Pathology Flashcards
think about:
ADAMTS13
LDH
Haptoglobin
DAT
This is acquired immune haemolytic anaemia
LDH : always high in haemolysis
ADAMTST13: Low in TTP
Haptoglobin: low free haptoglobin as it is bound to the free Hb released during haemolysis
DAT : positive in immune mediated
Blood film: most useful initial diagnostic test in haemolytic uraemic syndrome (SHISCTOCYTES)
A 63-year-old man presents to his general practitioner complaining of increased tiredness and shortness of breath over the last 3 months. He has a past medical history of type two diabetes mellitus, mitral valve prolapse for which he has had a valve replacement, and heart failure.
On examination, the patient appears pale and visibly jaundiced. He has a respiratory rate of 21 breaths/min and a clear chest on auscultation. His abdomen is soft and non-tender. There is no peripheral oedema.
What is the most likely cause of this presentation?
Haemolytic anaemia:
Prosthetic heart valves may result in haemolytic anaemia
A 22-year-old man presents with crampy abdominal pain diarrhoea and bloating. He has just returned from a holiday in Egypt. He had been swimming in the local pool three weeks ago. He reports that he is opening his bowels 5 times a day. The stool floats in the toilet water, but there is no blood. What is the most likely cause?
Giarda
glycaemia and cholera?
hypoglycaemia
A negative HBsAg suggests there is no active HBV infection. Positive anti-HBs suggests there is immunity to HBV and negative anti-HBc means there is no previous infection. Therefore, immunity to HBV is secondary to previous vaccination. Negative HCV RNA means there is no current HCV infection and positive anti-HCV antibodies means there has been a previously cleared HCV infection. There is no vaccination for HCV and therefore infection is the only cause of antibodies. Therefore, the correct answer is previous HBV vaccination, cleared HCV infection.
1st line management for kids under 5 with asthma symptoms
try inhaled steroid first
offer a twice-daily paediatric low-dose inhaled corticosteroid (ICS) for 8-12 weeks and review the response. If following treatment no respiratory symptoms present anymore, stop ICS and review after a while again. If symptoms re-occur, then regular ICS should be re-started and continued until objective testing is possible.
