4. A 32-year-old man sought medical attention for the onset of abdominal pain Ph

Question

4. A 32-year-old man sought medical attention for the onset of abdominal pain Physical examination revealed mild jaundice and palpable spleen. His past medical history included gallstones and a family history of anaemia. A complete blood count, blood film and biochemical screen were requested. Results Units RBC Hb Hct MCV MCH MCHC 4.28 ×1012L 12.5 g/dL 35.0 % 81.8fL 29.2 P 35.7 dL 13.1 x10L 251 ×109L WBC Platelets Reticulotyes 7.1 % (A). Blood film at presentation (B). Blood film after splenectomy Other laboratory results at presentation were as follows: haploglobin

Explanation / Answer

a) anaemia is the condition where there is low number of red blood cells or presence of low haemoglobin levels .

b) The patient is suffering from chronic anaemaia..may be haemolytic anaemia

C) The patient is suffering from spleenomegaly which can be diagnoised by abdominal pain,palpable speen and by fewer number of red blood cells.spleen is the organ which functions to produce and remove blood cells .ie it acts as a blood filter.

D) RDW is the measure of variation of RBC size .higher RDW values indicate greater variation in size.It is mainly used to differentiate an anemia from mixed number of causes.RDW from slide 1 shows low RDW in case of thalasemmia

e) a) destruction of RBc or haemlysis of RBC is in haemolytic anaemia due to spleenomegaly.

b) In slide 2 we can see the increased no of blood cells and also howell jolly bodies (small round bodies composed of DNA).In the absence of spleen nuclear material is removed ineffectively.

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