VIT B12 Deficiency Anemia.
Vit B 12 deficiency anemia under Ix. Chief Complaints A 17 yr old female has come with pain around umblicus and multiple episodes of loose stool and vomiting for past 4 days. Also giving 1 episode of black colored stool with mucus. No associated fever, dysuria, cough, pain radiation to back, chest pain etc. No H/O HTN, T2DM, Thyroid Disorder, substance abuse. Normal Menstrual cycle, Vegan. No H/O any drug intake or NSAID or any anti coagulant. Pt was examined showing pallor and mild Icterus. No edema, cyanosis or clubbing. Vitals were stable except sinus Tachycardia. Systemic Examination was normal. P/A soft, BS+, No Organomegaly or lymphadenopathy. Routine blood Ix along with workup for Anemia and Jaundice was done. Ix showed Hb of 8 , mild elevated T. Bil, Normal USG, stool for occult blood neg, macrocytic blood picture with Raised MCH and Hypersegmented Neutrophils. Ferritin is normal. Retic count and Sr vit B 12 reports are awaited.
Macrocytic anaemia Hypersegmented nutrophil B12 Or folate deficiency Inj vitcofol2 cc 10 im od
Inflammatory bowel disease to ruleout
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18 year old male patient from lower socioeconomic group presented with hyperpigmented lesions as shown in pictures. History of recurrent jaundice present. No history of prolonged fever or substance abuse. Blood reports- lymphocytosis, raised ESR (110), USG- hepatosplenomegaly (mild to moderate). LFT- deranged (ser. Bilirubin 1.9...with unconjugated fraction greater than 50%. ). Hb- 5.5 gm%. TLC normal, platelets 90k. Dx and MX plz.
Dr. Lalit Kumar0 Like7 Answers - Login to View the image
Pancytopenia under Ix. *Chief Complaints* A 52 yr old lady has come with Dizziness, 2 Episodes of blood Tinged sputum, multiple episodes of vomiting since 6 Jan. No Associated features. No past H/O HTN, T2DM, Thyroid disorder, Substance abuse. Routine Ix were done showing Pancytopenia, mild elevated Total Bil of 1.5,rest LFT was normal. Malaria n Dengue were Neg. Next MCH, MCV, MCHC, Reticulocyte count, Sr Iron profile, Stool for occult blood n USG W/A, Sputum for AFB, sputum for C/S, Mantoux test n CXR was advised. Reports were suggestive of Macrocytic anemia, MCV of 128,normal Sr ferritin n Iron profile, stool for occult blood was neg along with neg Sputum n Mantoux test. CXR n other test were Normal. USG W/A was normal. Normal Retic count. Next sample for Sr VIT B12 was sent n also planned for Bone Marrow Aspiration. Today pt arrived with Reports showing low Sr VIT B12 of 56. Hence a case of VIT B12 deficiency Anemia leading to pancytopenia n Dyserythropoeitic features. Conservative management has been started.
Dr. Ashutosh Chandan Dubey0 Like3 Answers - Login to View the image
A 60-year-old postmenopausal woman presents with fatigue, mild jaundice, and tingling in the lower extremities. Laboratory studies show elevated serum levels of homocysteine and methylmalonic acid, and mild thrombocytopenia. A peripheral blood smear :
Vinith Velmurugan7 Likes19 Answers - Login to View the image
37yf VH done 3yr back P3L3 c/o weakness, loss of appetite, hyperacidity vth regurgitation, low backache..BP-140/100.no H/O DM.HTN.thyroid.scd.her hb- 6.6gm, urea-88,creat-3 .plz help further ix n mgt
Dr. Santosh Sahu2 Likes32 Answers - Login to View the image
a girl child with h / o wheat allergy is now taking wheat without any problems but her ttg test is still positive. my question is whether one should stop her wheat diet.on other diet plans she start losing wt and appetite and her parents give her wheat again .she gains wt and has no other symptoms whatsoever while on wheat
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