CBC cases Flashcards
A 29-year-old patient considers herself ill for 2 weeks when she developed chills and high body temperature, hemorrhages on the trunk and extremities, nosebleeds. Weakness and lethargy quickly increased. Feeling unwell, weakness, fever up to 37.5 - 38.0C during the last 4-5 months. The condition at admission is severe. The patient is lethargic, adynamic, pale, the temperature is 39.5°C, hemorrhagic syndrome is pronounced, necrosis of the tonsils. Objectively: Heart: tachycardia, systolic murmur at the apex, border expanded to the left. The abdomen is soft and slightly painful in the upper sections. Liver 241814 cm, spleen 14*10 cm.
Acute Leukemia
White Blood Cell count (WBC): This parameter indicates the total number of white blood cells in the blood. In this case, the WBC count is significantly elevated, indicating an abnormal increase in the number of immature white blood cells (blasts) characteristic of leukemia.
Red Blood Cells (RBC): RBC count is decreased, which is common in leukemia due to the infiltration of bone marrow by leukemic cells.
Hemoglobin (HGB): Hemoglobin is a protein in red blood cells that carries oxygen throughout the body. A low HGB level is often associated with anemia, which can occur in leukemia.
Hematocrit (HCT): HCT is the percentage of blood volume occupied by red blood cells. A low value is also associated with anemia.
Mean corpuscular volume (MCV): MCV measures the average size of red blood cells. In this case, the MCV value is within the normal range.
Mean corpuscular hemoglobin (MCH): MCH measures the amount of hemoglobin per red blood cell. The MCH value is within the normal range.
Mean corpuscular hemoglobin concentration (MCHC): MCHC measures the concentration of hemoglobin in red blood cells. The MCHC value is decreased, which is again often observed in anemia.
Red cell distribution width (RDW-CV): RDW-CV provides information about the variation in sizes of red blood cells. A high RDW-CV value indicates variability in the size of red blood cells.
Granulocytes (GR), Lymphocytes (LYM), Monocytes (MON): These are different types of white blood cells. In this case, the percentage of granulocytes is increased while the percentage of lymphocytes and monocytes is decreased.
Platelets (PLT): Platelets play an important role in blood clotting. The PLT count is decreased in this case, which can lead to an increased risk of bleeding.
Erythrocyte sedimentation rate (ESR): ESR measures the rate at which red blood cells settle to the bottom of a test tube over time. A high ESR value indicates inflammation or infection in the body.
Reticulocytes: Reticulocytes are immature red blood cells. The reticulocyte count is within the normal range.
Megakaryocytes: Megakaryocytes are large bone marrow cells that produce platelets. The presence of megakaryocytes in the blood can indicate abnormal activity in the bone marrow. In this case, 3% of megakaryocytes were observed in the blood.
An 18-year-old patient who underwent appendectomy for appendicular peritonitis developed pain in the lower abdomen, tenesmus, and dysuria on the sixth day after the operation. Body temperature 39.4°C, with hectic swings, chills. The tongue is moist, the abdomen is soft, moderately painful in the pubic region. Clinical blood test - hemoglobin - 115 g / l, erythrocytes 3.7 * 1012 / l, hematocrit 0.32, leukocytes 14 * 109 / l
Question:
1. What is your diagnosis?
2. Give a detailed description of the clinical blood test.
Douglas pouch abscess
Based on the symptoms and clinical blood test results, the diagnosis for the 18-year-old patient who underwent appendectomy for appendicular peritonitis and developed pain in the lower abdomen, tenesmus, and dysuria on the sixth day after the operation, with a body temperature of 39.4°C, with hectic swings, chills, is Douglas pouch abscess.
Douglas pouch is a small space between the uterus and the rectum that can get infected and develop into an abscess. It is also known as the recto-uterine pouch or the posterior cul-de-sac. The symptoms described by the patient, such as pain in the lower abdomen, tenesmus, dysuria, and fever, are all indicative of an abscess in this region.
The clinical blood test results show:
Hemoglobin (HGB): 115 g/l (normal rate: 110-150) - HGB is a protein found in red blood cells that carries oxygen throughout the body. The result indicates that the patient’s hemoglobin level is slightly below normal.
