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Test results Hgb 77 g/L MCV 66  f/L RBC 3.2 x10 12 /L WBC 5.6 x10 6 /L - PowerPoint PPT Presentation


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Test results Hgb 77 g/L MCV 66  f/L RBC 3.2 x10 12 /L WBC 5.6 x10 6 /L Plat 525 x10 9 /L. Blood film. This is a 55 year old woman who has fatigue. Her only other symptom is a craving for chewing ice cubes. Apart from being pale her examination is normal.

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Test results Hgb 77 g/L MCV 66  f/L RBC 3.2 x10 12 /L WBC 5.6 x10 6 /L

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Test results

Hgb 77 g/L

MCV 66f/L

RBC 3.2 x1012/L

WBC 5.6 x106/L

Plat 525 x109/L

Blood film

This is a 55 year old woman who has fatigue. Her only

other symptom is a craving for chewing ice cubes. Apart

from being pale her examination is normal.


Which one of the following tests would best define the type of anemia she has ?

A. Hgb electropheresis

B. Serum iron and iron-binding capacity

C. Serum ferritin

D. Serum transferrin

E. Bone marrow iron


Test results

Hgb 77 g/L

MCV 66fL

RBC 3.2 x1012/L

WBC 5.6 x106/L

Plat 525 x109/L

Blood film

microcytosis

hypochromia

ovals

pencil

thrombocytosis

This is a 55 year old woman who has fatigue. Her only

other symptom is a craving for chewing ice cubes. Apart

from being pale her examination is normal.


Test results

Hgb 135 g/L

MCV 65 fL 

RBC 5.4 x1012/L

WBC 6.5 x106/L

Plat 355 x109/L

Blood film

A 44 year old executive is sent to you for an insurance

examination. He is fit, but on examination he has mild

hypertension.


Which test is likely to give a diagnosis in this case ?

A. Serum ferritin

B. Serum transferrin

C. Sickle Cell screen

D. Hgb electropheresis

E. Liver function tests


Test results

Hgb 135 g/L

MCV 65 fL

RBC 5.4 x1012/L

WBC 6.5 x106/L

Plat 355 x109/L

Blood film

microcytosis

hypochromia

target

teardrop

basophilic stippling

A 44 year old executive is sent to you for an insurance

examination. He is fit, but on examination he has mild

hypertension.


What would you tell this executive ?

A. You have Beta thalassemia minor

B. You have alpha thalasemia minor

C. You have Sickle cell trait

D. You have hemoglobin C trait

E. More tests are needed


Test results

Hgb 99 g/L

MCV 100 fL

RBC 3.7 x1012/L

WBC 3.4 x106/L

Plat 117 x109/L

bili 35 mol/L

blood film

This is an 18 year old boy who you are investigating for

Jaundice. He has this intermittently for some time. His

family are Christian Scientists. Physical exam shows

jaundice and splenomegaly


Which of the following would be most helpful in identifying this young man’s problem ?

A. Reticulocyte count

B. Osmotic fragility test

C. DAT (Coomb’s test)

D. Bone marrow test

E. Family studies


Test results

Hgb 99 g/L

MCV 100 fL

RBC 3.7 x1012/L

WBC 3.4 x106/L

Plat 117 x109/L

bili 35 mol/L

blood film

polychromasia

spherocytes

This is an 18 year old boy who you are investigating for

Jaundice. He has this intermittently for some time. His

family are Christian Scientists. Physical exam shows

jaundice and splenomegaly


Test results

Hgb 142 g/L

MCV 105 fL

RBC 4.9 x1012/L

WBC 6.7 x106/L

Plat 105 x109/L

Blood Film

A 46 year old diplomat is referred to you because of

abnormal blood results. On review of these you suspect

the cause and order appropriate blood tests.


What tests would you order on receiving these results ?

A. Serum B12 and folate

B. Bone marrow aspirate

C. Serum lipid studies

D. Liver function tests

E. Thyroid function tests


Test results

Hgb 142 g/L

MCV 105 fL

RBC 4.9 x1012/L

WBC 6.7 x106/L

Plat 105 x109/L

Blood Film

Macrocytosis

Target cells

stomatocytes

A 46 year old diplomat is referred to you because of

abnormal blood results. On review of these you suspect

the cause and order appropriate blood tests.


