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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? CASE STUDY 4 151 ly mo od ×— RBC count 200 b cle MCH George W. a 32-vear-old man was previously health but recently experienced significant discomfort in his abdomen. He felt full after eating less than usual and was tired all the time. At is wife’s prodidine he saw his physician because his wife thought he looked pale and that he had lost weight . The physical examination demonstrated that he had indeed lost weight and appeared pale. Splenomegaly was also detected. A CBC was ordered. COMPLETE BLOOD COUNT George W. Adult Male Reference Range WBC count 112.000 50 – 100X10/1 2.10 50-60 X 10″/ Hemoglobin 70 135-175 / Hematocrit 410-5396 MCV 95 80-100 L 33 25-34 MCHC 35 31 – 37/L RDW-CV 121 11.5 -1455 Platelets 150 – 200 X 1072 Differentials Neutrophils 25-60 Bands 0-105 Lymphocytes 20-50% Monocytes 1 2-11 Eosinophils 8 Basophils S 0-25 Metamyelocytes Myelocytes 5 Promyelocytes Blasts 7 Morphology Unremarkable 25 – min nd 10 0 th ma QUESTIONS 1. Describe George’s blood picture using proper hematologie terminolony 2. The differential diagnosis of granulocytosis should include consideration of bacterial infection is this likely based on the CBC or not? 6 Page
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