Hematology Exam 3 Review

Choose the thalassemia with the best prognosis from the following choices.
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An unknown sample reveals low serum iron, high TIBC, low ferritin, low hemoglobin, and a microcytic hypochromic picture in the peripheral blood. Which stage of IDA is this?•Stage 3 IDAEvolution dictates that patients with sickle cell disease have an inherent resistance to which of the following?•Plasmodium infectionsA bone marrow examination was ordered on a patient with a 6.8 g/dL hemoglobin. The examination revealed an increase in fibrous tissue. This is an indication that the anemia is likely the result of a:•Proliferation defectWhat organ is the primary storage depot for iron?•LiverWhich laboratory test would be most helpful in differentiating iron-deficiency anemia from anemia of chronic disease?•Serum transferrin receptorThe peripheral blood smear contains a normocytic, normochromic morphology with marked reticulocytosis. The hemoglobin solubility test is positive. What confirmatory test should follow?•Hemoglobin electrophoresisWhich laboratory test provides early and sensitive indication for the diagnosis of a hemolytic anemia?•Serum lactate dehydrogenaseAll of the following laboratory tests can be used for evaluation of hemolysis except:•Total proteinWhich of the following laboratory tests could be used to help identify the cause of an anemia?•Haptoglobin concentrationA patient with a bleeding problem is complaining to her physician about excessive fatigue. Physical examination reveals a thin, pale woman with pale mucosal membranes. Significant CBC findings included an MCV of 70 fl. Based on these findings, follow-up testing should be ordered for:•Iron studies?An 80 year old man is seen for an annual physical examination. He complains of shortness of breath on exertion and is often tired. His stool is black. Laboratory data are: Hgb: 8.2 g/dL Hct: 30% WBC Count: 4.2 x 109/L WBC Differential: -Neutrophils 60% -Lymphocytes 31% -Monocytes 7% -Eosinophils 2% -Basophils 0% RBC Count: 4.0 x 1012/L RDW 20% Platelet Count 400 x 109/L Reticulocyte Count: 1.2% Stool Occult Blood: PositiveWhat is this patient's MCV? Is this above, below, or within normal limits? - MCV (fL) = Hct x 10 / RBC to 30 x 10 / 4 = 75 fL (Normal Range 80-96 fL) How would you classify this anemia morphologically? -Hypochromic-microctyic. The patient has a decreased MCV. What is the cause of anemia seen in this patient? - Chronic bleeding/blood loss The most probable type of anemia seen in this patient is? Which serum iron studies would help aid in diagnosis? - Iron deficiency anemia. Iron, ferritin, TIBC.A 65 year old woman is seen in clinic. She complains of extreme fatigue, difficulty in breathing, and an extremely sore tongue. Laboratory data are: Hgb: 8.7 g/dL Hct: 25.5% WBC Count: 4.0 x 109/L WBC Differential: -Neutrophils 65% -Lymphocytes 31% -Monocytes 4% RBC Count: 1.97 x 1012/L RDW: 19% Platelet Count: 134 x 109/L Reticulocyte Count: 0.3%What is this patient's MCV? - Hct x 10/rbc to 25.5 x 10/1.97 = 129.4 ~ 129 (NR 80-96 fL) How would you classify this anemia morphologically? Macrocytic. The normal range for MCV is 80-96 fL. This patient's MCV is significantly increased. The most probable type of anemia seen in this patient is? Megaloblastic anemia from folate or vitamin B12 deficiency. Macrocytes, high MCV, decrease in RBC count, anisocytosis and poikilocytosis (increased RDW), reticulocytopenia. What may be noted about RBCs and WBCs on a peripheral smear? Macrocytic Ovalocytes Teardrop cells Hypersegmented neutrophils Howell-Jolly bodies