Wednesday Case studies


By Dr Olusegun Abraham

(Watsapp Group 1)

A 68-year-old man has been complaining of headache, dizziness, blurred vision and fatigue. On examination, he appears plethoric; ophthalmoscopic exam shows engorged retinal veins. His spleen is palpable 3 centimeters below the left costal margin. Complete blood count shows a hematocrit of 56 percent, normal red-cell morphology, increased red-cell mass, white blood cell count of 16,000/µL with increased basophils and eosinophils, and platelets at 700,000/µL.

Which of the following is the major cause of morbidity and death in this illness?

A. Bleeding

B. Heart failure

C.Opportunistic infection

D.Renal failure


A 9-year-old boy with type I diabetes goes to the pediatrician’s office accompanied by his mother. The boy requires several daily insulin injections for his diabetes, and his condition has been well-controlled. The pediatrician would like to introduce the patient to a newly released insulin-delivery system that makes administration of insulin much easier, convenient, and with less pain. In order to introduce this new system to the boy, what would the pediatrician require?

a. Consent from the mother and the boy

b. Consent from the mother and assent from the boy

c. Assent from the mother and the boy

d. Assent from the mother and consent from the boy

e. Neither consent nor assent from the mother or the boy


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