Nocturnal 2

Blood & Lymphoreticular System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This young lady has presented with dark urine, jaundice, and abdominal pain, while examination reveals the presence of pallor; this constellation of symptoms is strongly suggestive of an episode of hemolysis.\n\nThis is supported by the presence of severe anemia in the complete blood count (CBC), and the marked indirect hyperbilirubinemia in the liver profile.\n\nNote also the presence of a positive urine dipstick test for heme, but the absence of erythrocytes in the centrifuged sediment; in this clinical context, this is most suggestive of hemoglobinuria, hinting that this is very likely an intravascular hemolysis.\n\nThe elevated lactate dehydrogenase and decreased haptoglobin levels subsequently confirm this assertion.\n\nThus, a hemolytic anemia is the probable diagnosis; the question lies as to which of the many such types it might be.\n\nAt a high level, hemolytic anemias can be classified into congenital and acquired anemias; the terms intrinsic and extrinsic anemias can be used interchan"}]}

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