Erythrocytes (RBC): 3.7 * 1012 / l (normal rate: 3.8-5.3) - RBCs are red blood cells that carry oxygen. The result indicates that the patient’s erythrocyte count is slightly below normal.
Hematocrit (HCT): 0.32 (normal rate: 0.36-0.47) - HCT is the proportion of RBCs in the blood. The result indicates that the patient’s hematocrit level is below normal.
Leukocytes (WBC): 14 * 109 / l (normal rate: 4.0-9.0) - WBCs are white blood cells that help fight infections. The result indicates that the patient’s WBC count is significantly elevated, indicating an ongoing infection in the body.
Mean Corpuscular Volume (MCV): 88 fl (normal rate: 80-100) - MCV is a measurement of the average size of RBCs. The result indicates that the patient’s MCV is within the normal range.
Mean Corpuscular Hemoglobin (MCH): 30.2 pg (normal rate: 27-34) - MCH is the average amount of hemoglobin in each RBC. The result indicates that the patient’s MCH is within the normal range.
Mean Corpuscular Hemoglobin Concentration (MCHC): 32.2 g/dl (normal rate: 32-36) - MCHC is the concentration of hemoglobin in each RBC. The result indicates that the patient’s MCHC is within the normal range.
Red Cell Distribution Width-Coefficient of Variation (RDW-CV): 9.8% (normal rate: 11.6-14.8) - RDW-CV measures the variation in size of RBCs. The result indicates that the patient’s RDW-CV is below normal, which is expected in the setting of inflammation or infection.
Granulocytes (GR): 86% (normal rate: 39-64) - GR (also known as neutrophils) are a type of white blood cell that helps fight infections. The result indicates that the patient’s granulocyte count is significantly elevated, indicating an ongoing bacterial infection.
Lymphocytes (LYM): 12% (normal rate: 30-50) - LYM are a type of white blood cell that helps produce antibodies to fight infections. The result indicates that the patient’s lymphocyte count is significantly decreased, which can be due to redistribution of cells in response to an infection.
Monocytes (MON): 2% (normal rate: 3-9) - MON are a type of white blood cell that helps fight infections. The result indicates that the patient’s monocyte count is slightly below normal.
Platelets (PLT): 298 * 109/l (normal rate: 150-400) - PLTs are cells in the blood that help with clotting. The result indicates that the patient’s platelet count is within the normal range.
Erythrocyte Sedimentation Rate (ESR): 29 mm/h (normal rate: 2-15) - ESR is a test that measures how quickly RBCs settle in a tube of blood. The result indicates that the patient’s ESR is significantly elevated, which is consistent with inflammation or infection.
Reticulocytes: 0.5% (normal rate: 1-6) - Reticulocytes are immature RBCs. The result indicates that the patient’s reticulocyte count is below normal, which can be due to decreased production in the setting of infection.
A 56-year-old patient complains of weakness with drowsiness during the day and insomnia at night; rapid fatigue; decrease in working capacity; memory impairment; headache; muscle weakness. Feeling unwell and uncomfortable for 2-3 years. On examination, the skin is pale dry, the tongue is bright red, lacquered. Heart rate 96 min. BP 110 and 50 mm Hg Respiratory rate at rest is 18 per minute, with moderate physical exertion, shortness of breath occurs up to 22-24 per minute. The abdomen is soft and painless. Liver - 15 * 12-9 cm, spleen 9-7 cm.
B-12 deficiency
Based on the patient’s symptoms and laboratory results, the most likely diagnosis is B12 deficiency anemia
Hemoglobin (HGB): Normal range is 110-150 g/L. Hemoglobin is a protein in red blood cells that carries oxygen throughout the body. Low levels of hemoglobin can indicate anemia, which can have various causes including B12 deficiency.
Hematocrit (HCT): Normal range is 36-47%. Hematocrit measures the percentage of red blood cells in the blood. Low levels of hematocrit can also indicate anemia, which can be caused by B12 deficiency.
Red blood cell count (RBC): Normal range is 3.8-5.3 x 10^12/L. Red blood cells are responsible for carrying oxygen to the body’s tissues. Low levels of RBC can be seen in anemia, which can be caused by B12 deficiency.
