Anemiairon Deficiency

A 58-year-old black female complains of weakness, dizziness, anorexia, nausea, and occasional vomiting over the past 3 months. HPI She has also experienced shortness of breath (due to diminished oxygen-carrying capacity) as well as numbness and tingling in the extremities (due to megaloblastic peripheral neuritis). PE Slightly icteric eyes hepatosplenomegaly smooth, beefy-red tongue (glossitis) loss of balance, vibratory, and position sense in both lower extremities (due to posterior and...

Pyruvate Kinase Deficiency

ID CC A 6-month-old male is brought to a pediatrician for evaluation of listlessness, lethargy, and fixed gaze. PE Excessive extensor startle response to noise (hyperacusis) child is sleepy and hypotonic with poor head control and a fixed gaze appears to have translucent skin cherry-red macular spot found on funduscopic exam. Gross Pathology Diffuse gliosis cerebral and macular degeneration up to 50 increase in brain weight (due to deposition of sphingolipid). Micro Pathology Neuronal swelling...

Hereditary Spherocytosis

A newborn male in the normal nursery is noted to be cyanotic the pediatrician is called even though the child does not seem to be in respiratory distress. HPI That morning he had undergone circumcision (a benzocaine ointment was used). PE Cyanotic lungs clear and well ventilated heart sounds rhythmic no murmurs heard no cardiopulmonary problems evident. Labs CBC Lytes normal. Platelets, L.FTs, BUN, and creatinine normal. ABGs P02 normal. Methemoglobin level 18 total hemoglobin. Treatment Oxygen...

Hypokalemia

A 48-year-old female who has been on total parenteral nutrition for 2 weeks complains of weakness, cramps, palpitations, tremors, and depression. One week ago, she underwent her fifth major abdominal operation for intestinal fistula and sepsis. run down agitation with muscular spasticity and hyperreflexia o VS tachycardia hypotension. PE patient looks confused and heart sounds disclose skipped beats mild hypoaeration at lung bases abdomen with three colostomy bags at site of fistula no...

Diabetic Ketoacidosis

ID CC A 58-year-old white female comes to see her internist because of the development of polyuria, polydipsia (due to hyperglycemia), and a skin eruption that comes and goes in different parts of her body (necrolytic migratory rash). HPI She also complains of increasing intermittent diarrhea, nausea, vomiting, weight loss, and occasional weakness and dizziness. 2 PE VS normal. PE patient well hydrated marked pallor erythema- o tous rash on anterior chest, legs, and arms no neck masses g lungs...