Approach to a Patient – Investigation and Diagnosis of Blood Disorders

by Paul Moss, PhD

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    00:00 Hello, In this lecture, I would like to concentrate on investigation and diagnosis of the blood system.

    00:07 Learning outcomes of this lecture will include the fact that a diagnosis is made by combining the history, examination and investigation. Blood count, blood film and blood clotting are basic investigations used in many patients with hematological disorders, but sometimes a bone marrow may be required. Genetic analysis is now essential in many cases for the diagnosis of hematological disorders. And finally a range of additional specialized tests may be needed and that can often include imaging such as x-rays.

    00:50 Now the clinical approach to the diagnosis in the patient with blood disorders involves three major approaches.

    00:59 This is true for any clinical condition, diagnosing an infection, rheumatoid arthritis, its always the same.

    01:07 Firstly take a medical history, listen to the patient and listen to the symptoms they describe.

    01:15 Secondly, perform an examination. And finally, if necessary use of investigations.

    01:23 and in this lecture, we will be largely focusing on those investigations and their appropriate use within the management of patients with haematological disorders.

    01:34 Let's just spend a minute talking about taking a history in a patient with a blood disorder.

    01:42 Of course there's all sorts of things that one might need to ask and the patient may tell you.

    01:48 If it is a red cell problem, that will usually mean anaemia, in which patient will be fatigued, or short of breath because they are not getting enough oxygen to their tissues.

    02:01 If it is a problem with white cells, that might lead to unusual or prolonged infections.

    02:08 Whereas excess white cells, too many cells can happen in malignant diseases such as leukaemia and lymphoma.

    02:15 The patients may notice swellings or lumps.

    02:19 Finally, anything that affects platelet function can lead to bruising and bleeding and particularly looking for unusual bruising or bleeding that makes us suspicious.

    02:33 Now let us turn to the potential examination of a patient with a blood disorder.

    02:38 There's a range of things that you may wish to examine, but a broad examination is required in most cases.

    02:44 You might want to look at the nails and skin or the mucous membranes to see if there's anaemia or bleeding.

    02:52 Examination of the lymph nodes may suggest leukaemia or lymphoma and of course, excessive bruising may be seen in platelet disorders.

    03:03 I have a couple of photographs for you here in the top right, a patient with anaemia-iron deficiency anaemia.

    03:10 You will notice a slight ulceration at the corner of the mouth.

    03:16 At the bottom, the doctor is examining the spleen in the patient.

    03:21 Spleen lives under the left-hand side of your ribs and if you feel in that area, you shouldn't feel your spleen.

    03:27 It only becomes palpable when it's enlarged. But for the rest of this lecture, I want to focus on

    About the Lecture

    The lecture Approach to a Patient – Investigation and Diagnosis of Blood Disorders by Paul Moss, PhD is from the course Hematology: Basics.

    Included Quiz Questions

    1. Gum hypertrophy
    2. Ecchymosis
    3. Purpura
    4. Fatigue
    5. Pale finger nails
    1. Joint disorder
    2. Ecchymosis
    3. Purpura
    4. Spontaneous nose bleeds
    5. Increased bruises

    Author of lecture Approach to a Patient – Investigation and Diagnosis of Blood Disorders

     Paul Moss, PhD

    Paul Moss, PhD

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