24.Red Cell Disorders-4

Question 1

A 72 year old women with diagnosed Rheumatoid Arthritis has been hospitalized for 2 weeks. She is now in a Anemic state what would you expect her blood panel to show?

A.Serum Ferritin: Increased
Serum Iron:Reduced
Transferrin Sat.: Normal
TIBC: Increased

B. Serum Ferritin: Reduced
Serum Iron:Reduced
Transferrin Sat.: Reduced
TIBC: Increased

C.Serum Ferritin: Reduced
Serum Iron:Reduced
Transferrin Sat.: Reduced
TIBC: Increased

D.Serum Ferritin: Increased
Serum Iron:Reduced
Transferrin Sat.: Reduced
TIBC: Increased

E. Serum Ferritin: Increased
Serum Iron:Reduced
Transferrin Sat.: Normal
TIBC: Reduced

RFA

Answer 1

Ans. E. Serum Ferritin: Increased
Serum Iron:Reduced
Transferrin Sat.: Normal
TIBC: Reduced

The Patient has Anemia of Chronic Disease

B:Serum Ferritin: Reduced
Serum Iron:Reduced
Transferrin Sat.: Reduced
TIBC: Increased

Is what would be found in Iron Deficiency Anemia

Question 2

A 35 year old man has been complain of fatigue and rapid heart beat. He is taking the medication chloramphenicol. Lab test are done showing pancytopenia and bone marrow biopsy show few lymphocytes but many fat cells. What does condition increase the risk of development of?

A. Iron Deficiency Anemia  
B.Anemia of Chronic Disease 
C.Polycythemia
D. Hemolytic Uremic Syndrome 
E. Von Willebrand Disease 

RFA

Answer 2

Ans. D Hemolytic Uremic Syndrome(Hus)- is a Thrombocytopenia they all stem from bone marrow problems such as Aplastic anemia which the patient has as show by: pancytopenia and fat cell in the bone marrow and the use of chloramphenicol

A. Iron Deficiency Anemia- not the best answer, Aplastic anemia is a normocytic anemia and has more to do with lymphoid cells than blood cells than other anemias

B. Anemia of Chronic Disease- not the best answer since the condition is likely not chronic from the history due to it being caused by a medication

C. Polycythemia-Primary myeloproliferative neoplasm (opposite of what lab shows), secondary- lung disease cyanotic heart high altitude

E. Von Willebrand Disease- is a genetic condition so development of Aplastic anemia should not increase risk

Question 3

A patient comes to the ED for an MCV. She has sustained a great deal of trauma and blood loss. A transfusion is required. Routine labs are drawn and she is found to have an increased bleeding time and increased PTT. Which of the following factors acts as a cofactor in the coagulation cascade that is disrupted in her condition?

A. Factor VII
B. Factor IX
C. Factor X
D. Factor VIII
E. Factor XII

SZ

Answer 3

Ans. D Factor VIII

The patient has vWF disease.

Question 4

A 6 y/o boy eats bad meat at Subway and experiences diarrhea, fever, and is diagnosed with microangiopathic hemolyitc anemia. He is at risk for developing renal failure. Which of the following is the cause of his condition?

A. X linked recessive genetic disorder
B. Decreased ADAMTS13
C. E. coli
D.  Autosomal dominant disorder
E. Viral infection

SZ

Answer 4

Ans. C. E. coli

The patient is experiencing HUS (hemolytic uremic syndrome). Unlike TTP it does not have CNS syndromes.