An 88-year-old man with known metastatic prostate cancer is brought to the emergency department confused. He is unable to provide further history but reports feeling generally unwell. Upon examination, his chest is clear, heart sounds normal, and abdomen is soft with no tenderness. The initial blood tests reveal:
– Na+ 134 mmol/l
– K+ 4.7 mmol/l
– Urea 7.8 mmol/l
– Creatinine 104 µmol/l
– Adjusted Ca2+ 3.5 mmol/l
– Mg2+ 0.81 mmol/l
What would be your initial treatment plan?
A 27-year-old man with a medical history of sickle cell disease presents with intense pain in his left hip. He mentions having received antibiotics from his general practitioner for a chest infection. How would you categorize this sickle cell crisis?
An 85-year-old man has just undergone an emergency repair for a ruptured abdominal aortic aneurysm. Preoperatively he was taking aspirin and warfarin; intraoperatively he received unfractionated heparin prior to application of the aortic cross-clamp. His observation findings are heart rate 120 bpm, BP 100/60 mmHg, respiratory rate 23/min, oxygen saturation 98% on air, temperature 38ºC. His blood results on admission to the critical care unit are as follows:
Hb 110 g/L
Male: (135-180)
Female: (115 – 160)
Platelets 30 * 109/L
(150 – 400)
WBC 15 * 109/L
(4.0 – 11.0)
Fibrinogen 0.5 g/L
(2-4 g/L)
PT 20 seconds
(10-12 seconds)
APTT 60 seconds
(35-45 seconds)
FDP 60 ug/mL
(<10 ug/mL)
What is the most likely explanation for the blood abnormalities seen in this case?
A 43-year-old man is being evaluated for anemia by his primary care physician. He has been experiencing mild shortness of breath for the past 3 months. His medical history is significant for a previous diagnosis of polymyalgia rheumatica.
The results of his recent blood tests are as follows:
– Hemoglobin (Hb): 98 g/L (Male: 135-180, Female: 115-160)
– Mean Corpuscular Volume (MCV): 77 fl (76-95 fl)
– Ferritin: 195 ng/mL (20-230)
– Total Iron Binding Capacity: 610 µg/dL (250-450)
What is the most probable diagnosis?
A 63-year-old man presents to the haematology clinic with fatigue, significant weight loss, and easy bruising over the past 2 years. His blood test results are as follows:
– Hemoglobin: 90 g/L (normal range for males: 135-180 g/L; females: 115-160 g/L)
– Platelets: 85 * 109/L (normal range: 150-400 * 109/L)
– White blood cells: 70.5 * 109/L (normal range: 4.0-11.0 * 109/L)
– Neutrophils: 61.8 * 109/L (normal range: 2.0-7.0 * 109/L)
– Lymphocytes: 1.2 * 109/L (normal range: 1.0-3.5 * 109/L)
– Monocytes: 3.0 * 109/L (normal range: 0.2-0.8 * 109/L)
– Eosinophils: 2.5 * 109/L (normal range: 0.0-0.4 * 109/L)
The blood film shows obvious leucocytosis with eosinophilia and basophilia visible. There are also large numbers of immature granulocytes, but no blast cells are visible. What is the most appropriate first-line treatment for this patient?
A 35-year-old woman presents to her GP with complaints of unexplained weight loss and vague symptoms. During the examination, the GP detects a suspicious lump on her neck and refers her urgently to ENT. To expedite the process, the GP conducts several investigations and observes a significant elevation in calcitonin levels. Which type of cancer is associated with calcitonin as a tumor marker?
A 47-year-old man, currently admitted to a medical ward for acute pancreatitis, experiences intermittent episodes of epistaxis. Blood tests are conducted and reveal the following results:
– Platelets: 52 * 109/L (normal range: 150 – 400)
– Prothrombin time (PT): 23 seconds (normal range: 10-14 seconds)
– Activated partial thromboplastin time (APTT): 46 seconds (normal range: 25-35 seconds)
– Fibrinogen: 0.8 g/L (normal range: 2 – 4)
– D-Dimer: 1203 ng/mL (normal range: < 400)
Based on the probable diagnosis, what would be the expected findings on a blood film?
A 65-year-old woman presents to her GP with whole-body itching which is worse after she has taken a bath, tingling and burning sensations in her hands and feet, and headaches. She has felt fatigued over the past year and a half, however, the symptoms of itching and tingling peripheries have only been present for the past 3 months. On examination, she is noted to have a palpable spleen which is 3 cm below the costal angle. She has a full blood count which shows:
Hb 184 g/L Female: (115 – 160)
Platelets 380 * 109/L (150 – 400)
WBC 9.0 * 109/L (4.0 – 11.0)
What is the recommended first-line treatment for this patient?
The physician is analyzing the routine blood test results for a 65-year-old woman who has a medical history of hypertension, type 2 diabetes mellitus, and giant cell arteritis. The following are some of the findings:
– Hemoglobin (Hb) level of 133 g/L (normal range for females: 115-160 g/L; males: 135-180 g/L)
– Mean cell volume (MCV) of 88 fl (normal range: 82-100 fl)
– Platelet count of 390 * 109/L (normal range: 150-400 * 109/L)
– White blood cell (WBC) count of 10.7 * 109/L (normal range: 4.0-11.0 * 109/L)
– Neutrophil count of 8.4 * 109/L (normal range: 2.0-7.0 * 109/L)
– Lymphocyte count of 1.4 * 109/L (normal range: 1.0-3.0 * 109/L)
What could be the possible cause of these abnormal results?
A mother is referred to a paediatric gynaecologist with her 12-year-old daughter. Her daughter is extremely short for her age, is deaf in both ears and has shown no signs of pubertal development. On examination, the clinician notes neck webbing, a high arched palate and low-set ears. He suspects that the child may have Turner syndrome.
Which of the following chromosomal abnormalities best describes Turner syndrome?