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25th July 2024
An 82-year-old male is referred for review in hospital due to a 6-week history of fatigue
An 82-year-old male is referred for review in hospital due to a 6-week history of fatigue. He was previously fit and well, and independent in all activities of daily living (ADLs), however now his wife has to help him wash and he can’t climb the stairs due to dyspnoea.
He has a background of hypertension, T2DM, hypercholesterolaemia and SLE (systemic lupus erythematosus). He takes ramipril, amlodipine, simvastatin, metformin and hydroxychloroquine.
The GP performs outpatient bloods:
| Hb (130 – 180 g/L) | 73 g/L |
| WCC (3.6 – 11.0 x 10⁹/L) | 7.2 x10⁹/L |
| Platelets (140 – 400 x10⁹/L) | 205 x10⁹/L |
| Bilirubin (<21 μmol/L) | 37 µmol/L |
| ESR (0 – 20 mm/h) | 42mm/h |
| Direct antiglobulin test | Red cell agglutination at body temperature |
Abbreviations: ESR (erythrocyte sedimentation rate)
What is the first-line treatment for the cause of his current presentation?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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