complaints such as fever or chills, weight loss or fatigue. Of note, his blood tests who an elevated WBC count.
Chronic lymphoblastic leukaemia
25y/o male presents to his GP with a slowly enlarging, non painful right neck mass. He denies recent URTI, fevers, night sweats or unintentional weight loss. He suffered from glandular fever when he was 18y/o.
Hodgkin’s lymphoma
70y/o man presents for routine physical examination. He complains of fatigue, SOB and painful swallowing. He admits to daily alcohol consumption. His diet mostly consists of takeaways and ready-meals.
Folate deficiency
25y/o gravida 3 para 3 female presents with a history of fatigue and dyspnoea on exertion. On further questioning she admits to having a craving for ice.
IDA
54y/o man presents to his GP with a 2-mth Hx of fever malaise and weight loss. He also reports frequent epistaxis, abdominal fullness and early satiety. On examination, he is found to have hepatosplenomegaly.
Chronic myelogenous leukaemia
