50yo M presents with 3-days of fever and 2 months of fatigue. He has diffuse cervical LAD and HSM. Labs show anemia, thrombocytopenia, and leukocytosis with immature forms.
Most likely diagnosis?
Contrast with myelof
...
50yo M presents with 3-days of fever and 2 months of fatigue. He has diffuse cervical LAD and HSM. Labs show anemia, thrombocytopenia, and leukocytosis with immature forms.
Most likely diagnosis?
Contrast with myelofibrosis
Leukemia or more generally, hyperproliferation of hematopoietic progenitor cells
Myelofibrosis occurs in two phases:
- Proliferative - thrombocytosis, leukocytosis, etc.
- Pancytopenic - low everything
The fact that there's an abundance of lymphocytes and decreased RBC/plt means that there's simultaneous proliferation and crowding out of other cells
What is the mechanism of C. diff?
Be very general
Toxin-induced inflammation of colonic mucosa
An elderly patient with a long history of COPD presents with mild respiratory distress, early satiety, weight loss, JVD with prominent a wave, distant breath sounds, RV heave, tender/smooth/pulsatile liver, and trace lower extremity edema.
What is the most likely cause?
Mechanism?
Longstanding pulmonary disease + right heart symptoms --> cor pulmonale
This is due to constant hypoxic vasoconstriction of the lungs, which places strain on the right heart.
(True or False)
Exogenous ingestion of an organic acid causes anion-gap metabolic acidosis
True
Pt with a history of Crohn syndrome presents with 24 hours of severe abdominal cramps. Prior to this, he had 2 weeks of constipation. Physical exam shows signs of bowel obstruction. KUB shows no free air, but shows air-fluid levels.
Most likely cause?
Small-bowel strictures secondary to Crohn disease.
NOT intussusception (way rare in adults)
Pt presents with hemearthrosis after minor injury with increased PTT; normal BT and INR.
Most likely cause?
What is normal bleeding time?
Hemophilia A (Factor VIII deficiency)
2-7 minutes
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