1.8 Hematology Problem-Solving Flashcards
A 19-year-old man came to the emergency department with severe joint pain, fatigue,
cough, and fever. Review the following laboratory results:
What is the corrected WBC count?
16.7 × 10^9/L
A manual WBC count is performed. Eighty WBCs are counted in the four large corner
squares of a Neubauer hemacytometer. The dilution is 1:100. What is the total WBC count?
20.0 × 10^9/L
A manual RBC count is performed on pleural fluid. The RBC count in the large center square of the Neubauer hemacytometer is 125, and the dilution is 1:200. What is the total RBC count?
250.0 × 10^9/L
Review the scatterplot of WBCs shown. Which section of the scatterplot denotes the number of monocytes?
A
Review the following automated CBC values.
Many sickle cells were observed on review of the peripheral blood smear. On the basis of this finding and the results provided, what automated parameter of this patient is most likely inaccurate, and what follow-up test should be done to accurately assess this parameter?
WBC/perform manual WBC count
Review the following CBC results for a 2-day-old infant:
These results indicate:
Normal values for a 2-day-old infant
Review the following scatterplot, histograms, and automated values for a 21-year-old college student.
What is the presumptive diagnosis?
Infectious mononucleosis
Review the following scatterplot, histograms, and automated values for a 61-year-old woman.
What is the presumptive diagnosis?
CML
Review the automated results from the previous question. Which parameters can be released without further follow-up verification procedures?
None of the automated counts can be released without follow-up verification
Refer to the following scatterplot, histograms, and automated values for a 45-year-old man. What follow-up verification procedure is indicated before these results can be released?
Redraw blood sample using a sodium citrate tube; multiply PLTs × 1.11
Refer to the following scatterplot, histograms, and automated values for a 52-year-old woman. What follow-up verification procedure is indicated before these results can be released?
Warm the specimen at 37°C for 15 minutes; rerun the specimen
Refer to the following scatterplot, histograms, and automated values for a 33-year-old woman. What follow-up verification procedure is indicated before these results can be released?
Perform plasma blank Hgb to correct for lipemia
Refer to the following scatterplot, histograms, and automated values for a 48-year-old man. What follow-up verification procedure is indicated before the five-part WBC differential results can be released?
Prepare buffy coat peripheral blood smears, and perform a manual differential
Review the following CBC results for a 70-year-old man:
What is the most likely diagnosis on the basis of these values?
CLL
Refer to the following scatterplot, histograms, and automated values for a 28-year-old woman who had undergone preoperative laboratory testing. A manual WBC differential was requested by her physician. The WBC differential was not significantly different from the automated five-part differential; however, the medical laboratory scientist noted 3+ elliptocytes/ovalocytes while reviewing the RBC morphology. What is the most likely diagnosis for this patient?
HE (ovalocytosis)
A 25-year-old woman presented with symptoms of jaundice, acute cholecystitis, and an enlarged spleen. On investigation, numerous gallstones were discovered. Review the following CBC results:
What follow-up laboratory test would provide valuable information for this patient?
Osmotic fragility test
Refer to the following scatterplot, histograms, and automated values for a 53-year-old man who had undergone preoperative laboratory testing. What is the most likely diagnosis for this patient?
β-thalassemia minor
Review the following CBC results:
Which of the following additional laboratory tests would yield informative diagnostic information for this patient?
Hgb electrophoresis
