26 yrs married f presenting severe anemia,sob on exertion, swelling of both upper and lower extremities, puffiness of face, white conjunctiva,pale face, irregular menses with scanty flow h/o migraine no h/o dm,htn,piles bp 90/50 pr 100/mt spo2 97 one unit B.T. done yesterday

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This does not looks to be simple c/o anaemia as tlc shows Lecucoctysis with polymorphs are 90% with h/o sob seems to be septicimia and x-ray chest must be taken rather find out of the cause of septicemia. Pt should be hospitalised and investigate properly and manage it pt may require BT and iv broad spectrum antibiotic.

Agree with Dr. Agarwal Sir! Leucocytosis s/o infective origin and r/o site of infection
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Pt. Is having a leucocytosis so there is infection. So go for x ray chest and usg of abdomen to find out cause.treat the infection with antibiotics and give blood transfusion. See for serum creatinine and thyroid function tests.

Looks like microcytic hypochromic anemia sir. DD: . Chronic kidney disease but bp is low. . Tuberculosis . SLE . RA . Chronic anemia with CCF . Hypothyroidism - do thyroid function test

T LC very high . Go for usg chest X-ray blood culture urine acr re. Stool obt . If pos. Endoscpy Urea creatinine. . Bit B12 folic acid. TIBC ferritin hemoglobinopathies

Go for PBf to rule out acute leukaemia

Atleast 3 point blood transfusion anemia with leucocytosis megaloblastic anemia check before transfusion serum ferritin transferrin reticulocyte stool rt haemogram serum creatinine tsh serum protein urine rt xray chest ECG venous Doppler lower limb

Serum iron profile please tlc very high Rft normal?please start with braod spectrum antibiotics and work up on leukocytosis lets not forget the possibility of blood malignancy too so bone marrow examination too

What about RDW% P S for comment, organomegaly or not . Blood transfusion should be differed till diagnosis is made Now difficult to comment. History is als not in detail.

What medication was she on for migraine ?Lots of investigation required Admit the patient for proper work up in the meantime antibiotic therapy broad spectrum

Anemia of chronic disese... tb Explain microcytic hypochromic anemia incresed esr And respiratory syptoms Go for serum iron profile Afb cbnaat

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