case leukimia
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VITYA RESANINDYA
030.08.253
SUSPECT CHRONICGRANULOCYTIC LEUKIMIA
CASEREPOR
T
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Autoanamnese on 22nd of November 2012 at 13.00 pm
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Name : Mrs. A
Age : 38 years
Gender : Women
Address : Karangmulya, Kec Batujaya.
Occupation : Labor
Religion : Moslem
Marital Status : Married
Race : Sundanese
Edcuation : Elementary school Taken from : Jatisari
Addmision to hospital at November 2oth 2012
IDENTITY
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Patient came to Emergency Unit of Karawang Cityhospital with complaint of having pain and verydiscomfort on her left abdomen more than 2
weeks, then she also felt nausea with vomitting. Shethinks that in her left stomach filled by something like amass and becomes bigger day by day. Her appetitewas markedly less a few days ago.
Patient also complaint immense weakness withpalpitations, malaise and fatigue since 1 weeksbefore admitted to hospital. His breathing was very fastwhich was worsened by walking fast, climbing stairs,and by any kind of exertion.
HISTORY OF PRESENT DESEASE
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Patient never had history of nose bleed, bruise, andswelling in both of lower extremities, but she gotbleeding gum every brush her teeth. Fever, cough,and influenza denied by her. There’s no abnormality of defecation and urination.
Patient never consume any drugs for along time.
HISTORY OF PRESENT DESEASE
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Inspection : Symmetrical
Palpation : Equal vocal resonance
Percussion : Sonor in both lungs
Auscultation : Vesicular breath soundin both lung, ronchi (-/-),
wheezing (-/-)
THORAX L U N G
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NSPECTION Brown skin, Supple Icteric (-) ,pale (-), hematom (-), ptechie(-)
USCULTATION Bowel sound (+) normal 2x/minute, venous hum (-), Arterial bruit (-)
ERCUSSION Tymphany in all abdomen regio except hypocondrium
sinistra
ALPATION
ABDOMEN
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arm acral
dema
eformation (-), brown skin , icteric (-), flapping tremor (-),
EXTREMITY
LABORATOR
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Haematology Result Normal
Hemoglobin 4,0 12-17 gr/dL
Eritrocite 1,44 3.8 – 5.8 jt/mm2
Leukocytes 1100 5.000 – 10.000
Trombocytes 95.000 150.000 – 450.000
Hematocrite 14 37-43%
Diff. Count :
- Basofil 0 0-1
- Eusinofil 0 1-3
- Batang 0 2-6
- Segmen 45 40-70
- Limfosit 46 20-40
- Monosit 9 2-8
LABORATOR Y 20. 11. 2012
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Result Normal
PGC 97 80-140 mg/dl
FPG 70-100 mg/dl
2-h PG <140 mg/dl
Ureum 8,6 10-45 mg/dl
Creatinin 0,58 0,4-1,5 mg/dl
Result Normal
MCV 26 82-92 mc/L
MCH 32 27-31 Pg
MCHC 13,2 32-35 %
LABORATOR
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LABORATOR Y
Result Normal
Hemoglobin 6.8 12-17 g%
Leukocytes 2900 5.000 – 10.000 uL
Trombocytes 97000 150.000 – 450.000
Hematocrite 21 37-48%
Result Normal
Hemoglobin 9.9 12-17 g%
Retikulosit 19 < 2%
23. 11. 2012
25. 11. 2012
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ACUTE MIELOBLASTIK LEUKIMIA
CHRONIC LIMFOSITIC LEUKIMIA
APLASTIC ANEMIA
MYELODISPLASIA SYNDROM
NOCTURNAL PAROXISMALHEMOGLOBINURIA
DIFFERENTIAL DIAGNOSIS
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Pharmacology Nacl 0,9 % 20 dpm
Khalmetazone 3x1 mg
Omeprazole 1x1 vialAminofluid 1 kolf/day
Sohobion 2x1 tab
PRC transfution 5 kolf
NonPharmacology Resting when he
need toAvoiding contactsports
Self - Protecting from
germsExercise continously,rhytmical, interval,progressive 3-4
x/day
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Bone marrow biopsy
Chromosom test
Suggested examination