S2D: The Symptom to Diagnosis Podcast Anemia
15 snips
Mar 10, 2021 A 65-year-old man's case of leg pain and anemia sets the stage for a detailed exploration of diagnostic reasoning. The discussion highlights key principles for diagnosing anemia, emphasizing the importance of CBC results and reticulocyte counts. Clinical findings reveal a surprising cause—metastatic adenocarcinoma—after extensive testing. Listeners learn crucial clinical tips, such as recognizing iron deficiency and the significance of conjunctival pallor. This informative session sheds light on the complexities of diagnosing anemia and the need for thorough investigation.
AI Snips
Chapters
Books
Transcript
Episode notes
Leg Pain That Hid Anemia
- A 65-year-old man presented with severe leg pain self-diagnosed as sciatica and was admitted.
- His labs showed a hematocrit of 28 and hemoglobin of 9, which prompted further evaluation.
Always Check Full CBC And Retic
- Check the full CBC (WBC and platelets) and smear when you see anemia to detect pancytopenia or hemolysis.
- Ask for a reticulocyte count to distinguish underproduction from hemolysis before jumping to iron or B12 tests.
Order A Reticulocyte Count
- Always order a reticulocyte count when evaluating anemia to detect hemolysis.
- A high retic points to hemolysis and avoids missing diagnoses like TTP or autoimmune hemolysis.
