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Author8 Posts
  #1

A 35 y.o. female presents to your office complaining of weakness,fatigue and pallor.She denies having heavy menses or melena.PE is unremarkable except for conjunctival pallor.

Lab studies show:
Hb......................7.2g/l
Erythrocytes count......................1.8mln/mm3
MCV....................90fl
Reticulocytes.................0.1%
Platelet count..........................280,000mm3
Leucocyte count.............6,500/mm3

Iron studies and B12 and folic acid are within normal limits.

Which of the following condition is most likely responsible of this patient symptoms?

a.-Hepatocellular carcinoma
b.-Thymic tumor
c.-Renal cell carcinoma
d.-Uterine fibroid
e.-Cerebellar hemangioblastoma
f.-VHL






  #2

b?


  #3

c.-Renal cell carcinoma ??


  #4

A,C,D,E,F aint the ans.
2 to go.
pure rbc aplasia? due to thymoma.
and renal cell ca. renal cell ca will produce erythropitin and pt will have raised rbc count.
but in case of thymoma pt can present with weaknes and dyspnea and pallor.
only thing to be asked is why she has no jaundice developed?
still i think B is a reasonable ans.


  #5

b.-Thymic tumor is the right answer cos a very few present with Pure REd Cell Aplasia which is the clinical picture here. Although not a very prominent finding but th epts do present with Weakness and only 5% will have Pure Red Cell Aplasia

The REst of the Choices Cause Polycythemia



  #6

surely thymic tumor


  #7

nodnod B


Pure red cell aplasia(PRCA) is a rare form of marrow failure characterized by marked hyoplasia of marrow erythroid elements in the setting of normal granulopoiesis and thrombopoiesis.
PRCA is associated with Thymoma and Parvovirus B19 infection



  #8

retic count too low..........suggests marrow failure....
but i didnt know that thymic tumor causes PRCA....i thought only of parvo B....

i went for HCC....bad time....

nice Q





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