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35yrs old male presented with c/o generalised waeakness, fever on and off also c/o vomiting multiple episode with depression since one month.. diagnosis and treatment??

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A case with HB- 2.9 , TLC - 1500 , Platelets 21000- Indicative of Pancytopenia ( severe anaemia , severe leukopenia, alarming thrombocytopenia needs an urgent admission. Although widal is positive and bilirubin is 6.7 and liver enzymes slightly raised . Most likely Diagnosis is MYELODYSPLASTIC SYNDROME (MDS) Which is also inclusive of other possibilities like Aplastic anaemia , multiple myeloma , Acute leukemia. Patient needs further investigations . 1.Bone marrow Examination 2.Ultrasonography abdomen. 3.X- ray chest 4.Tests for haemolytic anemia like HB electrophoresis, osmotic fragility test, indirect coombs test , G6PD 5.Urine for Bence Jones proteins 6 S.Iron and B12 studies 7.HbASG and hepatitis C Meanwhile awaiting reports he needs blood transfusion preferably Packed cells , inj methyl cobalamin 2500 mg alternate days , UDCA 300 mg B.D . Pantoprazole with a prokinetic Avoid using anti- depressant at this stage

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Obs.jaundice Advise usg

A case with HB- 2.9 , TLC - 1500 , Platelets 21000- Indicative of Pancytopenia ( severe anaemia , severe leukopenia, alarming thrombocytopenia needs an urgent admission. Although widal is positive and bilirubin is 6.7 and liver enzymes slightly raised . Most likely Diagnosis is MYELODYSPLASTIC SYNDROME (MDS) Which is also inclusive of other possibilities like Aplastic anaemia , multiple myeloma , Acute leukemia. Patient needs further investigations . 1.Bone marrow Examination 2.Ultrasonography abdomen. 3.X- ray chest 4.Tests for haemolytic anemia like HB electrophoresis, osmotic fragility test, indirect coombs test , G6PD 5.Urine for Bence Jones proteins 6 S.Iron and B12 studies 7.HbASG and hepatitis C Meanwhile awaiting reports he needs blood transfusion preferably Packed cells , inj methyl cobalamin 2500 mg alternate days , UDCA 300 mg B.D . Pantoprazole with a prokinetic Avoid using anti- depressant at this stage

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? Typhoid fever , ? Ananestic reaction Anemia, Pancytopenia Hyperuncojugated bilurubinemia Increased liver enzymes DD Dengue fever, needto do dengue profile , abdominal ultrasound. Anemia profile to rule out hemolytic crisis , including bone marrow biopsy . This can explain leucothrombocytopenia, hepatitis, fever, vomiting . Needs admission IV fluid support Blood transfusions Hepatoprotectives CARIPILL.

Enteric fever with hepatitis with septicemia causing pancytopenia and hemolytic jaundice.There is some amount of obstructive jaundice causing increase increase direct bilirubin and alkaline phosphatase.A blood culture to be done and higher antibiotic started.I V glucose and symptomatic treatment for vomitting and fever.Hemolytic profile to be done before blood transfusion to rule out hemolytic anemia

Pt having pancytopenia with hemolytic hepatitis picture Peripheral smear Usg abdomen Blood culture,Hbsag,dengue check, coombs test Iron and vit B 12 profile Bone marrow biopsy if necessary.. Treatment with... Broad spectrum antibiotics Packed cells and SDP transfusion (if bleeding manifestation present) Udiliv 300mg Multi vitamin and iron supplements Other supportive treatment..

Diagnosis : Haemolytic jaundice with severe anemia with pancytopenia D/d Rull out obstructive jaundice Adv: HB Electrophoresis, LDH, Retic count, BMA, serum iron profile, vit b12 level Usg upper abd

Jaundice ?severe anemia with pancytopenia Investigations for HbsAg and dengue Pack cell and platelet transfusion

Hepatitis a with enteric fever inj monocef2gm iv 7 days udiliv300 bd hydration rest

Anemia investigate
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Obstructive jaundice, Do USG

Megaloblastic anaemia is most common cause of pancytopenia. Needs to rule out other causes also like aplstic anemia, post viral illness ,autoimmune

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