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18.3 CASE STUDY #3 Frank S., a 54-year-old man was seen in the emergency department of a large metropolitan hospital. The man was homeless and an alcoholic. He was brought to the hospital by the director of the homeless shelter. The director was concerned about allowing the man to stay at the shelter because he appeared seriously ill and might be infectious to others, Frank was experiencing fever, chills, and a deep productive cough. Frank S. Adult Male Reference Range WBC count 5.0 – 10.0 X 10/L RBC count 3.10 5.0-6.0 X 10″/L Hemoglobin 11.0 13.5 – 17.5 g/L Hematocrit 34 41 – 53% MCV 108 80 – 100 L MCH 35 26 – 34 PE MCHC 34 31-37/dL RDW-CV 16 11.5 -14.5% Platelets 237 150 – 400 X 10°/L Differential % Neutrophils 75 25 -60% Bands 15 0-10% Lymphocytes 10 20 – 50% Monocytes 0 2-11% 0-8% 0 Eosinophils 0-296 0 Basophils Morphology 1+ macrocytes Occ. Target cells Toxic granulation vacuolization Dohle bodies QUESTIONS 1. Describe Frank’s blood picture using appropriate terminology 2. Explain the etiology of the WBC abnormalities noted using appropriate terminology 3. For Frank, What is the likely explanation for the WBC abnormalities described? 4. Describe the RBC parameters for Frank and their likely etiology 5. Discuss the mechanism by which anemia develops in this condition 6. The RBC morphology described for Frank can be seen in other conditions. What conditions are those, and how would the anemia of alcoholism be differentiated from those conditions? UN
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