Case 9: Sickle Cell Disease
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If a patient with known sickle cell disease presents with a probable stroke, what should be done?
The patient should be admitted to the hospital for a simple or partial exchange transfusion to reduce the amount of sickle cells and prevent further neurological damage
Once a sickle cell child has a stroke, what are their chances of having a stroke in the next 2 years?
Between 70 and 80 percent
What are some special vaccines that are given to children with sickle cell disease?
Meningococcal and 23 valent pneumococcal vaccines are given at 2 years of age, because many sickle cell patients become functionally asplenic at a young age
What are some pain medications that can be used for patients in sickle cell pain crises?
Morphine, and hydromorphone, in addition to hydration
What respiratory syndrome should be worried about in patients with sickle cell disease?
Acute chest syndrome
What percent of children with sickle cell disease have an acute stroke?
If a patient with a history of sickle cell disease presents with a significant increase in pallor, fatigue, or lethargy, what may he have?
An aplastic crisis. These patients should be hospitalized
If a boy with sickle cell has a priapism episode for more than how many hours should he be evaluated by a urologist?
More than 4 hours
What is the treatment for priapism secondary to sickle cell disease?
Aspiration and irrigation of the corpora cavernosa
If a patient with sickle cell disease presents with right upper quadrant pain, what is the most likely diagnosis?
Cholecystitis or cholelithiasis, because patients with sickle cell disease are at increased risk of developing gallstones
What routine measurements are preformed on sickle cell patients?
Baseline and then periodic CBC and reticulocyte measurements every 2 months
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