lady_soofia_20020
Forum Newbie
Topics: 1
Posts: 1
|
a young 17 Y/O boy with CC of faint and decrease of level of consciousness for 24 hours, now admited in hospital. he has some evidence of hemolysis and dark urine and his retic count is below the normal! he also has some non-specific symptoms such as systolic murmur and gynecomastia. what is your nest step?
|
| Drmos
Forum Junior
Topics: 8
Posts: 41
|
ok.....this is a difficult q......first the pt has anemia bcz hemolysis, dark urine....however, his bone marrow doesn´t respond, right?....and the murmur, systolic, is due to anemia?.....so, if you give me the VFs perhaps there will be tachycardia (?)....and the first step would be give red blood cells......so I ask for hemoglobin level......next....what about the gynecomeastia?.....chronic liver dz with hemolysis??????.......or a producing-tumor of strogens?????.....with hemolysis???????'.......it doesn´t fix......but.....mmmmmmmm.........give me more options.....give me a vital functions first........ :cry:
|
| drvic
Forum Elite
Topics: 10
Posts: 181
| | 05/15/05 - 07:10 PM
1 of 1 forum leaders found this post helpful
| #3 |
the answer is WILSON'S DISEASE
chronic liver disease with hemolysis - always rule out wilson's first
gynaecomastia - a sign of chronic liver failure
murmur - probably related to anemia
as for next step (- which the question actually asks -) - do a blood glucose and electrolytes to rule out any metabolic cause for the acute deterioration in sensorium.
___________________
say what you mean... and mean what you say...
|
| amitjosh
Forum Senior
Topics: 9
Posts: 116
|
good thinking drvic
___________________
Criticisms welcome
|
|
| |
| | | | |
