ANSWERS ON QUESTIONS
Main part
Patient K., 60 years old, was hospitalized in the Central District Hospital at the place of residence in connection with
severe weakness, shortness of breath, palpitations at the slightest exertion.
I felt weak for several years, the last 2 years I began to notice pain in the spine.
In her youth she was a blood donor 8 times, has 3 children, had 4 abortions. General practitioner
Sorbifer was assigned as a precinct in connection with the detected anemia (red blood cells - 3.12 × 1012 / l)
Durules 2 tablets per day for 1.5 months. No effect was obtained. General analysis
blood: red blood cells - 1.42 × 1012 / l; hemoglobin - 50 g / l, color indicator - 1.0;
reticulocytes - 0.4%; platelets - 98 × 109
/ l; white blood cells - 2.6 × 109
/ l (stab
neutrophils - 3%, segmented neutrophils - 30%, lymphocytes - 60%, monocytes -
7%), anisocytosis ++++, poikilocytosis +++; ESR - 72 mm / hour.
The questions are:
1. Is it possible to preliminarily make one of the following diagnoses:
"Aplastic anemia"? "Acute leukemia"? "Multiple myeloma"?
2. How to make a preliminary diagnosis?
3. Does the patient need a hematologist's consultation, sternal puncture?
4. In biochemical analyzes revealed: total blood protein - 140 g / l, albumin -
30%, globulins - 70%, an M-gradient was detected in the gamma-globulin zone. Will it shrink
Your diagnostic search?
5. In which department should this patient be treated?