30y F (known sickle) c/o chest pain

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30y F (known sickle) c/o chest pain

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bioguy
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04/09/08 - 07:42 AM

why ask about

vomiting

fever

blood in urine

blood transfusion

how does this help in DD?

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P4a99
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04/09/08 - 09:18 AM

Excuse me:

Are you done with Stap 1? wasn't it on the 29th? raised eyebrow

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bioguy
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04/09/08 - 12:08 PM

dude! i postponed, indefinitely. grin

most probably i will give both 1 and 2CK in august/september

CS coming up on April 28th

so prepping for that.

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P4a99
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04/09/08 - 12:15 PM

What about the 2 weeks you took off and the 600$ ?

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ganesha123
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04/09/08 - 04:18 PM

sickle cell disease>anemia> blood transfusion> reaction can cause chest pain..

sickling in the kidneys can cause hematuria

vomiting and fever.... LRTI,

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bioguy
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04/09/08 - 07:44 PM

praying4a99 wrote:
What about the 2 weeks you took off and the 600$ ?

that was 3wks, and who would believe that 3wks are enough for prep after a 6y gap sticking out tongue

the $675 was my donation to ecfmg cool

(a forced one of course sad

)

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bioguy
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04/09/08 - 07:46 PM

ganesha123 wrote:
sickle cell disease>anemia> blood transfusion> reaction can cause chest pain..

sickling in the kidneys can cause hematuria

vomiting and fever.... LRTI,

thanks so much ganesha!!! will you please stick around, i will be posting more questions like this

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bioguy
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04/09/08 - 08:34 PM

Retinopathy similar to that noted in diabetes is often present and may lead to blindness.

so do you check the eyes of this patient?
how important is this? i mean given the time constraints, do we get credit if we check the eyes of this pt.?

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bioguy
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04/09/08 - 08:41 PM

Even though the patient came only for chest pain, do we ask/look for signs of chronic hemolysis - jaundice,hepato(spleno?)megaly, gallstones (biliary pain).

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bioguy
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04/09/08 - 08:52 PM

#10

ganesha123 wrote:

vomiting and fever.... LRTI,

LRTI could be a DD of chest pain,

alternatively, any infection (fever) could result in precipitation of vaso-occlusive crisis resulting in chest pain

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bioguy
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04/09/08 - 08:57 PM

#11

Whats the significance of family history of blood clots in this case?

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ganesha123
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04/09/08 - 09:29 PM

#12

hey bio guy..i wish more people were active here.. shaking head

family history of blood clots is to rule out chances of pulmonary embolism..causing chest pain..

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ganesha123
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04/09/08 - 09:31 PM

#13

yeah looking for signs of chronic hemolysis is good..but only if time permits..first need to rule out /diagnose the cause of the acute chest pain and in all probability that cud use up all the time... smiling face

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