Test results

Hgb 85 g/L

MCV 110 fL

RBC 3.9 x1012/L

WBC 2.4 x106/L

Plat 89 x109/L

Blood Film

A 65 year old woman is referred to you because of memory

loss. Her family physician had received tests which included

bilirubin of 28  mol/L and an LDH of 1560 U/L. He was

puzzled by these results.


Which one of the following tests is most appropriate ?

A. Liver function

B. Thyroid function

C. RBC folate

D. Serum B12

E. Bone marrow aspirate


Test results

Hgb 85 g/L

MCV 110 fL

RBC 3.9 x1012/L

WBC 2.4 x106/L

Plat 89 x109/L

Blood Film

Macrocytosis

oval macroytes

hypersegmented

neutrophils

A 65 year old woman is referred to you because of memory

loss. Her family physician had received tests which included

bilirubin of 28  mol/L and an LDH of 1560 U/L. He was

puzzled by these results.


Test results

Hgb 103 g/L

MCV 99 fL

RBC 3.8 x1012/L

WBC 3.4 x106/L

Plat 125 x109/L

Blood Film

A 65 year old woman complains of back pain. Her X-rays

show diffuse osteoporosis. She also complains of increased

thirst and drowsiness.


Which one of these tests would most likely lead to the diagnosis ?

A. Serum osmolarity

B. Serum viscosity

C. Serum protein electrophersis

D. Serum TSH

E. Serum PTH


Test results

Hgb 103 g/L

MCV 99 fL

RBC 3.8 x1012/L

WBC 3.4 x106/L

Plat 125 x109/L

Blood Film

rouleaux

background staining

A 65 year old woman complains of back pain. Her X-rays

show diffuse osteoporosis. She also complains of increased

thirst and drowsiness.


Test results

Hgb 115 g/L

MCV 115 fL

RBC 2.2 x1012/L

WBC 8.4 x106/L

Plat 246 x109/L

Blood Film

You admit a 36 year old woman with pneumonia. She has

fever, shortness of breath and requires oxygen. She is also

noted to be anemic.


These test results would help you choose which one of these antibiotics ?

A. Cephalexin

B. Penicillin G

C. Erythromycin

D. Sulfamethoxazole

E. Ciprofloxacin


Test results

Hgb 115 g/L

MCV 115 fL

RBC 2.2 x1012/L

WBC 8.4 x106/L

Plat 246 x109/L

Blood Film

RBC agglutination

You admit a 36 year old woman with pneumonia. She has

fever, shortness of breath and requires oxygen. She is also

noted to be anemic.


Test results

Hgb 75 g/L

MCV 107fL

RBC 2.8 x1012/L

WBC 8.9 x106/L

Plat 377 x109/L

Blood Film

An 18 year old woman has symptoms of cystitis. After urine

cultures are taken she is given Sulfamethoxazole. Her urinary

symptoms improve but she becomes short of breath. A week

later on follow-up her investigation shows.


What type of anemia is causing this problem ?

A. An idiosyncratic drug reaction

B. An allergic drug reaction

C. Marrow suppressive effect

D. Immune hemolysis

E. Oxidative hemolysis


Test results

Hgb 75 g/L

MCV 107fL

RBC 2.8 x1012/L

WBC 8.9 x106/L

Plat 377 x109/L

Blood Film

ploychromasia

blister

bite cells

An 18 year old woman has symptoms of cystitis. After urine

cultures are taken she is given Sulfamethoxazole. Her urinary

symptoms improve but she becomes short of breath. A week

later on follow-up her investigation shows.


Test results

Hgb 115 g/L

MCV 91 fL

RBC 4.1 x1012/L

WBC 14.5 x106/L

Plat 52 x109/L

Blood Film

You are called to see this 29 year old primip in the case

room. The obstetrician is concerned about her platelet

count. She is well but a bit hypertensive.


What diagnosis is most likely ?

