MedBugs: SAQ #294

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Case: Chest pain in sickle cell disease

A 25-year-old man with sickle cell disease presents with non-productive cough, severe central chest pain and hypoxia. Vitals are as follows : T 38.0°C

HR 120
BP 110/65
RR 28
Sats 88% RA

1. What is the most concerning diagnosis in this patient? 1 mark

2. Excluding infection, list two possible precipitants for this presentation. 2 marks

3. State four initial management priorities for this patient with justification. 4 marks

4. List three other acute crises which may occur in patients with sickle cell disease. 3 marks

5. List two indications for exchange transfusion in sickle cell crisis. 2 marks

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