doc179
Forum Guru
Topics: 67
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A 79-year-old woman has developed increasing dyspnea for the past 2 weeks. On physical examination she has diffuse rales in all lung fields. A CBC shows Hgb 7.1, Hct 22.2, MCV 93 fL, platelet count 205,000/microliter, and WBC count 6500/microliter with differential count of 60 segs, 4 bands, 25 lymphs, 9 monos, and 2 eos with 10 nucleated RBCs/100 WBCs. Which of the following is the most likely diagnosis?
A Iron deficiency anemia
B Pernicious anemia
C Anemia of chronic disease
D Sickle cell anemia
E Hemolytic anemia
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| po
Forum Elite
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Posts: 356
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E
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| po
Forum Elite
Topics: 39
Posts: 356
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"10 nucleated RBCs/100 WBCs."
DINT GET THIS
RETIC COUNT IS TOLD PER NO. OF WBC'S?
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| dncosta
Licensed, finally
Topics: 19
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I initially thought that C would be the best option, but considering the increased number of reticulocytes I think it is E
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| Addicudo
Forum Guru
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I too initially thought that C would be the best option, but considering the increased number of reticulocytes I think it is E
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| epica
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E is CORRECT. She may have an autoimmune hemolytic anemia, or a leukemia or lymphoma may be present. The marked anemia has led to high output congestive heart failure with pulmonary edema.
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| doc179
Forum Guru
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yes E is correct and thats the explanation posted by epica.
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| ssrpk
Forum Fanatic
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nucleated rbc's are even privimitive than reticulocyte and their presence calls for further correction of "corrected retic count" by dividing it by 2...indicates that bone marrow is really putting up its effort to correct the anemia
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| Ig F
Forum Elite
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thatz a reticulocyte index.which is corrected retic count/2 as bone marrow retic cellz which are also called shift cellz take twice as much time for their maturation......the bone marrow response is good which goes in the favour of hemolytic anemia..answer is E
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