Master the board step 3

Master the Boards: USMLE Step 3
Microangiopathic Intravascular Hemolysis
Sickle Cell Anemia
The most likely hemolysis question to be asked will concern sickle cell anemia.
The question will describe pain in the chest, back, and thighs that is very severe.
Physical Exam
A complete physical examination is very important for the sickle cell case. If
there is a fever after you give oxygen, fluids, analgesics, and antibiotics, then
perform a complete physical examination.
Possible findings of the physical include the following:
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HEENT: Retinal infarction
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CV: Flow murmur from anemia
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Abdomen: Splenomegaly in children; absence of spleen in adults
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Chest: Rales or consolidation from infection or infarction
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Extremities: Skin ulcers (unclear etiology in sickle cell) and aseptic necrosis
of hip. Aseptic necrosis is found on MRI.
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Neurological: Stroke, current or previous
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