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Interpretation of Results. Dr. Esther Tsang August 2011. Case One. Asymptomatic patient, 34/female Hb 9.1 g/dL, WBC 7.4, platelets 455 MCV 65 fL, MCH 23 pg What kind of anaemia is this? Which parameters do you look at?. What are the two main differential diagnoses?

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Interpretation of Results


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    1. Interpretation of Results Dr. Esther Tsang August 2011

    2. Case One • Asymptomatic patient, 34/female • Hb 9.1 g/dL, WBC 7.4, platelets 455 • MCV 65 fL, MCH 23 pg • What kind of anaemia is this? • Which parameters do you look at?

    3. What are the two main differential diagnoses? • Name 3 main investigations to send.

    4. PBF as follows : • What are the abnormalities seen? • What are the possible causes for this diagnosis?

    5. Case Two • 40/male • Breathlessness • Hb 5.0 g/dL, Plt 125, TWC 3.9 • MCV 100fL • Name three differential diagnosis?

    6. How do you confirm your differential diagnoses? • Some other results comes back abnormal

    7. What is your diagnosis now? • Is there another test to support your diagnosis?

    8. What are the other differential diagnosis of macrocytic anemia?

    9. Case Three • Elderly lady with hypertension comes with confusion. • BUSE as follows :

    10. What are the abnormalities? • What are the possible differential diagnosis?

    11. You decide to give him 1 pint NaCl 3% over one hour. • The next day, his Na was 149 mmol/L. However, he is quadriplegic and his GCS was M3V2E2. • What do you think occurred?

    12. What is the indication for fast correction of Na? • What is the safe rate of correction of Na?

    13. Case 4 • 25/male was admitted for generalized weakness. • BUSE :

    14. What is the abnormality? • You order an ECG : what do you see?

    15. How do you correct the potassium?

    16. Case 5 • 60 year old lady with DM presented with tachypnoea. • ABG as follows : • pH 7.3 • PaO2 12kPa • PaCO2 3.0kPa • HCO3 11.0 mmol/L

    17. How do you interpret the ABG? • Why is she tachypnoeic?

    18. What are the possible causes of metabolic acidosis in this patient? • The renal profile is as follows : • Na 134 • K 5.7 • Urea 23.0 • Creat 500

    19. What are the abnormalities on the renal profile? • How would you manage the hyperkalaemia?

    20. What are the possible causes of renal failure in this patient? • How will you investigate this patient?

    21. UFEME shows • protein +++ • nitrates ++ • RBC++ • Leu+ • Ketone negative • How would you interpret the results?

    22. Case 6 • 60 year old man with yellow eyes and skin • LFT • TP 65 • Alb 24 • Bilirubin 85 • ALT 20 • ALP 200 • Identify the abnormalities.

    23. How would you further investigate him? • What are the possible causes of his problem?

    24. Case 6 • 28/male • Asymptomatic, health screening showed the following : • TP 60 • Alb 40 • Bilirubin 5 • ALT 120 • ALP 40

    25. What is the abnormality? • Name 3 possible causes :

    26. What other investigations would you order?

    27. Case 7 • 70 year old lady, admitted with fever and bruising. • FBC Hb10, TWC 4.0, Plt 100 • Coagulation profile : • PT 32s • INR 3.0 • APTT 60 • Identify the abnormalities.

    28. What is the diagnosis? • What other investigations to support this diagnosis?

    29. What are the causes of this disorder?

    30. Case 8 • 70/male with acute breathlessness • CXR as shown • Identify the abnormalities

    31. Case 9 • 70/female with acute breathlessness • CXR as shown • What are the abnormalities?

    32. Case 10 • 25/male, acute breathlessness • CXR shown • What abnormalities?

    33. Case 11 • 30/male • Cough for 4 months • What abnormalities?