Clinical Case: Mr. Herbert is tired.
 
Symptoms & History

Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

What was so important?
  • Patient history and physical is the most important part of any evaluation.
  • An anemia is a symptom, not a disease. 
  • There is always an underlying cause for an anemia.
  • Size, shape and average width (RDW) of the RBCs will help group the anemia.
  • Retic count is one of the most important lab tests you can get.
    • High values tell you there is rapid turnover.
    • Low values tell you the bone marrow can't produce the RBCs.
  • The occult blood test must be interpreted carefully.
    • It reflects both upper and lower GI bleeding.
    • There are both false negatives and positives.
  • Sophisticated tests, such as the CEA, have their limitations.
  • You can't know it all. Be sure to use the resources available to you. 
  • Although only indirectly referred to, I hope it is evident that the physician is part of a team. Nurses, laboratory personnel and others play a vital role in the outcome of a patient's recovery. Don't be a jerk. 
I am feeling so smart now, bring on the quiz.                                           Back

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