00:00
Continue.
00:00
Well, obviously, the
symptoms here with
any type of anemia is going
to be fatigue and tiredness.
00:06
And here, with iron deficiency,
weakness, pallor, tachy.
00:11
Oftentimes, anemia, because
you have decreased viscosity.
00:14
You’ve heard what I just said,
remember this from physio.
00:17
In anemia, you don’t have as
much hemoglobin concentration,
so it is the opposite
of polycythemia.
00:22
Are we clear?
Opposite of polycythemia.
00:26
So we have decreased viscosity.
00:26
Oh, what does that mean?
Tachy,
tachy.
00:30
We’ll talk more
about that later.
00:31
Next, well, let’s say that your
patient tells you about these issues:
“Hey, doc, I’m having a
hard time swallowing.”
“What is it that you’re having a
hard time swallowing, my friend?”
“I’m having a hard time
swallowing solids.”
"Okay. Tell me about this.
Is it getting worse?"
"Are you having a hard time
swallowing liquids by chance?"
"No. I can have smoothie
all day long, no problem."
"But when I try to have that
piece of chicken, that darn –"
"It feels like I get a bone stuck
in my throat, every single time."
"Oh, okay."
So, so far, we have
dysphagia to solids only.
01:10
Next,
you take a look at the patient’s
tongue and it’s beefy red.
01:13
Beefy red.
01:14
Not mine, okay?
I have a lot of -- Whatever.
01:16
So mine is not this, but
if it was beefy red,
then that will be
glossitis, wouldn’t it?
And then the patient tells you, “Hey, doc.
When I’m eating ice cream,
I don’t even need a spoon because
my finger can do the job for me.”
So this is spooning of the nails,
welcome to koilonychia.
01:33
What are all that I just give you here?
I gave you webbing or a webbed
type of esophagus, right?
So esophageal web, number one, hence
the dysphagia to solids only.
01:47
Number two, I gave you glossitis, I gave
you koilonychia and iron deficiency,
no doubt, what does your patient
have with those types of symptoms?
Oh, very good.
01:56
Plummer-Vinson syndrome.
01:57
Are we clear?
So chronic iron deficiency
may cause pica.
02:01
What does that mean?
You’re going to start finding –
Remember the body’s amazing.
02:06
It will try to find nutrition
everywhere that it can,
so look for an individual that might
be perhaps eating unusual things,
looking for that iron, known as pica.
02:17
Pica.
02:20
Take a look at the nails
here, they are spooned.
02:23
This is not clubbing,
be careful.
02:25
So if you take a look at the
sagittal view here on your right,
the clubbing would show expansion
of the nail bed, right?
Or if it was bronchogenic carcinoma, you
would find what’s known as clubbing-like
and it’s called hypertrophic
osteoarthropathy, isn’t it?
This is not that.
02:42
This is the opposite,
this is spooning.
02:44
Welcome to koilonychia
and this should automatically as
a high suspicion differential be
something like Plummer Vinson.
02:52
Okay.