Mean corpuscular volume (MCV): Normal range is 80-100 fl. MCV measures the average size of red blood cells. High levels of MCV or macrocytosis can indicate macrocytic anemia, which is commonly seen in B12 deficiency.
Mean corpuscular hemoglobin (MCH): Normal range is 27-34 pg. MCH measures the average amount of hemoglobin in each red blood cell. High levels of MCH can also indicate macrocytic anemia.
Mean corpuscular hemoglobin concentration (MCHC): Normal range is 32-36 g/dL. MCHC measures the concentration of hemoglobin in each red blood cell. Low levels of MCHC can also be seen in macrocytic anemia.
White blood cell count (WBC): Normal range is 4-11 x 10^9/L. White blood cells are a component of the immune system and help fight infections. Normal levels of WBC suggest that there may not be an active infection or inflammation.
Neutrophil (GR) count: Normal range is 39-64%. Neutrophils are a type of white blood cell that help fight infection. High levels of neutrophils can indicate an acute bacterial infection or other acute inflammation.
Lymphocyte (LYM) count: Normal range is 30-50%. Lymphocytes are a type of white blood cell that play an important role in the immune system’s response to viral infections and cancer. Low levels of lymphocytes can be seen in various conditions, including B12 deficiency.
Platelet count (PLT): Normal range is 150-400 x 10^9/L. Platelets are responsible for blood clotting. Low levels of platelets can be seen in various conditions, including B12 deficiency.
Erythrocyte sedimentation rate (ESR): Normal range is 2-15 mm/h. ESR measures the rate at which red blood cells settle in a test tube over time. Elevated ESR can be seen in various conditions, including B12 deficiency and other inflammatory processes.
In summary, the blood test results in this case suggest a diagnosis of B12 deficiency anemia based on the presence of macrocytic anemia (low hemoglobin, hematocrit, and RBC count along with high MCV and MCH), along with other abnormalities such as low MCHC and elevated ESR.
the abdomen, nausea, repeated vomiting of gastric contents, severe weakness, fever up to 38.5 ° C. The condition is severe, the skin is pale, cold to the touch. Heart rate - 100 per minute. BP 100 and 60 mm Hg. RR - 22 per min. The abdomen is swollen, gurgling intestinal motility, painful on palpation in all departments. Positive Blumberg sign. Percussion determines tympanitis in all parts of the abdomen, dullness in the lateral areas of the abdomen.
Question:
1. What is your diagnosis?
2. Give a detailed description of the clinical blood test.
Acute intestinal obstruction, peritonitis
Based on the symptoms and physical examination findings provided, the diagnosis for Patient L is Acute Intestinal Obstruction with Peritonitis. Acute intestinal obstruction occurs when there is a blockage in the intestine that prevents the passage of food and stool. This can lead to severe cramping pain throughout the abdomen, nausea, repeated vomiting of gastric contents, severe weakness, fever, and gurgling intestinal motility. Peritonitis is the inflammation of the peritoneum, which is the membrane that lines the abdominal cavity and covers the organs within it. It can be caused by the spread of infection from the intestines due to the obstruction.
The clinical blood test results provided for Patient L are as follows:
Certainly! Here are the blood test results and their significance in relation to the diagnosis of acute intestinal obstruction with peritonitis:
WBC: Elevated white blood cell count (18.2 x10^9/L, normal range: 4.0-9.0 x10^9/L) indicates an inflammatory or infectious process, which is consistent with the diagnosis of peritonitis.
RBC, HGB, HCT: Within normal limits, indicating that there is no significant anemia or bleeding, which is expected in this condition.
MCV: Slightly lower than the normal range (86 fl, normal range: 80-100 fl), indicating a slightly smaller average size of red blood cells. This can be seen in some cases of anemia, but is not specific to acute intestinal obstruction with peritonitis.
MCH: Lower than the normal range (26.5 pg, normal range: 27-34 pg), indicating less hemoglobin in each red blood cell. Again, this can be seen in some cases of anemia, but is not specific to acute intestinal obstruction with peritonitis.
