Hematology Case-@ © A 60 year old male patient presented with pallor, weakness and bone pain. On Exanimation- Investigations: Hb: 8 gmv/dl TLC: 9x 10°/L, DLC: Polymorphs 65%, lymphocytes 30%, Monocytes 5% PBS: Red cells show rouleaux formation and are normocytic normochromic Platelet count: 102 x 10°/L ESR: 132mm 1* hour (Westergren) S. Calcium: 12.1mg/dl Imaging studies- Lytic lesions are present in skull, pelvis and spine. DLC of bone marrow aspirate- Granulocytes- 20% Lymphocyte- 5% Plasma cells- 65%, Mott cells +. Flame cells + Erythroid precursors-10% Q.1) What is your diagnosis? Q.2) Mention atleast four criteria.Case- 5 Xase= = aediatric OPD with History-_4 years old boy presented to p: sal bleeding, bruising throughout the body, soft complaints of na tissue haematoma formation, Haemorrhage into the joints (Haemarthrosis) & haematuria. Investigations- Bleeding time - Normal Platelet count - Normal Clotting time - Prolonged APTT- Increased Factor VIII - Deficiency Q 1) - Give your diagnosis . Q 2) Give 2 complications resulting from this haematological disorder.> einialCSF CHART: 1 Case 1. A 22-year-old ale was admitted with complaints of hi hours, severe he grade fever since 18 ts). On examination, he + Brudzinski sign Positive .He had no significant ‘adache, confusion, photophobia (Bright lights hi revealed neck stiffness. Kerning’s sign + Past history illness or medications. (Temp 102.2°F, P 80/min, RR 24 breaths per minute, BP 150/86 mua/Hg) PHYSICALEXAINATION Biological Reference Interval Volume 08 mi Appearance Cloudy (Turbid)* Coagulum Absent Cobweb Absent (CHEMICALEXAMINATION Proteins 160 mg/dL * 15~45 mg/dL. Glucose 20 mg/dL * 45-80 mg/dL. (260% Plasma) Chlorides 120 mEq/aL 118 -132 mEq/L. MICROSCOPICEXAMINATION Total Nucleated cells 1200 * 0-5 /cellsimm* RBCs 2 0-4/PHE Lishman Stain Neutrophils 95% ,*5% Monocytes ---Send for C/S Grams Stain / organism + sample sent for culture/ sensitivity ZN Stain No AFB Seen © Q. 1. What is your diagnosis? © Q.2. Write at least two causative agents.| gpa pares suontpdo9 HED zysnope mins (CO gagsoidoyp anos stawuan (LO ABHON ~ aanedon -uaitoulid Sausod=— WMT yore N01 oizot- = *S sun sh - osesaysueounae aurueTe) LAOS sun or - @seuopsuranoumune overdse) LUODS o4Suay 192K ui GST G AND “4A OF “UM Ss mon Ns9AUT5 Yr. sindhi male child presented with severe pallor weakness and joint pain. History of repeated blood transfusion since last 2 years. Give your diagnosis and 2 investigations to confirm the diagnosis.45 Yr. old female patient presents with pain in Rt. Lumber region, oliguria and low grade fever since 15 days. Patient has past history of renal stones. Urine Examination : 40 — 50 RBCs / Hpf 10 — 15 puscells/Hpf Granular casts present. Blood Examination : Serum Urea — 40 gm. / dl. Serum Creatinine : 20 mg./dl. Serum Sodium 220 meq/Itr, Serum Pottasium — 8 meq/Itr. Write your diagnosis and write common causes for this condition. q25 Yr. male patient presented with fever jaundice and nausea since 4 days. He received blood transfusion 15 days before the start of fever and jaundice. Give your diagnosis and write 2 investigations to confirm the diagnosis.“poieyp ano wren 1 voReSasu) yeoopas 2915 (Z ouBep mot ani9 ( “Aanppodses yn 064 19,009 148 ¥.LODs Poreaaye ApaTEN } suo SHACT ox euauopqe>9 oS #¢ THOINIT?a HAEMATOLOLY Case- 2 d with complaints of fever, History- 52 years male presente weakness & had hepatosplenomegaly on clinical examination, On CBC examination, WBC count- Markedly raised, Haemoglobin & platelet- Reduced, On peripheral blood smear examination, myeloblasts- 60%, QD-GiHAEMATOLOGY Case- 1 History - 4 Years old male child presented with complaints of fever & mild hepatosplenomegaly on CBC, total WBC count is markedly raised with 80% lymphoblasts on peripheral blood smear examination. Platelet Count & haemoglobin is reduced, Q1)- Give diagnosis,HAEMATOLO UY Case- 4 aints of weakness , ars male presented with compl History yei bone pain & pathologic fractures. 1) Peripheral blood smear examination. RBC's showed rouleaux formation. WBC- Normal Platelet- Normal. 2) Urine- Bence jones proteins present. Q 1)- Give your diagnosis . Q 2) Give 2 investigations to confirm your diagnnosis.CLINICAL Case- 1 abdominal pain loss of appetite & History 35 years/ male presented with yellowish discolouration of sclera. Investigations- Serum bilirubin (Total)- 6 mg/dl Direct bilirubin- 4 mg/dl Indirect bilirubin- 2 mg/dl SGOT: 110 U/L, SGPT- 125 U/L ‘Unine bilirubin- present. QU) Wiite interpretation & diagnosis. 2) Write causes of this clinical condition.MATOL |4hE need obY 2 History- 45 years male presented with complaints of weakness & fatigue. On clinical examination- moderate to massive hepatosplenomegaly. Investigations- - CBC- Marked leucocytosis 1,00,000/mm3. - On peripheral smear examination, differential leucocyte count is as follows, - Myeloblasts- 10%. ~ Myelocytes- 25%. ~ Metamyelocytes- 10%, - Band forms- 20%, ~ Neutrophils- 15%, ~ Basophils- 4%, - Eosinophils- 10% ~ Monocytes- 0696, Q1)- Give diagnosis . Q2)- Write the chromosomal haematological disorder,CSF CHART -3 Case 3. A22 year male presented with fever, d running nose and malaise EXAMINATION Reference Interval Volume Appearance Gagulam Cobweb idache, and neck stiffaess, Findings 6mi Clear Absent Absent Proteins Glucose Plasma) Chlorides ICROSCOPICEXAMINATION Total Nucleated cells 400 Cells/ mm? +* 0-5 /eells/mm? RBCs Absent 0-4 /PHE Lishman Stain 90 % Lymphocytes *, 10% monoeytes Grams Stain/ No Organisms ‘No organisms ZN Stain AFB Absent Sample sent for PCR testing 60 mg/dt, * 15~45 mg/dL 60 mg/dL. 45-80 mg/dL (260% 120 mEq/L. 118 -132 mEq. Q.L.What is your diagnosis? Q.2.What is Xanthochromia?22. Montion at least» etiology ieausative conditions.)