Hematology Case Study

866 Words 4 Pages
Hematology Assignment 1
Name: Asenaca Matameli
Student ID: s160177
Hematology Case 3-2
Answers:
1) Fred G, the 22 year old white man has leukocytosis as his White blood cell (WBC) count is increased (16.5×10^9/L) as shown in the Complete Blood Count results. This raises the intuition of blunt trauma and it is also an initial marker of injury along with physical exam. Leukocytosis in trauma is however due to neutrophilia as seen in this patient having a high neutrophil count. Increased in neutrophils can be best explained by neutrophil margination. This event of leukocytosis only last a short period of time. Also, Red blood cell (RBC) count is low (4.77×10^12/L) as a result of internal hemorrhage. (1)

2) a) The drop of about 30g/L of Hemoglobin
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b) The hemoglobin measurement taken shortly after the injury is not a true reflection of the actual hemoglobin level if there is rapid blood loss. This is due to the time taken for the plasma level to equilibrate. (1)

4) a) The size of the Red blood cells is determined by the Mean corpuscular volume (MCV) level. Since, this patient has acute bleeding the loss is actually from blood that is already in the circulation. Thus, his peripheral blood film within the first 24hours would be normocytic normochromic with normal red blood cell indices which may include a normal MCV, mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). However, MCV and MCH may decreases under chronic condition of anemia such as that of Iron deficiency anemia (IDA). (3)
b) Chronic hemorrhage would result in iron deficiency thus red blood cells will morphologically be microcytic hypochromic. Both mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) would be relatively low. (3)

5) a) Fred’s mean corpuscular volume (MCV) would be decreased and since there is lower level of hemoglobin, his mean corpuscular hemoglobin (MCH) would also be low. However, his red cell distribution width (RDW) will be increased.
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Rodak's hematology : Clinical principles and applications. 5th ed. Saint Louis: Saunders; 2015:286. http://replace-me/ebraryid=11073954

2) Lahsaee SM, Ghaffaripour S, Hejr H. The effect of routine maintenance intravenous therapy on hemoglobin concentration and hematocrit during anesthesia in adults. Bulletin of emergency and trauma. 2013;1(3):102-107. http://www.ncbi.nlm.nih.gov/pubmed/27162835

3) Turgeon ML. Clinical hematology : Theory and procedures. 4th ed. United States: A Wolters Kluwer company; 1999:117. http://catalog.hathitrust.org/Record/004025688

4) Kristi S. Lively, DVM, DABVP. Primary and secondary polycythemia. . 2011.

5) Luks AM, Swenson ER. Travel to high altitude with pre-existing lung disease. European Respiratory Journal. 2007;29(4):770-792. http://erj.ersjournals.com/cgi/content/abstract/29/4/770. doi: 10.1183/09031936.00052606.

6) Christensen CC, Ryg MS, Kare Refvem O, Henning Skjonsberg O. Effect of hypobaric hypoxia on blood gases in patients with restrictive lung disease. European Respiratory Journal. 2002;20(2):300-305. http://erj.ersjournals.com/cgi/content/abstract/20/2/300. doi:

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