Bl and Lympg Anemia Script PDF

English Language Patient Consultations BLOOD & LYMPHATIC MODULE Anemia

© 2007 OCB MEDIA Page 1 of 11

BLOOD & LYMPHATIC MODULE : Anemia

History & Symptoms

Hi! I’m Dr. Hampton. How can I help you?

Well, basically, over the last couple of weeks—I play football on Sundays—and a bit

more than a couple of weeks ago, I was getting a bit more tired than I used to be. Like I’d

get out of breath in the game. I’d get puffed out. But more recently, it’s been little things, like

walking up and down stairs, and stuff like that. That’s got me a bit tired as well. So I was

just wondering what’s… what’s up with me, really,

OK. When did you first start feeling poorly? Can you remember?

That’s the thing: I had a cold, you see. Well, I thought it was a cold: I had a sore

throat. And I was quite under the weather for that. But I’ve never really recovered since

then.

And how long ago was that?

That’d be about a couple of months ago now

A couple of months? Did we see you with that?

No. So I …



No, I didn’t see you on the computer. So, you just basically managed that yourself,

and ah…

Yes. I thought it was getting better, but it’s never really… I suppose that’s never really

gone away entirely. So maybe it was something more than a cold. I don’t know.

OK. What symptoms were you getting with that cold at the time?

Um… Bad sore throat. My glands were… felt quite big, as well. So, um. I was just

really tired, really…, really, you know. No energy.

Were you short of breath at that time during that cold?..

Yes, but not as much as now. That’s why I’ve come in now, because

… it’s got worse…

.yeah, . it’s got a bit more noticeable

Have those cold symptoms gone away now?

Yes. Pretty much. I still get a bit of a sore throat every now and again.

Pretty much… Right, OK. When you are at rest, do you get short of breath?



No.

No. Okay. Have you noticed any noisy breathing…?

No… No, not really.

Never had asthma, or any sort of chest problems, as far as you know?

No, nothing like that. That’s why I’ve come in: because it’s strange to me.

Yes? OK. And what about your appetite and weight? How are you with eating and

drinking?

Fine, yes. Been OK.

And do you have a particular diet?—Do you—are you a vegetarian, or anything?

No, I’m not a vegetarian. I eat quite a lot of meat, actually.

You do?

Yes.



Red meat?

Yes, yes.

What about green, leafy vegetables—sort of…?

Whenever I can, yes.

OK. Um—Have you noticed any problems with abdominal pain, or indigestion

No, no. Nothing severe, no.

Nothing severe…have you had some from time to time?

No, not really. I’ve had mild discomfort, but that could be just indigestion, I suppose. I

don’t know.

Yes, OK. Is that something you’ve had on and off for many years? Or, new with this

It’s nothing new, no.

It’s nothing new—OK. Um—Any nausea or vomiting with this?

No.



What about your bowels? Have they been working normally?

Yes. Been fine.

. Been fine? Not passed any diarrhea or …

No, no, no.

In particular, not passed any black, or very dark motions?

No.

No? OK. You mentioned getting out of puff… In yourself, just day-to-day, how are you

feeling at the moment?

Just generally, a bit worn down, to be honest with you. Feel a bit “under the weather”,

I suppose you’d say.

Just “not right,” sort of

Yes. Something’s wrong I can feel something’s wrong, because I’m a bit…just a bit

dozy, almost. Just a bit… you know.

Are you suffering from any fevers, or sweats, or anything like that?



Mm. Not really, no.

And, um, what about family history? Is there a family history of people getting anemic,

for example, for any reason, as far as you are aware?

No, not that I can think of,,,

No-one’s had any, sort of, um—blood disorders, or anything…? Nothing like that, as

far as you’re aware. Parents both healthy?

Yes, yes.

And brothers and sisters…?

Yes, they’re fine.

Right. Fine. And did you have an idea in your own mind, what this might be?

I thought it maybe could have been related to the cold I had, because one of my

friends did have glandular fever around like a few months ago. Because my glands were

up, I thought it could be related to that.

Yes, OK. But you think the glands have gone down now?



Yes, they’ve gone down now, but, you know—it could be, like, an after-effect of that.

Physical Examination

OK, so you just lie, flat on your back, and just relax all your muscles. I’m going to be feeling round the abdomen, and I just want you to tell me if you feel any tenderness first of all.

Nothing there, no

No, OK. Right. If I do hit tenderness, let me know…. No tenderness there?

No.

How about here?

