male patient 56years old is noticed to have pallor , jaundice, splenomegally and orthopnea
he is known to be hepatic and received blood at different times
his lower right chest was dull in percussion. his Hb was as follows
he is known to be hepatic and received blood at different times
his lower right chest was dull in percussion. his Hb was as follows
his x_ ray as follows showing obliteration of the angle
questions
CBC will show : choose
hypochromic anemia
leukocytosis
reticulocytosis
abnormal cells
for management : choose
surgical splenectomy
radio splenectomy
continuous blood transfusion
iron supplementaion
هناك 6 تعليقات:
reticulocytosis
surgical splenectomy
reticulocytosis
surgical splenectomy
بسم الله الرحمن الرحيم
hepatic patient with chronic anemia ,splenomegaly may refer to hypersplenism
so CBC will show reticulocytosis
and presence of jaundice and pleural effusion indicates hepatic decompensation so surgery is contraindicated and this case will be managed by splenectomy by radiation or embolization
i was asked this question by the patient
thanks
السلام عليكم ورحمه الله وبركاته
اعتقد فى الحاه صعوبتها انى اتاكد انه hypersplenismلان المفروض انها بتتشخص بpancytopenia(one or more component of blood decrease),وبتاكد لما اشيل الspleen وتتحسن الحاله وفى الحاله دى حضرتك وضحت انه عنده انيميا وما ذاكرتش باقىcbcاخبارها ايه وفى مريض الكبد لازم هيكون عنده انيميا لاسباب كتير وبالتالى كده انا ما قدرش اجزم بالhyper splenismفانا شايفه انى هحاول ادى دم لو اترفعت النسبه وكملت كويس ماشى واحاول احل مشكله pleural effutionولو احتاج بزل اعمله لانى اعتقد ان splenectomy by embolization مش متوفر فى طنطا الا اذا قدرت اعمله فده كويش ومفيش مشكله واكيد هيحسن الحاله بجميع الاحوال حتى لو مش hypersplenism ومفيش ضرر على المريض زى الجراحه مثلا
يا ريت اسمع رايكم بكل وضوح يمكن اكون فاهمه حاجه غلط
male patient aged50 years old came to emergency room with his family he was conscious and can wake but he was very annoying as he suffers from severe epigastric pain refered to his left shoulder from two hours and it is the first time.his history revealed only that he is smoker from 30 years ago and he never complained before.his blood pleasure was120/80
and his pulse rate was 72b/min.by examination of abdomen nothing except epigastric tendernes. by heart examintion heart sounds just audible but no murmurs.
what is your dignosis and how to manage??
دى حاله جيت الطوارىء انا كشفت عليه وبعدين طلبت مساعده دكتور امتياز لانى شكيت فى حاجه وبعدين هو فحصها وتناقشنا وعايزه اشوف رايكم
وان شاء الله هعرفكم طلعت ايه
ممكن تعتبرها اول حالاتى يا دكتور شادى ويا رب تستفيدوا حاجه
بسم الله الرحمن الرحيم
هذه الحاله هى كما هى لم اجد معها صورة دم كامله او اى تحاليل اخرى
العيان كان متواجد بالمستشفى عشان ينقل دم وتكرر الموقف قبل كده كتير
الكلام كله كان كانها حالة hypersplenism
وفى الحالات دى بيكون one or more of blood components يعنى ممكن انيميا بس ومكنش فيه وسيله انى اعرف بقية الاحتمالات
بالنسبه splenectomy by embolization فانا فعلا اعتقد انه غير موجود فى طنطا ولم يكن ضمن الخيارات
شكرا
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