A patient presents to you with diffuse petechiae (2mm areas of minor bleeding visible on the surface of the skin), pupura (bigger verisons of petechiae) and ecchymoses about both cheeks, the temples, and under his left eye. A significant limp is noted in his left leg, and his right arm exhibits an intermittent tremor. He complains of abdominal pain and describes a single episode of hemoptysis earlier in the day.
Upon questioning, the patient tells you that he “fell down some stairs” and may have swallowed some rat poisoning. Fearing a concerning lifestyle, you ask the patient if he drinks to which he responds…”naw…but tonight seems like a great time to start!”
Your patient is likely suffering from:
A) You have no idea
B) Disseminated Intravascular Coagulation
C) Internal Bleeding
D) Institutional abuse at the hands of a Heme/Lymph exam
E) All of the above:
I have to wonder sometimes, whether there is a professor watching our class struggle on his/her exams via CCTV, chuckling to herself while wringing her hands malevolently. I’m certain of it. Heme/Lymph, a block of material focused on clotting, leukemias, and anemias was my first reminder this semester that I am a medical student – and lessons learned with a bruise are seldom forgotten.
It’s good to be back.