Anemia Diagnosis and Assessment

Questions and Answers

Which additional lab test is most likely needed to confirm a diagnosis of macrocytic anemia?

Serum B12 and folate (correct)

Iron panel: serum iron, iron binding capacity, and ferritin

Osmotic fragility

Hematologic malignancy panel by next generation sequencing

Given the vital signs and findings, which condition is least likely to cause the symptoms presented by the patient?

Hereditary spherocytosis (correct)

Anemia of inflammation

Iron deficiency anemia

Macrocytic anemia due to B12 or folate deficiency

What is the most likely diagnosis for the 71-year-old woman's symptoms of fatigue, weakness, and palpitations?

Iron deficiency anemia

Chronic hypoxia due to lung disease

Heart failure

Macrocytic anemia due to B12 or folate deficiency (correct)

When assessing a patient with dry mucous membranes and a shiny red tongue, which condition should be considered?

B12 deficiency anemia Signup and view all the answers

What underlying condition could explain the patient's history of myocardial infarction and current symptoms?

Anemia of inflammation Signup and view all the answers

In evaluating fatigue and malaise in an elderly woman, which risk factor could have a significant impact on her condition?

Age-related physiological changes Signup and view all the answers

Which laboratory test combination is appropriate for evaluating anemia?

RBC count, Hb, Hct and RDW Signup and view all the answers

How can this anemia be classified based on lab findings and history?

Hypoplastic/hypoproliferative Signup and view all the answers

Which additional lab test is crucial to confirm the diagnosis?

Hemoglobin electrophoresis Signup and view all the answers

Which finding in the physical exam is most indicative of a possible hematological issue?

Palpable spleen Signup and view all the answers

What is the most likely diagnosis for the patient's anemia?

Hereditary spherocytosis Signup and view all the answers

What might the symptoms indicate in a 10-month-old with swelling of hands and feet?

Sickle cell crisis leading to vaso-occlusive pain Signup and view all the answers

What does the elevated reticulocyte count suggest in this patient?

Increased red blood cell production Signup and view all the answers

Which laboratory finding is most consistent with the diagnosis of anemia in this patient?

Low hemoglobin levels Signup and view all the answers

What laboratory work-up is essential for a suspected case of anemia during a fever episode?

Complete blood count, blood culture, and BMP Signup and view all the answers

Which vital sign is not typical in a well-conditioned child but is present in this case?

Increased heart rate Signup and view all the answers

What is the significance of the increased RDW in this patient's blood count?

Suggests a variation in red blood cell size Signup and view all the answers

Which of the following physical signs would most likely be observed in an infant with a severe hemolytic anemia?

Jaundice due to bilirubin buildup Signup and view all the answers

In evaluating the total bilirubin level of 1.6 mg/dL, what might this indicate?

Hemolysis of red blood cells Signup and view all the answers

What is the primary concern if the MCV is recorded at 79 fL?

Presence of microcytic anemia Signup and view all the answers

Which of the following findings is least relevant for making a diagnosis in this case?

Cranial nerves II-XII intact Signup and view all the answers

Based on the laboratory results, what do the low levels of hemoglobin suggest?

Potential anemia or blood loss Signup and view all the answers

Which laboratory finding indicates the presence of macrocytic anemia in the patient?

High MCV Signup and view all the answers

Which combination of laboratory findings supports the diagnosis of anemia of chronic disease?

Hb/Hct, MCV, MCHC, and normal bilirubin Signup and view all the answers

What physical exam finding in the patient suggests potential anemia?

Shiny and red tongue Signup and view all the answers

What does a reticulocyte count of 2.0% indicate in this patient?

Normal response to anemia Signup and view all the answers

Which symptom is least likely to be associated with anemia of chronic disease?

Frequent nosebleeds Signup and view all the answers

What can be inferred from the low platelet count of 51,000/uL?

Risk of bleeding complications Signup and view all the answers

Which laboratory value is indicative of a microcytic anemia?

