Multiple

Blood & Lymphoreticular System


Step 1: View Clinicals

{"ops":[{"insert":"A 63 year old woman presents with \u0027aches and pains\u0027 in her knees, shoulders, and lower back for 3 months, in association with worsening fatigability. She has also lost weight during this time period, although the extent has not been measured.\n\nHer medical, surgical, and family histories are unremarkable, and she is not on any medications. She does not smoke, drinks only socially, and is on a normal diet.\n\nHer complete blood count is significant for a Hb of 9.5 g\/dL, WBC of 3,800\/mm3, and a platelet count of 115,000\/mm3.\n\nA follow up peripheral blood picture reveals a normocytic, normochromic anemia with marked rouleaux formation. Her ESR is 89 mm\/1hr.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-127_en.png"}},{"insert":"\n"}]}

Step 2: Order Relevant Investigations

1. Metabolic profile
2. Skeletal Survey
3. Monclonal Gammopathy Screen
4. Bone Marrow Biopsy

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