Heme cases 3-22-11_teaching aid

Heme cases 3-22-11_teaching aid - CASE 1 A 31 year-old...

Info iconThis preview shows pages 1–8. Sign up to view the full content.

View Full Document Right Arrow Icon
9/14/11 CASE 1 A 31 year-old woman complaining of fatigue was evaluated in her doctor’s office. She was found to have the following values on her CBC. WBC 4,800 RBC 3.75x106/µl Hgb 9.2 g/dl HCT 29% MCV 77.7 MCH 31.7 MCHC 24.5 RDW 25.5 Platelets 225,000 You order a reticulocyte count and it comes back “elevated” at 1.8%. 1. What is the reticulocyte index for this case? 2. What is the absolute reticulocyte count for this case? 3. Does the answer to questions 1 or 2 represent an adequate response to the anemia?
Background image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
9/14/11 1. What is the reticulocyte index? Effectively normalizes the reticulocyte percent to the degree of anemia Factor of 2 takes into account early release of reticulocytes from the
Background image of page 2
9/14/11 2. What is the absolute reticulocyte count for this Percent reticulocytes (%) x total number of RBCs 0.018 x 3.75 x 106/µl = 6.75 x 104/µl
Background image of page 3

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
9/14/11 3. Does the answer to questions 1 or 2 represent an adequate response to the A reticulocyte index less than 2 is consistent with inadequate production of RBC by the marrow for that degree of anemia. A reticulocyte index greater than 3 on the other hand reflects a vigorous response of the marrow to the anemia, meaning that the primary defect is not one of decreased RBC
Background image of page 4
9/14/11 4. Is this a microcytic, normocytic, or microcytic MCV = 77 (normal 80-100) Mnemonic for microcytic = FALT Fe = iron deficiency A = anemia of chronic disease L = lead poisoning T = Thalessemia (and Hgb C disease)
Background image of page 5

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
9/14/11 5. What does the RDW say about the RBC? The RDW is a measure of variation (dispersion from the mean) of the RBC size (MCV) RDW = (SD ÷ MCV) x 100 (normal < 15) In this case RDW = 25.5, which indicates anisocytosis
Background image of page 6
9/14/11 6. From the MCHC, what would be your best guess about the intensity of the
Background image of page 7

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Image of page 8
This is the end of the preview. Sign up to access the rest of the document.

This note was uploaded on 09/14/2011 for the course PHARM HEM taught by Professor Staff during the Spring '11 term at UCSD.

Page1 / 25

Heme cases 3-22-11_teaching aid - CASE 1 A 31 year-old...

This preview shows document pages 1 - 8. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online