A middle-aged college professor from Boston is in the Swiss Alps studying astron

Question

A middle-aged college professor from Boston is in the Swiss Alps studying astronomy. He arrived two days ago and plans to stay the entire year. However, he notices that he is short of breath when he walks up steps and that he tires easily with any physical activity. His symptoms gradually disappear: after two months, he feels fine. Upon returning to the United States, he has a complete physical exam and is told that his erythrocyte count is higher than normal. (a) Attempt to explain this finding, (b) Will his RBC count remain at this higher-than-normal level? why or why not?

Explanation / Answer

ESR test: Blood is allowed to stand in a test tube and the red blood cells ( erythrocytes fall to the bottom) . It is a good indicator to assess any inflammation present in the body.

a) From the above mentioned decription, high level of ESR and breathlessness on exertion could result in following diagnosis. Tests should be recommended for further evaluation of the diseases listed below.

i) Anemia

ii) Asthma

iii) Atrial Fibrillation

iv) Atrial myxoma

v) Bronchiectasis

vi) Cardiomyopathy

vii) Leukemia

b) Low ESR levels are usually seen with polycythaemia ( a condition where a patient makes too many red blood cells). So in this case, we can see fewer RBCs. Again, further evaluation is necessary to validate and conclude the complete diagnosis.

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