Common Presentations

Question 1

Differential diagnosis for patient presenting with fatigue

Answer 1

Psychological: depression, anxiety, etc
Hematologic: anemia, leukemia/lymphoma, 
Infection: mono, tb
Neurologic: MS, Myasthenia
Pharmacologic: antidepressant, antihistamine
Cancer

Question 2

What are the elements of 
Hx
PE
Lab
that can assist in determining etiology of fatigue?

Answer 2

Hx: chest pain, SOB, bowel habits, changed activities, abdominal pain,
PE: abdominal exam, heart/lung, pallor, rectal exam, check stool for blood,
Tests: CBC, Occult blood, colonoscopy, endoscopy, iron study (colon ca/gi bleed), peripheral smear

Question 3

What are common presentations of anemia?

Answer 3

Micro, macro, normocytic
fatigue, pallor, hepatosplenomegaly if hemolytic, jaundice, short of breath,
iron deficiency: fatigue, weakness

Question 4

What is a logical approach to bleeding disorders?

Answer 4

IF GI bleed: B12 def, Ulcer, Cancer

Question 5

What is the manifestations and causes of increased RBCs in the circulation?

Answer 5

Polycythemia rubra vera (RBC, granulocytes, and platelets up)
2ndary - Smoker - increased EPO
- Renal cancer, pheochromocytoma, uterine finds
- COPD
- EPO self injection

For PV
Tx: phlebotomy, low dose aspirin to lower platelets

Question 6

Understand risk recognition and risk mitigation for thrombotic disorders

Answer 6

d