A. ITP ( immune thrombocytopenia )

B. TTP ( thrombotic thrombocytopenic purpura)

C. PIH (pre-eclampsia)

D. Benign thrombocytopenia of pregnancy

E. DIC (disseminated intravascular coagopathy)


Test results

Hgb 115 g/L

MCV 91 fL

RBC 4.1 x1012/L

WBC 14.5 x106/L

Plat 52 x109/L

Blood Film

polychromasia

rbc fragments

thrombocytopenia

You are called to see this 29 year old primip in the case

room. The obstetrician is concerned about her platelet

count. She is well but a bit hypertensive.


Test results

Hgb 115 g/L

MCV 105 fL

RBC 3.8 x1012/L

WBC 9.2 x106/L

Plat 420 x109/L

Blood Film

This 35 year old man is sent to you because of unusual

blood results. His complaints are of fatigue and an episodic

itchy rash.


What condition do you think is responsible for these results ?

A. Pernicious anemia

B. Sickle cell anemia

C. Hyposplenism

D. Leaky prosthetic valve

E. Liver cirrhosis


Test results

Hgb 115 g/L

MCV 105 fL

RBC 3.8 x1012/L

WBC 9.2 x106/L

Plat 420 x109/L

Blood Film

targets

acanthocytes

fragments

howell jolly bodies

This 35 year old man is sent to you because of unusual

blood results. His complaints are of fatigue and an episodic

itchy rash.


What is the most likely cause ?

A. Blind loop syndrome

B. Coeliac disease

C. Ulcerative colitis

D. Crohn’s disease

E. Wilson’s disease


Test results

Hgb 99 g/L

MCV 96 fl

RBC 3.4 x1012/L

WBC 3.65 x106/L

Plat 560 x109/L

Blood Film

You are asked to asses a 72 year old woman for anemia

and splenomegaly. She has been losing weight for 1 year.

She has had 2 episodes of gout.


What test would give a definitive diagnosis ?

A. LAP score

B. Osmotic fragility

C. Hgb electropheresis

D. Bone scan

E. Bone marrow biopsy


Test results

Hgb 99 g/L

MCV 96 fl

RBC 3.4 x1012/L

WBC 3.65 x106/L

Plat 560 x109/L

Blood Film

thromboytosis

tear drop cells

leukoerythroblstic

You are asked to asses a 72 year old woman for anemia

and splenomegaly. She has been losing weight for 1 year.

She has had 2 episodes of gout.


Test results

Hgb 136 g/L

MCV 88 fL

RBC 4.9 x1012/L

WBC 17.3 x106/L

Plat 110 x109/L

Blood Film

This 24 year old man has acute abdominal pain. He has not

been feeling well for 5 days. After a baseball game he had

acute upper abdominal pain and was quite tender in the upper

abdomen. The surgeon asks you to see the patient.


What is the disorder most likely responsible for his condition ?

A. Acute leukemia

B. Pancreatitis

C. Malaria

D. Infectious mononucleosis

E. Liver abcess


Test results

Hgb 136 g/L

MCV 88 fL

RBC 4.9 x1012/L

WBC 17.3 x106/L

Plat 110 x109/L

Blood Film

variant lymphocytes

atypical

reactive

This 24 year old man has acute abdominal pain. He has not

been feeling well for 5 days. After a baseball game he had

acute upper abdominal pain and was quite tender in the upper

abdomen. The surgeon asks you to see the patient.


Test results

Hgb 139 g/L

MCV 93 fL

RBC 5.1 x1012/L

WBC 29 x106/L

Plat 178 x109/L

Blood Film

This 55 year old man is referred for unexplained elevated

White cell count. He feels well. Examination is normal.


What test would confirm your diagnosis ?

A. Mono spot test

B. LAP score

C. Bone marrow biopsy

D. Immunophenotyping

E. Skeletal survey


Test results

Hgb 139 g/L

MCV 93 fL

RBC 5.1 x1012/L

WBC 29 x106/L

Plat 178 x109/L

Blood Film

Lymphocytosis

Smudge cells

This 55 year old man is referred for unexplained elevated

White cell count. He feels well. Examination is normal.


