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Francis Caldwell, a man in his 40s, comes to the clinic with complain of…
Francis Caldwell, a man in his 40s, comes to the clinic with complain of fatigue and anemia. He lives an active life and is exposed to environmental issues.
History of presenting complain:
Stressful life
Took vitamin supplements, they didn't work
No previous diseases
Previous warehouse work, expose to chemicals
Ischemic heart disease: family history
Smoker (10 per day or more when stressed)
Back pain at times
Sleep issues
Healthy diet normally
Physical examination:
High BMI
Conjunctival and palmar creases: not pale
No brusing: no bleeding diseases
No lymph glands are swollen
No bruits
Normal peripheral pulse
CVS and respiratory is normal
Normal bowel sounds
Spleen is 6-7 times enlarged and tender
CBC
Leukocytosis
Neutrophils, monocytes, eosinophils, basophils, blasts, promyelocytes, myelocytes, metamyelocytes, platelets: all elevated
RBC's count, Hb, HCT: all low
Diagnosis:
Chronic myeloid leukemia