12 yr female pt presented with mild grade fever with anemia since 1 month...received blood transfusion for anemia...but she repeatedly presented with anemia...what will be line of investigation and management...?? cbc s/o of lymphocytic leukocytosis.....




Anemia with Thrombocytopenia and Leukocytosis with Splenomegaly....r/o Acute Leukemia, MF..,..Do peripheral smear and bone marrow

H/O Bleeding, Look for patecheal hamorhage, lymphenopathy. CBC,Investagation to Identify common cause of pyrexia should be incuded.Then prior to blood transfusion Bone marrow exam.Peri pheral blood smear for Anaemia typing, premature cell, haemoglobnopathy,should be done.12 year female child, Fever,Splenomegaly,marked Leucocytosis as well as Thrmbocytopenia.Further,Bone marrow exam as there is a marked Leucocytosis & thmbocytopenia.Peripheral blood smear, Haemoglobnopathy, Dengue, Assessment in relation toSplenomegaly should be included. In Some area kala Azar also prevalent.Urine test,USG abd.LFT including s.protein, albumin BUN,S.Creat,S.electrote, Blood & Urine Culture may require. Avoid Aspirin & NSAID ,IM Injection.Consider sponging, paracetamol oral or infusion.Imperical Antibiotic can be considered.Platlate concentrate must be considered.Avoid stored blood.Consider only Fresh blood transfusion after Peripheral blood smrear exam.Haematologist,Medical Oncologist & paediatrician consultantation must.

A case with high TLC...with thronbocytopenia...low hb.......low rbc..some immunogenic..phenamena...going..on...go..RA....facter ...ANA...blood culture..

Peripheral smear.iron studies.chest x-ray .urine routine USG abdomen and malaria.dengue.afb

Bone marrow aspiration cytology needed ?ALL

Two cell lines are depressed. Bone marrow examination is investigation of choice and diagnostic.

? ALL, bone marrow aspiration cytology

CBC in favour of acute leukaemia Peripheral smear for immature cells is easy and cheap investigation. If positive, go for bone marrow aspiration. If negative, investigate for PUO and leukemoid reaction.

Bone marrow study

I agree with Dr A Lakra

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