Low MCHC Signup and view all the answers

What is a potential cause of the patient's symptoms and findings, considering her age and medical history?

Chronic kidney disease Signup and view all the answers

What does a low hemoglobin (HGB) level of 5.0 g/dL indicate about the patient's condition?

The patient has a diagnosis of anemia. Signup and view all the answers

Which of the following laboratory findings is indicative of microcytic anemia?

Low MCV Signup and view all the answers

Considering the laboratory findings, which combination indicates a potential diagnosis?

Hb/Hct, MCV, RDW, and platelet count Signup and view all the answers

What does a high platelet count of 535,000/uL suggest in this patient?

There may be an inflammatory response. Signup and view all the answers

Which differential finding may raise suspicion for an acute response in this patient?

Increased lymphocyte percentage Signup and view all the answers

What could be inferred from the presence of a low MCH level of 17.2 pg?

It could suggest iron deficiency anemia. Signup and view all the answers

What does the patient's pale and dry mucous membranes suggest regarding her hydration status?

The patient may be dehydrated. Signup and view all the answers

Study Notes

Case 1: Anemia Assessment

Patient: Well-nourished woman with normal vital signs and no acute distress.
Physical exam noted a palpable spleen and normal abdominal findings.
Complete blood cell (CBC) results display low hemoglobin (9.8 g/dL) and low hematocrit (29.4%).
Elevated reticulocyte count (5.5%) suggests increased red blood cell production.
Total bilirubin levels are elevated (1.6 mg/dL), indicating potential hemolysis.
Relevant findings for diagnosis include the palpable spleen and abnormal blood counts.
Anemia diagnosis can be classified as hereditary hemolytic based on lab findings.
Additional testing may include osmotic fragility and EMA binding test for confirmation.

Case 2: Pediatric Assessment

Patient: 10-month-old African-American boy with recent swelling in hands and feet and irritability.
Physical exam shows inconsolable crying and swollen extremities.
Vital signs indicate fever (39.2°C) and tachycardia (160 bpm).
Anemia of chronic disease is suspected due to symptoms and physical findings.
Sepsis work-up initiated, including CBC and BMP to evaluate for infections.

Case 3: Elderly Patient Evaluation

Patient: 75-year-old woman with symptoms of weakness and nosebleeds, history of heartburn.
Physical exam reveals pale, thin appearance and neurological deficits.
CBC results show low WBCs (3,200/uL), RBCs (3.05 x 10^6/uL), and hemoglobin (9.6 g/dL).
Laboratory findings suggest macrocytic anemia (MCV of 112.9 fL).
Relevant findings are dry, erythematous mucous membranes and abnormal neurologic exam.
Additional tests needed include serum B12 and folate levels to confirm diagnosis.
Most likely diagnosis is macrocytic anemia due to B12 or folate deficiency.

Case 4: Comprehensive Assessment

Patient: 71-year-old woman with progressive fatigue and weakness, indicating possible anemia.
Physical exam findings include pale and frail appearance, dry mucous membranes.
CBC indicates severe anemia with hemoglobin at 5.0 g/dL and critically low hematocrit (16.9%).
Platelet count elevated at 535,000/uL suggests potential inflammatory or compensatory response.
Overall, the low reticulocyte count (2%) indicates inadequate bone marrow response for her anemia.
Diagnosis supported by evaluating laboratory findings, particularly low Hb, Hct, and MCV.

Key Points

Diagnosis of anemia relies heavily on CBC findings, clinical presentation, and physical exam findings.
Definitions of anemia types include hereditary, chronic disease, B12/folate deficiency, and iron deficiency.
Additional tests are often needed for confirmation, and treatments may vary based on underlying causes.
Consider patient history and symptom patterns when evaluating the etiology of anemia.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Explore detailed case studies focusing on anemia assessment in a well-nourished adult woman and a 10-month-old child. Learn to identify key diagnostic findings such as blood test results and physical symptoms. This quiz covers hereditary hemolytic anemia and chronic illness-related anemia in children.