03-11-2015, 04:16 PM
A 57-year-old woman is brought to the emergency department 45 minutes after she fell after an episode of lightheadedness.
She has a 6-month history of progressive fatigue, tingling sensations in her fingers and toes, and loss of
balance. She underwent a partial gastrectomy for peptic ulcer disease 10 years ago. She has type 2 diabetes mellitus.
She has smoked one pack of cigarettes daily for 40 years. Her only medication is insulin. She appears pale. Her temperature is 37°C (98.6°F), pulse is 105/min, respirations are 20/min, and blood pressure is 124/76 mm Hg. The abdomen is soft with a well-healed surgical scar. Sensation to vibration and position is absent over the upper and lower extremities. She has a broad-based gait. Laboratory studies show:
Hemoglobin 8.3 g/dL
Mean corpuscular volume 105 μm3
Leukocyte count 4800/mm3
Platelet count 100,000/mm3
Serum
Bilirubin, total 2.1 mg/dL
Direct 0.2 mg/dL
Lactate dehydrogenase 320 U/L
Which of the following is the most likely explanation for these findings?
(A) Amyotrophic lateral sclerosis
(B) Diabetes mellitus
© History of gastrectomy
(D) Meniere disease
(E) Multiple sclerosis
(F) Vertebrobasilar deficiency
answer is C, everything fits, but does someone has explanation for the hemolysis pattern??
thanks in advance guys!!
She has a 6-month history of progressive fatigue, tingling sensations in her fingers and toes, and loss of
balance. She underwent a partial gastrectomy for peptic ulcer disease 10 years ago. She has type 2 diabetes mellitus.
She has smoked one pack of cigarettes daily for 40 years. Her only medication is insulin. She appears pale. Her temperature is 37°C (98.6°F), pulse is 105/min, respirations are 20/min, and blood pressure is 124/76 mm Hg. The abdomen is soft with a well-healed surgical scar. Sensation to vibration and position is absent over the upper and lower extremities. She has a broad-based gait. Laboratory studies show:
Hemoglobin 8.3 g/dL
Mean corpuscular volume 105 μm3
Leukocyte count 4800/mm3
Platelet count 100,000/mm3
Serum
Bilirubin, total 2.1 mg/dL
Direct 0.2 mg/dL
Lactate dehydrogenase 320 U/L
Which of the following is the most likely explanation for these findings?
(A) Amyotrophic lateral sclerosis
(B) Diabetes mellitus
© History of gastrectomy
(D) Meniere disease
(E) Multiple sclerosis
(F) Vertebrobasilar deficiency
answer is C, everything fits, but does someone has explanation for the hemolysis pattern??
thanks in advance guys!!