Master the board step 3

Hematology 7
Anemia
All forms of anemia lead to fatigue and a subjective sense of loss of energy. The
case will use words such as tired, fatigue, malaise, or loss of energy. You will be
able to recognize more severe anemia when the question says short of breath,
lightheadedness, or confusion. Other diseases may also present with fatigue or
shortness of breath, similar to anemia.
If the question describes
a craving for ice or dirt
(i.e., forms of pica), think
anemia. Step 3 loves to use
pica as a lead in to anemia.
Diseases with presentations similar to those of anemia:
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Hypoxia
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Carbon monoxide poisoning
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Methemoglobinemia
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Ischemic heart disease
Physical Examination
On CCS, choose the following physical exams: general appearance, CV, chest,
extremities, and HEENT.
Potential positive findings are pallor, flow murmur described as I/VI or II/VI
systolic murmur, and pale conjunctiva. Hemolysis will also give jaundice and
scleral icterus (yellow eyes). The chest exam is chosen routinely in any patient
with shortness of breath, even though there are no positive findings in anemia,
to exclude other causes of shortness of breath. In severe anemia, an ECG is
needed to exclude ischemia. Anemia kills through myocardial ischemia.
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