Case 1 - History

A 35 year old man presented to his doctor with the following symptoms; melaena, tendency to bruising, and weight loss over the last few weeks.
On examination he showed multiple petechiae and purpura on limbs, and an enlarged spleen.

Glossary

Melaena - This is a condition of the stools in which dark, tarry masses are passed from the bowel. It is due to bleeding from the stomach or from the higher part of the bowel, the blood undergoing chemical changes uder the action of the secretions, and being finally converted in large part into sulphide of iron.

Bruising (extravasations) - An escape of fluid from the vessels which ought to contain it ('a bruise').

Petechiae - These are small spots on the skin, of red or purple color, resembling flea bites. They are small haemorrhages of the skin, as in purpura.

Purpura - These are purple spots on the skin of the body, due to extravasations of blood in the skin, associated occasionally with haemorrhages from mucous membranes.