MCHC: Elevated (53.5 g/dl, normal range: 32-36 g/dl), indicating a higher concentration of hemoglobin in each red blood cell. This finding is often seen in patients with dehydration, which can occur in acute intestinal obstruction due to vomiting and inability to keep fluids down.
RDW-CV: Lower than the normal range (9.4%, normal range: 11.6-14.8%), indicating a narrower range of variation in the size of red blood cells. This finding is not specific to acute intestinal obstruction with peritonitis.
GR: Elevated percentage of granulocytes (88%, normal range: 39-64%), indicating an increase in the number of neutrophils, which are a type of white blood cell that play a role in fighting infection. This finding is consistent with the diagnosis of peritonitis.
LYM: Lower than the normal range (9%, normal range: 30-50%), indicating a decrease in the number of lymphocytes, which are another type of white blood cell that play a role in the immune response. This finding is also consistent with the diagnosis of peritonitis.
MON: Within normal limits (3%, normal range: 3-9%), indicating no significant increase or decrease in the number of monocytes, a type of white blood cell that plays a role in the immune response.
PLT: Within normal limits (350 x10^9/L, normal range: 150-400 x10^9/L), indicating that there is no significant bleeding or clotting abnormality.
ESR: Within normal limits (2 mm/h, normal range: 2-15 mm/h), indicating that there is no significant inflammation present.
Reticulocytes: Lower than the normal range (0.5%, normal range: 1-6%), indicating a decrease in the production of new red blood cells. This finding can be seen in some cases of anemia, but is not specific to acute intestinal obstruction with peritonitis.
A 66-year-old patient complains of weakness, a sharp decrease in working capacity, satiety with a small amount of food, periodically appearing black stools. The patient is undernourished. The skin is pale, dry. Heart rate 98 per minute, BP 110 and 70 mm Hg. Respiratory rate - 20 per minute, with a slight load, severe shortness of breath appears. The abdomen is soft, slightly painful in the epigastrium. Liver 14129 cm. In the lateral places of the abdomen, dullness of percussion sound is determined.
Stomach cancer. Chronic iron deficiency anemia
Based on the patient’s symptoms, physical examination findings, and laboratory results, the most probable diagnosis is stomach cancer with chronic iron deficiency anemia.
The patient’s complaints of weakness, decreased working capacity, satiety with a small amount of food, and black stools indicate gastrointestinal bleeding, which is a common symptom of stomach cancer. Additionally, the patient is undernourished, has pale and dry skin, and shows signs of shortness of breath upon exertion, which can be due to chronic blood loss and anemia.
The dullness of percussion sound in the lateral places of the abdomen suggests ascites, which is commonly seen in advanced stage stomach cancer. The enlarged liver may also be a sign of metastatic disease.
A clinical blood test is a common diagnostic tool that provides important information about the patient’s overall health. The following are the detailed descriptions of the patient’s blood test results:
White blood cells (WBC): 5.4 x 10^9/L - This indicates a normal WBC count.
Red blood cells (RBC): 3.19 x 10^12/L - This indicates a decreased RBC count, which is consistent with anemia.
Hemoglobin (Hb): 74 g/L - This indicates a low Hb level, which is consistent with anemia.
Hematocrit (Hct): 22% - This indicates a low Hct level, which is consistent with anemia.
Mean corpuscular volume (MCV): 69 fl - This indicates microcytic anemia, which is consistent with iron deficiency anemia.
Mean corpuscular hemoglobin (MCH): 23.2 pg - This also indicates microcytic anemia, which is consistent with iron deficiency anemia.
Mean corpuscular hemoglobin concentration (MCHC): 33.6 g/dL - This indicates a normal MCHC level.
Red cell distribution width (RDW-CV): 18.3% - This indicates an increased RDW-CV, which is commonly seen in iron deficiency anemia.
Granulocytes (GR): 64% - This indicates a normal GR count.
Lymphocytes (LYM): 31% - This indicates a normal LYM count.
Monocytes (MON): 5% - This indicates a normal MON count.
Platelets (PLT): 295 x 10^9/L - This indicates a normal PLT count.