Test results

Hgb 92 g/L

MCV 81 fL

RBC 3.4 x1012/L

WBC 5.2 x106/L

Plat 13 x109/L

Blood Film

This 36 year old man is admitted to hospital with generalized

bruising and bleeding. He is febrile. There are many bruises

and petichia present.


What disease is most responsible for his condition ?

A. Septicemia

B. Drug reaction

C. Infectious mononucleosis

D. Chronic leukemia

E. Acute leukemia


Test results

Hgb 92 g/L

MCV 81 fL

RBC 3.4 x1012/L

WBC 5.2 x106/L

Plat 13 x109/L

Blood Film

Cytopenias

Blasts

This 36 year old man is admitted to hospital with generalized

bruising and bleeding. He is febrile. There are many bruises

and petichia present.


Test Results

Hgb 11.0 g/L

MCV 92 fL

RBC 4.3x1012/L

WBC 5.2x106/L

Plat 565x109/L

Blood film

This is a 65 year old male who at retirement has his last regular work medical checkup. He is a bit fatigued but otherwise well.


What test would best establish the diagnosis ?

A. Serum iron and iron binding capacity

B. Serum B12

C. Urine hemosiderin

D. Bone marrow aspirate

E. Serum transferrin


Test Results

Hgb 11.0 g/L

MCV 92 fL

RBC 4.3x1012/L

WBC 5.2x106/L

Plat 565x109/L

Blood film

Normocytic

Normochromic

Microcytic

Hypochromic

Dimorphic population

This is a 65 year old male who at retirement has his last regular work medical checkup. He is a bit fatigued but otherwise well.


Test Results

HGB 146 g/L

MCV 92 fL

RBC 5.5x1012/L

WBC 25X106/L

Plat 465x109/L

Blood Film

This is a 35 year old male who is found to have persistent leukocytosis. His family physician wants you to rule out a Chronic leukemia.


What test would be most cost effective in helping to establish a diagnosis ?

A. Immunophenotyping

B. Leukocyte alkaline phosphatase

C. Bone marrow aspirate

D. Cytogenetics

E. Blood cultures


Test Results

HGB 146 g/L

MCV 92 fL

RBC 5.5x1012/L

WBC 25X106/L

Plat 465x109/L

Blood Film

Normocytic

Normochromic

Neutrophilia

Metamyelocyte

This is a 35 year old male who is found to have persistent leukocytosis. His family physician wants you to rule out a Chronic leukemia.


Test Results

HGB 96 g/L

MCV 103 fL

RBC 3.8x1012/L

WBC 2.4x106/L

Plat 74x109/L

Blood Film

A 75 year old woman is admitted to hospital because of pneumonia. She has not been feeling well for some months.


Test Results

HGB 96 g/L

MCV 103 fL

RBC 3.8x1012/L

WBC 2.4x106/L

Plat 74x109/L

Blood Film

Macrocytes

Mild pancytopenia

A 75 year old woman is admitted to hospital because of pneumonia. She has not been feeling well for some months.


Which test would you do next ?

A. Reticulocyte count

B. Serum B12 and Folate

C. Thyroid function tests

D. Liver function tests

E. Bone marrow aspirate and biopsy


Which do you think is the most likely ?

A. RA - Refractory anemia

B. RARS - Refractory anemia , ring sideroblasts

C. RAEB - Refractory anemia excess blasts

D. RAEBt - RAEB in transformation to Acute


Test Results

HGB 7.1 g/L

MCV 80 fL

RBC 2.7x1012/L

WBC 6.3x106/L

Plat 345x109/L

Blood Film

A 25 year old female university student is found to have a very low hemoglobin. She in fact feels fairly well. Physical exam shows pallor only.


Which test do you think will give the diagnosis ?

A. Iron studies

B. Reticulocyte count

C. Endocrine studies

D. Liver function

E. Renal function


Test Results

HGB 7.1 g/L

MCV 80 fL

RBC 2.7x1012/L

WBC 6.3x106/L

Plat 345x109/L

Blood Film

Irreg contracted

Burr cells

A 25 year old female university student is found to have a very low hemoglobin. She in fact feels fairly well. Physical exam shows pallor only.


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