sandra
Forum Guru
Topics: 200
Posts: 468
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An 18-year-old man with sickle cell disease comes
to the emergency department because of shortness
of breath for 6 hours. He has had a low-grade
fever, joint aches, and a rash for 3 days. He was
previously healthy and has had few vaso-occlusive
crises. He takes folic acid regularly and has
required no blood transfusions for 8 years. His
hematocrit has been stable at 32%. His
temperature is 38.1
EC (100.6EF), pulse is3, and platelet count is 450,000/mm3.
120/min, respirations are 36/min, and blood
pressure is 120/86 mm Hg. The lungs are clear to
percussion and auscultation. Cardiac examination
shows normal findings. There is no hepatomegaly
or splenomegaly. He has pain with movement of
the joints, but there is no evidence of arthritis. His
hematocrit is 21%, leukocyte count is
11,500/mm
An x-ray of the chest shows normal findings.
Which of the following is the most appropriate
next step in diagnosis?
(A) Hemoglobin electrophoresis
(B) Measurement of bleeding time
(C) Measurement of reticulocyte count
(D) Serum HIV antibody assay
(E) CT scan of the abdomen
please explain ur answer
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| dr.wad
Forum Senior
Topics: 3
Posts: 335
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C
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| Adam
Forum Senior
Topics: 6
Posts: 136
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C. aplastic crisis due to Parvovirus infection
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| Ivonne
Forum Guru
Topics: 55
Posts: 1,445
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Sounds like C to confirm aplastic crisis------->the reticulocyte count would be low------->probably due to parvovirus.
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| inkspot
Forum Guru
Topics: 26
Posts: 559
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the answer in my opinion is c coz the rest dont fit in. But the question is that why do sickel ppl get acute abdomen? ( the reason for arthritis is sickling at low 02 tension and RBCs are responsible for O2 carrying in body) would the same principle apply for acute abdomen?
also most likely this pt has autosplenectomy considering his age.
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