Erythrocyte sedimentation rate (ESR): 35 mm/h - This indicates an increased ESR, which is commonly seen in inflammatory conditions such as cancer.
Reticulocytes: 7% - This indicates an increased reticulocyte count, which is commonly seen in response to anemia.
Overall, the blood test results suggest iron deficiency anemia, which is consistent with the patient’s clinical presentation. Additionally, the increased ESR may indicate an underlying inflammatory condition such as cancer.
An 18-year-old patient 4 hours after eating in the canteen developed nausea, uncontrollable vomiting, and increased body temperature to 38.5°C. Condition of moderate severity. The skin is pale, dry, hot to the touch. Heart rate 96 min. BP 110 and 70 mm Hg The abdomen is soft, painful in the actual epigastric region. Blumberg’s symptom is negative. Liver 987 cm. Spleen 6*4 cm.
Food Poison
Based on the presented symptoms and lab results, my diagnosis would be acute gastroenteritis due to food poisoning.
The clinical blood test reveals the following:
White Blood Cell count (WBC) of 13.4 x 10^9/L: Elevated WBC count is a non-specific indicator of inflammation and can be seen in various infectious diseases, including gastroenteritis.
Red Blood Cell count (RBC) of 5.52 x 10^12/L: Within normal range.
Hemoglobin (HGB) level of 149 g/L: Normal HGB level indicates adequate oxygen-carrying capacity of the blood.
Hematocrit (HCT) level of 48%: Slightly elevated HCT level can be seen in dehydration, which can occur due to vomiting and diarrhea in gastroenteritis.
Mean Corpuscular Volume (MCV) of 87 fl: Within normal range.
Mean Corpuscular Hemoglobin (MCH) of 27.1 pg: Within normal range.
Mean Corpuscular Hemoglobin Concentration (MCHC) of 55.2 g/dL: Within normal range.
Red Cell Distribution Width-Coefficient of Variation (RDW-CV) of 12.3%: Within normal range.
Granulocytes (GR) percentage of 76%: Elevated GR count is a non-specific indicator of inflammation, which can be seen in various infectious diseases, including gastroenteritis.
Lymphocytes (LYM) percentage of 19%: Decreased LYM count can be seen in acute infections, including gastroenteritis.
Monocytes (MON) percentage of 5%: Within normal range.
Platelet (PLT) count of 450 x 10^9/L: Elevated PLT count can be seen in inflammatory conditions like gastroenteritis, and it can also suggest dehydration.
Erythrocyte sedimentation rate (ESR) of 3 mm/h: Within normal range.
Reticulocytes percentage of 0.5%: Slightly decreased reticulocyte count is expected in acute infections like gastroenteritis.
Overall, the clinical blood test indicates an inflammatory response due to the acute gastroenteritis caused by food poisoning. The elevated WBC count, GR count, and PLT count, along with the slightly elevated HCT level, indicate a mild degree of dehydration.
A 28-year-old patient is worried about severe weakness, dizziness, flies flickering before his eyes. 6 hours ago, the patient vomited profusely with unaltered blood several times. The patient’s condition is severe, he is conscious, excited. The skin is pale, cold to the touch. Heart rate 89 min. BP 90 and 50 mm Hg RR 21 per min. The abdomen is soft, painless in all departments. The abdomen is moderately enlarged, participates in the act of breathing. Percussion is determined by tympanitis in all parts of the abdomen, dullness in the lateral areas of the abdomen.
Question:
1. What is your diagnosis?
2. Give a detailed description of the clinical blood test.
Based on the presented symptoms and test results, the diagnosis for this patient is bleeding from varicose veins of the esophagus with signs of portal hypertension.
The clinical blood test results are as follows:
White blood cells (WBC): 11.2 x 10^9/L - This indicates that there may be an infection or inflammation present in the body.
Red blood cells (RBC): 3.64 x 10^12/L - This value is slightly lower than the normal range, indicating a possible anemia.
Hemoglobin (HGB): 110 g/L - This value is also slightly lower than the normal range, further supporting the possibility of anemia.
Hematocrit (HCT): 31% - This value is significantly lower than the normal range, which is expected in cases of bleeding.
