Investigation of Erythrocytes Series Cases PDF
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Universitätsmedizin Campus Hamburg
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Summary
This document is a set of medical case studies on the investigation of erythrocytes series. It includes various cases, each with symptom descriptions and laboratory findings. The format of the study points to a medical education program.
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PAGE 1 UNIVERSITÄTSMEDIZIN NEUMARKT A. M. https://edu.umch.de www.umfst.ro CAMPUS HAMBURG May Investigation of erythrocytes series. Cases. Case no 1...
PAGE 1 UNIVERSITÄTSMEDIZIN NEUMARKT A. M. https://edu.umch.de www.umfst.ro CAMPUS HAMBURG May Investigation of erythrocytes series. Cases. Case no 1 PAGE 2 A 40-year-old woman visits the clinic complaining of fatigue. She had recently been treated for an infection. Her laboratory values are as follows: red blood cell (RBC) count, 1.8 × 106/μl; hemoglobin (Hb ), 5.2 g/dl; hematocrit (Hct), 15; white blood cell (WBC) count, 7.6 × 103/μl; platelet count, 320,000/μl; mean corpuscular volume (MCV), 92 fL; and reticulocyte count, 24%. What is the most likely explanation for this presentation? A)Aplastic anemia B)Hemolytic anemia C)Hereditary spherocytosis D)B12 deficiency Case no 1 PAGE 3 Answer B) This patient has increased production of RBCs as indicated by a markedly increased reticulocyte count in the setting of significant anemia (low number, Hb, and Hct). The RBCs being produced have a normal size (MCV = 90), and thus the patient does not have spherocytosis (small RBCs) or vitamin B12 deficiency (large RBCs). The normal WBC count and the increased reticulocyte count suggest that the bone marrow is functioning. The increased reticulocyte count means that a large number of RBCs are being produced. These laboratory values support an anemia due to some type of blood loss—in this case an anemia due to hemolysis. Case no 2 PAGE 4 A 34-year-old man with schizophrenia has had chronic fatigue for 6 months. He has a good appetite but has refused to eat vegetables for 1 year because he hears voices saying that vegetables are poisoned. His physical and neurological examinations are normal. His hemoglobin level is 9.1 g/dl, his leukocyte count is 10,000/μl3, and his MCV is 122. What is the most likely diagnosis? A)Acute blood loss B)Sickle cell anemia C)Aplastic anemia D)Hemolytic anemia E)Folic acid deficiency Case no 2 PAGE 5 Answer E) This patient is anemic; Hg levels are
