Chronic 2

Blood & Lymphoreticular System


Step 1: View Clinicals

{"ops":[{"insert":"A 72 year old woman presents with progressive, bilateral hearing loss for 1 year.\n\nShe was treated for bilateral otitis media earlier, which included placement of myringotomy tubes. However, her symptoms have not improved.\n\nClose questioning reveals a history of chronic fatigue and dyspnea on exertion for more than 2 years, which she attributed to old age.\n\nHer medical, surgical and family histories are unremarkable and she is not on any medications currently.\n\nHer complete blood count reveals a leukocyte count of 85,600 with 80% lymphocytes, a hemoglobin level of 10.9 g\/dL, and a platelet count of 130,000\/mm3.\n\nA peripheral blood film reveals lymphocytosis, thrombocytopenia and smudge cells.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-115_en.png"}},{"insert":"\n"}]}

Step 2: Order Relevant Investigations

1. Flow Cytometry
2. Bone Marrow Aspiration and Biopsy
3. Biopsy Tympanic Membrane
4. CSF Analysis

Want to continue playing?

Open your Clinical Odyssey account today.


Enjoy unlimited access to 600+ simulations.
Safely improve your skills, anytime and anywhere.
Get answers to your follow-up questions from practicing physicians.