No

OK that’s fine. And here. I want you to just try and keep all your muscles relaxed but

breathe deeply in, just…. (breath) and out. Just keep on breathing in and out now. …..Just

keep on going. And out. OK that’s good.

Same thing on this side now. No pain or anything around there?

No

OK . And again. And out, OK that’s fine. I want to feel this side more closely for a

minute. I want you to just turn so you’re facing slightly towards me, about there. That’s

perfect. Are you comfortable there just for a minute? If you could just pop your arm down

so you’re relaxed, as best you can.



Do you want me to breathe?

Just carry on breathing in and out please yes. OK. Just want to do that again. And

again, OK that’s fine. You can get dressed again

Diagnosis & Explanation

Right. The main thing I find when I’m examining you is you are, you have all the signs anyway of being anemic. Do you know what anemia is?

. Something to do with the blood?

That’s right. It means that basically you’ve not got enough of the blood cells that carry

the oxygen around the body.

OK

And when that’s the case in your case when you’re not doing anything it's fine but if

you’re trying to then exert yourself ; play football or run up the stairs

Oh I see

… your body takes a bit of time to catch up which is why you’re getting a bit short of

breath

What could be causing it?



Well this is the next question for me really. There’s no obvious cause. I mean, by and

large, the main causes are that your diet’s not sufficient and you need to build up on the

elements to give you the supplies to make the blood cells. Sometimes that there’s a slow

bleed going on somewhere but there’s certainly no evidence of that whatsoever. Or that

there for some reason you’re just not producing the right blood cells that you need for

whatever reason. Now at this stage I’m afraid I’m not in a position to answer those

questions. I think the first thing is that I need to just establish that my suspicion you are

anemic is in fact correct so I need to do a blood test is what I’m saying

Oh OK

And I’d like to get it within a short-ish timescale. I’ll be doing a few other blood tests

that might also then give some more information about why you’re anemic, if you’re anemic

and what type of anemia it is. Because there’s all sorts of different reasons why it might be.

It could be because you haven’t got enough of certain vitamins or not enough iron. So in

other words we need to look into this and I need to see you again

Treatment & Advice

At this stage I don’t think I want to give you any treatment, I really want to know what were dealing with before we take it any further. So I would be grateful, in fact I’ll give the receptionist a ring, if we could squeeze you in this morning to get a blood test done and we’ll get that done today and I'll see you in 4 days time. So if you just let the receptionist know and she’ll sort out all the dates with you. So I’ll get those results back and we’ll talk it through The glandular fever, or sorry the infection, could well be, could be relevant

It could have been glandular fever?

Well it could have been. When I examined you, the only thing apart from anemia I

could find was your spleen, (it’s an organ in the body that deals with red blood cells), is

slightly enlarged. But not very much, and it certainly wasn’t bothering you. So, you know,

I’m not sure of the relevance of that at this stage. Given that you’re a slim chap maybe I can



just feel a normal spleen. But with you being anemic, I’m not quite sure what to make of

that at this stage but I think that there’s enough reasons for me to say look we need to look

into this to get things right for you

OK right

. and I can’t really answer too many questions at this stage because I haven’t got the

foundations to answer them. So you know at this stage not quite sure what’s going on,

need to find out more, I’ll find that out within a short-ish time scale, and see you again in 4

days time when we have all the blood tests back

and take it from there.

and take it from there. Now I realize there’s a lot of uncertainties with this. Any

particular concerns you have on your mind at the moment?

Just that if it is anemia, or I am anemic what can I do to fix it?

I think again it depends on why you’re getting it, if it’s just purely that you’re low on

iron, well (1) we’ve got to find out why you’re not absorbing iron because your diet seems

good enough, or if it’s a vitamin deficiency of another type, we just replace that and that’s

the end of that. Again being fair haired, blue eyes there’s a chance you might have a

certain type of vitamin deficiency which is quite common in people of Nordic descent,

interestingly. But there are other reasons as well so I suppose I can’t really answer your

questions right now.

OK, it’s too early. OK, we’ll wait until we get the tests back.



Any other questions?

No

No, OK, that’s fine. So make the arrangements with the receptionist, they’ll squeeze

you in for a blood test today. If there’s any problem with that, tell them to give me a ring and

I’ll sort it all out. I’ll see you in 4 days and at that point will have a lot more certainty on

which to base some more advice

.OK ,so it’s a waiting game

It is indeed. So I’ll see you in a few days

OK

OK

. Thanks, bye

Documents

Bl and Lympg Anemia Script PDF