Sunday Lucky

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@TSM_Humanist @rkalyes1 Agreed. Very exhaustive

[Sunday Lucky @_SundayLucky]

@rkalyes1 @TSM_Humanist @Internist_02 @DrOribaDan @CelestinoGutirr @DennisPhd1 @ps_lukwago @SemitalaFred @DrMutungaEA Also AKI management. If he can withstand BMA/Bx it would be the confirmatory test.

[Sunday Lucky @_SundayLucky]

@rkalyes1 @TSM_Humanist @Internist_02 @DrOribaDan @CelestinoGutirr @DennisPhd1 @ps_lukwago @SemitalaFred @DrMutungaEA HyerCa2+, high Creat, Lyici lesions, mass in/above the spleen.
Dx: Multiple Myeloma with Plasmacytoma. Elevated total protein----> Hyperviscosity---->epistaxis. Whats the cbc like? Hb, wbc plt
Plenty of IV fluids + calcitonin for hyperCa2+,
Do spep and paraprotein quantfication

[Sunday Lucky @_SundayLucky]

@mtnug @brianmozes Why will the renewed offer be removed and when?

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@ZarahConnolly Excellent work🫡

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@David_Ornstein @TheAthleticFC Jim Ratcliffe after he got the green light from Sesko💲💲💲

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@IAmTheOlum @JohnsHopkins @JohnsHopkinsSPH @JohnsHopkinsEPI Congratulations big man

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@mkainerugaba "Sprints down the hall, and slides into the room." Michael Scott from The Office

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@rkalyes1 @TSM_Humanist @DrOribaDan @ChefKarim02 @DrAkhilX @drkeithsiau @divyaa24 @ACCESS_UG @ps_lukwago @graekan @DennisPhd1 @dr_katumwa Very challenging case. With the b Symptoms lung mass with associated effusion and the significant leukocytosis this could be a high grade lymphoma, especially in a young man. Could we have a breakdown of the wbcs/rest of cbc. How is the Ldh.

[Sunday Lucky @_SundayLucky]

@batenkss Typical canon balls. Does he have lymphadenopathy? Anemia GI bleeding especially melena. Any tumor markers? Are you able to do upper +lower GI Endoscopy, CT abdomen to identify a possible primary for histology?

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@GILBERTGILO2 @ganeshuor Good one. Difference of squares

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@Asadthegeek @rkalyes1 @DrOribaDan @TSM_Humanist @NiravValand30 @ChefKarim02 @27Jipman @ACCESS_UG @JoyMoreen1 @CelestinoGutirr @DrKisaBrian @DennisPhd1 @graekan @dr_katumwa @eddympuuga True. Philadelphia chromosome test would settle the debate.

[Sunday Lucky @_SundayLucky]

@rkalyes1 @DrOribaDan @TSM_Humanist @Asadthegeek @NiravValand30 @ChefKarim02 @27Jipman @ACCESS_UG @JoyMoreen1 @CelestinoGutirr @DrKisaBrian @DennisPhd1 @graekan @dr_katumwa @eddympuuga Splenomegaly makes CML more likely than AML. Let's hope for the best

[Sunday Lucky @_SundayLucky]

@rkalyes1 @DrOribaDan @TSM_Humanist @Asadthegeek @NiravValand30 @ChefKarim02 @27Jipman @ACCESS_UG @JoyMoreen1 @CelestinoGutirr @DrKisaBrian @DennisPhd1 @graekan @dr_katumwa @eddympuuga For Cytoreduction ➡️ Hydroxyurea or low dose cytarabine
NB: Rehydration is crucial. Apheresis is possible but expensive
Qtns: How long is the history, is there splenomegaly, is a BMA/Bx possible.

[Sunday Lucky @_SundayLucky]

@rkalyes1 @DrOribaDan @TSM_Humanist @Asadthegeek @NiravValand30 @ChefKarim02 @27Jipman @ACCESS_UG @JoyMoreen1 @CelestinoGutirr @DrKisaBrian @DennisPhd1 @graekan @dr_katumwa @eddympuuga Patient has features of Leukostasis. Dx: Myeloid Leukemia (CML blast phase vs AML) However the basophilia of 0.2 is not very convincing for CML
?Tumor Lysis Syndrome (need to look at his extended electrolytes: K, Ca, Phosphate) ➡️ In this case Febuxostat > Allopurinol due to AKI

[Sunday Lucky @_SundayLucky]

@DougieCritchley @MinaFootball Agreed, I didn't know her before, but she knows what she is doing. Some people just can't stand to see others doing well.

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@HKaweesi The nephrologist even restarted fluids

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@DenisMungasa @rkalyes1 @27Jipman @PlatinumHosp @DrOribaDan @NiravValand30 @damshae87 @graekan @JosephOgavu @DrMutungaEA @CelestinoGutirr @ACCESS_UG @amutuhair @AnaesthesiaMak I wonder how many doses can be bought using an interns monthly salary

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@drkaggwek @NamaWellness Congrats big man

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@thefutballboy_1 Fred for Man Utd Vs Crystal Palace