Haematology

Haematology

Case
Study
Assignment
A
57
year-­-old
female
presented
to
her
GP
with
a
history
of
fatigue,
weight
loss
and
increasingly
severe
back
pain.
On
examination
she
appeared
pale
with
no
signs
of
hepatomegaly
or
splenomegaly..
Table
1
Laboratory
Test
Results
Test
Result
Reference
Range
RBC
2.82
x
1012/L
3.8-­-5.8
x1012/L
HGB
7.6
g/dL
11.5-­-16.5
g/dL
HCT
0.239
L/L
0.37-­-0.47
MCV
84
fL
80-­-96
fL
MCH
26.9
pg
27-­-32
pg
MCHC
31.8
g/dL
32-­-36
g/dL
RDW
16.8
12-­-16
PLT
423
x
109/L
150-­-400
x109/L
WBC
8.4
x
109/L
4.0-­-11.0
x109/L
Differential:
Neutrophils
5.04
x
109/L
2.0
–
7.5
Lymphocytes
2.18
x
109/L
1.3
–
3.35
Monocytes
1.10
x
109/L
0.2
–
0.8
Eosinophils
0.08
x
109/L
0.04
–
0.44
Basophils
0.08
x
109/L
0.0
–
0.1
Blood
Film:
Normocytic
normochromic
with
occasional
hypochromic
cells.
Moderate
rouleaux
formation
Bone
Marrow
Aspirate:
Plasma
cells
with
variable
morphology
present.
Bone
Marrow
Trephine:
Hypercellular
with
clusters
of
plasma
cells.
Immunohistochemical
staining
for
?/?
shows
sheets
of
?
with
few
?
restricted
cells.
Chemistry:
Total
Protein
11.0
g/dL
Serum
protein
electrophoresis:
Albumin
Globulins:
a1
a2
ß
?
3.2
g/dL
0.4
g/dL
1.0
g/dL
0.8
g/dL
5.8
g/dL
5.2-­-8.3
g/dL
0.1-­-0.5
g/dL
0.5-­-1.2
g/dL
0.5-­-1.1
g/dL
0.6-­-1.7
g/dL
Monoclonal
protein
(in
g
fraction)
5.5
g/dL
IgA
9
mg/dL
85-­-450
mg/dL
IgG
5800
mg/dL
800-­-1700
mg/dL
IgM
25mg/dL
60-­-370
mg/dL
Radiography

demonstrated multiple lesion of the skull, spine, pelvis and femurs.The patient began treatment with combination therapy of
melphalan and thalidomide, with radiotherapy support treatment of bone pain.

Questions
1. Appraise the results and identify the diagnosis.
2. Explain with reference to the clinical and laboratory data the pathophysiology of this disease.
3. Identify possible treatment modalities for this patient and others like her.

ORDER THIS ESSAY HERE NOW AND GET A DISCOUNT !!!

You can place an order similar to this with us. You are assured of an authentic custom paper delivered within the given deadline besides our 24/7 customer support all through.