Haematology Cases

Question 1

70 year old man
tired and tingling in hands and feet

low Hb
low rbc
raised MCV

Answer 1

B12 deficiency

• age
• fatigue
• peripheral neuropathy

other signs

• beefy tongue
• mild jaundice
• psychosis

Question 2

53 year old male
found collapsed at home
alcohol excess

normal Hb
normal rbc
raised MCV

Answer 2

Folate deficiency
(life-style)
- reduced dietary intake

Question 3

26 year old pregnant female

normal Hb
normal rbc
normal MCV
low B12

Answer 3

Pregnancy increases demand for B12

Question 4

1 year old boy
vegan parents
still being breast fed

low Hb
low MCV
raised platelets
low ferratin

Answer 4

Iron deficiency anaemia
- due to diet

Mx
eat solids
ferrous fumarate (liquid) ??

Question 5

6mth old baby from India
pale, lethargic, two borthers died of anaemia (<6mths)

low Hb
low MCV
raised ferratin

Answer 5

Beta Thalassaemia Major

Question 6

7 year old female
intermittent jaundice and fatigue (usually after a cold)
dad had a splenectomy as a child

low Hb
normal MCV
raised platelets
raised bilirubin

Answer 6

Hereditary Haemolytic Anaemia