UnFiNiShEd CaSe CoMe BaCk LaTeR
History of Present Illness: a woman in her late 80’s with a history of lymphoma and last chemo 3 months ago presents with one week of gradually worsening malaise and loss of apetite. She denies fever, pain, vomiting, diarrhea or other complaints
Vital Signs & Physical Exam:
Vital signs are normal except for pulse of 103 and SPB of 108
Physical exam is otherwise normal except for slight slurred speech
Initial Diagnostic Testing:
- CBC: WBC 175, Hb 12, Plt 36, 60% blasts
- Chem 7: normal except for BUN/Cr 33/2.3 and Na 125
- Trop: 0.11
- Imaging: CXR and head CT nl
What is the most likely diagnosis?
- A)
- B)
- C)
- D)
- E)
SCROLL DOWN FOR ANSWERS & 1-MINUTE CONSULT
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ANSWER:
- A)
- B)
- C)
- D) Leukostasis – CORRECT
- E)
1-Minute EM Consult on the topic for this case from the Emergency Medicine 1-minute Consult Pocketbook
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CASE CONCLUSION: Acute myelogenous leukemia with suspected acute blast crisis. Peripheral flow cytometry suggestive of AML. 92% circulating blasts. Expired 3 days after admission from AML and renal failure
CASE LESSONS: