 
                            Is "overlap Myeloproliferative Disorder,monoclonal B-cell Lymphocytosis" A Terminal Condition?
 
 
                                    
                                    
                                          
                                               Posted on
                                          
                                            
                                         
                                           Wed, 29 Jan 2014
                                           
                                        
                                        
                                        
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                                             Wed, 29 Jan 2014
                                                
                                            
                                                Answered on
                                                
                                                Wed, 29 Jan 2014
                                                
                                            
                                                Answered on
                                             
                                             Mon, 24 Feb 2014
                                                
                                                
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                                                Mon, 24 Feb 2014
                                                
                                                
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                                            Question : We would like to know whether a geriatric male with overlap myeloproliferative/myelodysplasticity disorder; monoclonal B-cell lymphocytosis; COPD; pulmonary oedema; and CCF is now likely to be terminal. Much more detailed information will be sent to  YYYY@YYYY 
                            
                                    Brief Answer:
I would not label this patient as terminal
Detailed Answer:
Hello,
I have read your query and the attached reports. 
I would not label this patient as terminal. 
Something can be tried for him. 
Kindly let me know few more details.
1. why is his HR at 92/mt with pacemaker?
2. What is his 24 hr. urinary output?
If I were the treating doctor, I would manage his fluids according to output and electrolytes. 
In addition you could give him 20% albumin 100 ml daily @5drops/mt for 3 days and a better antibiotic like Meropenem with sulbactam and Inj. Metronidazole only 100 ml twice daily.  
Thanks again...........Dr. P.C.Singh 
                                    
                                    
                                    
                                    
                                    
                             Above answer was peer-reviewed by :
                              
                            
                                  
                                      Dr. Shanthi.E
                                  
                              
                                          
 
                                    
                                    
                                 
  
 
                                    Thank you Dr XXXXXXX   I value your expertise greatly.  Unfortunately, I don't know the answer to your two questions.  Could you tell me the significance of a HR at 92 with a pacemaker? Why should he have 20% albumin 100 ml daily?  There is a suspicion that he has sepsis even though the blood cultures were negatiive.  Why would the alternative antibiotics be better. I'm sorry to be asking all these question of you, but I am trying to gain a better understanding of the situation.
                                
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