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Clinical Case

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  2. 2. 38 year old patient has been admitted for raised Hb,RBC . Currently the patient is asymptomatic.
  3. 3. ON EXAMINATION Jaundice: Nil Anemic:Nil LN:Nil Cyanosis:Nil Clubbing:Nil Oedema:Nil Dehydration:Nil VITALS: P:80/min BP:150/100mmHg R/R:20/min T:36.6c Wt:102kg
  4. 4. CHEST: B/l clear air entry CVS:S1.S2.M0 P/A:Soft nontender,no organomegaly
  5. 5. MEDICAL h/o:HTN+,no DM,PTB,Hepatitis SURGICAL h/o:non significant ALLERGIC h/O:non significant PERSONAL h/o:Smoker X 10 years,alcoholic+
  6. 6. INVESTIGATIONS COMPLETE BLOOD COUNT: WBC:10.44X10*9/L(N=62.5%),L(29.3%), RBC:6.56X10*12/L,HB:203g/L,HCT:60.2% PLT:193X10*9/L Random Blood Sugar:6.71mmol/L RENAL FUNCTION TEST: Urea:4.7mmol/L,Cr:78umol/L Na:140mmol/L,K:3.78mmol/L
  8. 8. INTRODUCTION  Polycythemia (also known as polycythaemia or polyglobulia) is a disease state in which the proportion of blood volume that is occupied by red blood cells increases.  Blood volume proportion can be measured by HCT levels.
  9. 9.  An increase in the number of red blood cells  Elevated hematocrit measurement  Elevated levels of hemoglobin  Very low levels of erythropoietin
  10. 10. TREATMENT Phlebotomy Low dose of ASPIRIN Medication to decrease blood cells: Hydroxyurea,IFN@
  11. 11. COMPLICATIONS Blood Clots:Leading to risk of CVA,MI Massive Splenomegaly Itching of Skin Other Blood Disorder:Myelofibrosis,MDS,Acute Leukemia
  12. 12. DEBATABLE POINTS Why not to use Hydroxyurea ,IFN@? Is it worthy sending serum EPO? Random Blood Sugar is high,Patient is obese to send Fasting Blood Sugar is a must?  While using ASPIRIN,PPI should be used to protect patient from Peptic Ulcer,UGI bleeding?
  13. 13. Reference checked=true
  14. 14. THANK YOU