Teaching Cases - American Society of Hematology


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Teaching Cases

Anemia and Renal Insufficiency – Robert A. Kyle, MD, and Michael Tomasson, MD
Dr. Kyle: Washington University School of Medicine, St. Louis, MO; Dr. Tomasson: Mayo Clinic College of Medicine

I. History	II. Physical Exam	III. Laboratory Data	IV. Pathophysiology
V. Differential Diagnosis	VI. Prognosis/Clinical Course	VII. Teaching Points	VIII. Bibliography

II. PHYSICAL EXAM

While examining the patient you find the following:

The blood pressure was 170/90.
Temperature: 37^o C (98.6^o F)
She appeared pale.
The lungs were clear.
The liver and spleen were not palpable and there was no lymphadenopathy.

There were no other significant findings on examination.

What questions might you ask the patient at this time? Select the questions that will help you in this case.

	Are you under a lot of stress?
	Have you had a fever recently?
	Have you noticed any swelling in your lymph nodes?
	Have you had swelling of your lower extremities?
	Have you noticed any change in your tongue?
	Do you have any numbness or tingling of your extremities?
	Do you have bone pain?
	Do you have any pets?
	Have you lost weight recently without dieting?
	Do you have any excess bruising?
	Have you noticed any change in your voice?

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