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Morning Stiffness, Fatigue, Bilateral Knee Pain. Lab Tests Show Low Hg, Hct, RBC, High ESR. Diagnosis?
Mrs. Harris is a 38 year old woman with new onset of early morning stiffness , fatigue , and bilateral knee pain . Her lab values are the following: Hg 9.8 (12-16g ref. range) Hct 31% (37-47% ref. range) RBC 3 million (3.2-4.5 million ref. range) MCV 84 fl (81-99 ref range) ESR 45 (less than 15 is ref. range) 1. Name 4 Differentials to consider. 2. What further laboratory testing would you do?
Sat, 24 Aug 2013
Good evening there..well you have to evaluate her further. Does the knee swell also or is it just pain? Hw about associated backache or neck pain?any other joints affected.? Any fever oral ulcers eye pains? U should get a crp done. At her age it s important to rule out inflammatory arthritis like rheumatoid, spondyloarthopathy or any other ctd. According to the history she needs to be investigated rather than doing whole lot of tests. If you could let me know the answers can guide you better
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