Pathology Notes

Practice Question Answers Anemia V © Jun Wang, MD, PhD   Abbreviations: Hb: hemoglobin HCT: hematocrit MCV: Mean Corpuscular Volume MCH: Mean Corpuscular Hemoglobin RDW: Red Cell Distribution Width TIBC: total iron binding capacity   1. D. This case is characterized by microcytic anemia. The history of living in an old house is suspicious for lead exposure, further supported by PE finding of lead line in gingiva. Peripheral blood smear reveals small red cells with basophilic stippling, highly suggestive of lead poisoning . Bone marrow biopsy is useful in specific diagnosis of many anemia, especially hematopoietic stem cell abnormalities, such as aplastic anemia and myeloid neoplasms . Eosin-5-maleimide binding assay and osmotic fragility test is used to diagnose hereditary spherocytosis . Hemoglobin analysis by electrophoresis of HPLC is very helpful in diagnosing hemoglobin abnormalities, includi

Practice questions Anemia V © Jun Wang, MD, PhD   Abbreviations: Hb: hemoglobin HCT: hematocrit MCV: Mean Corpuscular Volume MCH: Mean Corpuscular Hemoglobin RDW: Red Cell Distribution Width TIBC: total iron binding capacity   1. Use this case for the next five questions . A 5-year-old boy is brought to the pediatric clinic due to fatigue, irritability, abdominal pain and decreased appetite over the past few months. The mother mentions that they live in an old house built in the 1910s, and she recently discovered peeling paint in the boy's bedroom. Physical examination reveals pale skin and mucosa. His conjunctivae are pale, and there are blue-black lines visible at the gingival margin. Laboratory tests reveal the following: Hemoglobin: 9.2 g/dL (11.5-15.5 g/dL) MCV: 68 fL (80-100 fL) Reticulocyte count: 1.5% (0.5-2.5%) An image of his peripheral blood smear is shown. What test needs

Practice questions answers Anemia IV © Jun Wang, MD, PhD   Abbreviations: Hb: hemoglobin HCT: hematocrit MCV: Mean Corpuscular Volume MCH: Mean Corpuscular Hemoglobin RDW: Red Cell Distribution Width TIBC: total iron binding capacity   1. E. This is a case of anemia with history of bleeding. Her lab results show microcytic anemia with elevated RDW. Peripheral blood smear reveals enlarged central pallor area, consistent with hypochromic anemia. One of the most cause in such a setting is iron deficiency anemia . Bone marrow biopsy is useful in specific diagnosis of many anemia, especially hematopoietic stem cell abnormalities, such as aplastic anemia and myeloid neoplasms . Direct antiglobulin test can identify antibodies/complement bound directly to RBCs, usually positive for immune hemolytic anemia . Hemoglobin analysis by electrophoresis of HPLC is very helpful in diagnosing hemoglobin abnormaliti

Practice questions Anemia IV © Jun Wang, MD, PhD   Abbreviations: Hb: hemoglobin HCT: hematocrit MCV: Mean Corpuscular Volume MCH: Mean Corpuscular Hemoglobin RDW: Red Cell Distribution Width TIBC: total iron binding capacity   1. Use this case for the next seven questions . A 45-year-old woman presents to clinic with fatigue, weakness, and shortness of breath on exertion for the past 3 months. She has occasional palpitations and lightheadedness as well. Her menstrual periods have been heavier than usual over the past year. She does not have any significant weight loss, night sweats, or changes in bowel habits. Her past medical history is unremarkable. Physical examination reveals pale skin and conjunctivae and spoon-shaped nails. Her CBC reveals a hemoglobin of 9.0 g/dL (normal: 12-15 g/dL), MCV of70 fL (normal: 80-100 fL), and RDW of 25% (11.5-14.5%). Her WBC and platelet counts are within norm