A 19 year old woman with sickle cell disease presents with pleuritic chest pain, fever, and shortness of breath 1 day after admission for a pain crisis. Pulse oximetry is 88 percent on room air. Chest radiograph shows a new right lower lobe infiltrate. Which of the following is the best next step in management in addition to oxygen and analgesia?
- A)Intravenous iron infusion
- B)Warfarin monotherapy
- C)Exchange transfusion or simple transfusion as clinically indicatedGABARITO
- D)Immediate splenectomy
- E)Vitamin B12 replacement
Explicação
Exchange transfusion or simple transfusion as clinically indicated is correct. Acute chest syndrome is a life threatening sickle cell complication defined by a new pulmonary infiltrate plus respiratory symptoms or hypoxemia. Management includes oxygen, pain co... Ver explicação completa e trilha adaptativa →