Friday, May 8, 2009

pallor&lethargy


ahmad,5 years old boy come to the clinic due to PALLOR and LETHARGY.Below are the result of investigation:

colour of urine sample

urine FEME -->

pus cell & RBC –nil,
epithelial cell - <5/ul,>

question

i-Comment about the appearance of the urine (2m)

ii- What are the most likely substance responsible for (i) (4m)

iii- 2 relevant questions to be asked on patient’s arrival (4m)

iv- 2 clinical conditions that can give rise to these findings (4m)

v- 3 other relevant investigations & state the expected result (6m)

p/s:sorry!answers are not provided

2 comments:

SYed on May 8, 2009 at 12:21 PM said...

I'll ..try to answer.It's not the definite answer though,and correct me if I'm wrong ;)


i-Comment about the appearance of the urine (2m)

The urine appeared as black colored urine.

ii- What are the most likely substance responsible for (i) (4m)

HEMOSIDERIN
since the question ask abt "substance" and not "substances"
but i wonder..(4m).

iii- 2 relevant questions to be asked on patient’s arrival (4m)


1)Adik ada makan kacang parang?
2)family history of same illness

iv- 2 clinical conditions that can give rise to these findings (4m)

1)G6PD deficiency
2)AIHA

v- 3 other relevant investigations & state the expected result (6m)

1)Screening test for G6PD
-Glucucose-6-phosphate level will be low.
2)FBP
-haptoglobin will be low
-normocytic hyperchromic red cells
3)Liver Function test
-liver enzymes ALt,AST will be normal
-LDH increase.

SYed on May 8, 2009 at 12:37 PM said...

Also, for history,ask about hx f neonatal jaundice.

the FBP will show contracted and fragmented cells,which are 'bite' and 'blister' cells.

 

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