Mean corpuscular volume (MCV): 85 fl - This value indicates the size of red blood cells, which is within the normal range.
Mean corpuscular hemoglobin (MCH): 30.2 pg - This value indicates the amount of hemoglobin in each red blood cell, which is also within the normal range.
Mean corpuscular hemoglobin concentration (MCHC): 35.5 g/dl - This value indicates the concentration of hemoglobin in each red blood cell, which is within the normal range.
Red cell distribution width coefficient of variation (RDW-CV): 9.4% - This value measures the variability in the size of red blood cells, which is within the normal range.
Granulocytes (GR): 72% - This value measures the percentage of mature white blood cells, which is higher than the normal range and may indicate an infection or inflammation.
Lymphocytes (LYM): 25% - This value measures the percentage of white blood cells responsible for fighting infections, which is lower than the normal range and may indicate a compromised immune system.
Monocytes (MON): 3% - This value measures the percentage of white blood cells responsible for fighting infections, which is within the normal range.
Platelets (PLT): 290 x 10^9/L - This value measures the number of platelets in the blood, which is within the normal range.
Erythrocyte sedimentation rate (ESR): 4 mm/h - This value measures the rate at which red blood cells settle in a test tube over time, which is within the normal range.
Reticulocytes: 1.0% - This value measures the percentage of immature red blood cells in the blood, which is within the normal range.
In summary, the clinical blood test results show signs of anemia and possible infection/inflammation, which are consistent with the diagnosis of bleeding from varicose veins of the esophagus. The low hematocrit value indicates significant bleeding, while the normal platelet count and ESR suggest that the bleeding is acute rather than chronic.
For 3 weeks, the patient has been disturbed by sudden rises in body temperature up to 39.5 ° C, weakness, loss of appetite, sudden weight loss, cough, and the release of a large amount of purulent sputum with ginger coloring. Severe condition. The patient is conscious, somewhat retarded. The skin is pale, warm to the touch. Heart rate - 92 per minute, blood pressure 110 and 70 mm Hg. RR - 24 per min.
Question:
1. What is your diagnosis?
2. Give a detailed description of the clinical blood test
Based on the symptoms and clinical blood test results, the diagnosis is severe pneumonia.
The clinical blood test results indicate the following:
WBC (white blood cells): Elevated at 26.4 x10^9/L, indicating an infection or inflammation in the body.
RBC (red blood cells): Slightly below the normal range at 3.97 x10^12/L, which may be due to the patient’s recent weight loss or other underlying conditions.
HGB (hemoglobin): Below the normal range at 106 g/L, which may be due to the patient’s recent weight loss or other underlying conditions.
HCT (hematocrit): Below the normal range at 31%, which may be due to the patient’s recent weight loss or other underlying conditions.
MCV (mean corpuscular volume): Slightly below the normal range at 78 fl, which may be due to the patient’s recent weight loss or other underlying conditions.
MCH (mean corpuscular hemoglobin): Below the normal range at 26.7 pg, which may be due to the patient’s recent weight loss or other underlying conditions.
MCHC (mean corpuscular hemoglobin concentration): Within the normal range at 34.2 g/dl.
RDW-CV (red cell distribution width-coefficient of variation): Within the normal range at 13.5%.
GR (granulocytes): Elevated at 86%, indicating an increased number of white blood cells that fight bacterial infections.
LYM (lymphocytes): Below the normal range at 9%, indicating a decrease in the immune response to viral infections.
MON (monocytes): Within the normal range at 5%.
PLT (platelets): Elevated at 460 x10^9/L, which may be the body’s response to the infection.
ESR (erythrocyte sedimentation rate): Elevated at 26 mm/h, indicating an inflammatory response in the body.
Reticulocytes: Below the normal range at 0.6%, which may be due to the patient’s recent weight loss or other underlying conditions.
Overall, the clinical blood test results suggest that the patient is experiencing a severe bacterial infection, as evidenced by the elevated WBC count and high percentage of granulocytes. The low levels of lymphocytes may indicate that the patient’s immune system is compromised. The elevated platelet count and erythrocyte sedimentation rate may be the body’s response to the infection
