Cedrick
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A previously healthy 32 year old woman has the onset of recurrent headaches
she develops nausea,vomiting,weakness,abdominal pain and easy bruisability
her temperature is 38.5C (101.3F)
Laboratory shows
Hemoglobin 6.9g/dL
leukocyte count 15,000/mm
Mean corpuscular volumen 78 um
Platelet 30,000/mm
She is immediatetly admited to the hospital
over the next few days,she develops progressive lethargy and lapses into a coma
A peripheral blood smear is most likely to show
a.-macrocytes
b.-schistocytes
c.-sickle cells
d.-spherocytes
e.-target cells
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| Cedrick
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?
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| Cedrick
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anybody awake
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| Cedrick
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sleeping
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| Cedrick
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b.-schistocytes ?
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| Cedrick
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guess not ok I will check later
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| Cedrick
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?
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| mitty
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b
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| Cedrick
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Thanks mitty
could you be nice and tell why?
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| Cedrick
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Ok I thnik she has like a TTP {purpura}
it been a dead day so it is time to move
thanks
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| study_ing
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its B. i think her PC is more consistent with DIC rather than TTP cedrick.
schistocytes suggest mechanical damage to cells eg in dic microangiopathic hemolysis wud occur
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| Cedrick
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Still B right
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| twesting2173
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but the MCV is below 80 here...which means it's microcytic i think. DIC, TTP (MAHAs) are normalicitic. i guess target cells would be microcytic. what do others think?
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| mediocre
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DIC--B
in TTP---coagulation profile is normal
In Sickle cell ds(target cells)---WBC,plat are high(to cause occlusion)
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| ManuNastai
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I think it's C
The clinical picture coresponds to small infarctions in the brain stem and throughout the body, the fever and leucocytosis corresponds to the same thing. Also, mediocre, the infarctions in Sickle cell disease are caused by the RBCs tangled in the small vessels, they are RBC thrombi, not plat ones; and is not SCD that is carracterised by target cells.
Personally I think the RCB count is too low for an microangiopatic purpura. She has a hard time dying (I think DIC would have killed her quicker than a few days)
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