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A 25-year-old man with a history of sickle cell disease presents with a 2-day history of non-productive cough and worsening non-pleuritic severe central chest pain radiating to both shoulders. He usually presents to your ED 1–2 times per month with complications arising from his sickle cell disease.

Vitals:

  • T 38.0Β°C
  • HR 120
  • BP 110/65
  • RR 28
  • Sats 88% RA

Sickle cell complications

1. What is the MOST CONCERNING diagnosis in this patient? 1 mark

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

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

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4. List (3) other ACUTE crises which may occur in patients with sickle cell disease. 3 marks

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

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