Hematology Exam 2 Case Studies

A 75-year-old male experiencing mental confusion and fatigue was seen by his physician. Laboratory tests were ordered:

RBC      /mcL

Hb       g/dL

Hct       %

PLT      X 103 /mcL

WBC     X 103 /mcL

Differential

Segmened neutrophils   %

Band neutrophils        %

Lymphocytes           %

Monocytes            %

Eosinophils            %

RBC morphology: Will be given a description of what the RBCs look like

Laboratory data for anemia workup:

Reticulocyte count                %

Serum iron                       mcg/dL 

Total iron-binding capacity (TIBC)    

·       Which anemia of defective heme synthesis is associated with this type of red cell morphology?

·       Which laboratory result(s) is(are) most useful in distinguishing this patient's anemia

·       From the results of these laboratory studies, how would you describe the patient's red blood cells?

·       A bone marrow examination was performed and sections were stained with Prussian blue. XXX sideroblasts. What is the most probable cause of this anemia

A woman severely burned in a house fire had blood drawn in the trauma center. Her Hgb was XXX and

the Hct was XXX

A. Are these values normal for a woman? Explain why or why not and give a reason for the results seen.

B.  Are the Hgb and Hct technically and physiologically accurate? Explain why or why not the values are technically and physiologically accurate

 

A 1-year-old child is brought to a clinic. Her mother states that the child was listless. The following laboratory results were reported. RBC xxx Hgb xxx Hct xxx WBC xxx

1.  What are the patient’s hematologic findings, i.e. what is the diagnosis and why?

2. What is the morphologic classification (TWO WORDS) of the red blood cells based on your calculations of the MCV and MCHC (show your work, including the normal reference ranges)?

Two patients each have a hemoglobin of xxx and a hematocrit of xxx. Mr. Smiths RBC count is xxx and Mr. Jones RBC count is xxx. Both have an MCHC of xxx. The RBC morphologies of these two men are best described by which of the following statements?

A patient has xxx NRBCs per 100 leukocytes. In addition to increased polychromasia on the peripheral smear, what other two findings may be present on the CBC? Explain why

2-year-old child was tested for blood lead level. The result was XX mcg/dL. He also had XXXX anemia. The child's parents were questioned, and it was determined that a source of lead was a painted crib in his day care center. The child was enrolled in another day care center. Follow-up testing revealed that the blood lead level was XXXXXX but the XXXXX anemia still present. Which follow-up test(s) would you recommend to help identify the etiology of this anemia?