HEMATOLOGY lec 2: problem solving and cases of RBCs disorders

Question 1

• Microcytic (MCV <80 µ3):

Answer 1

1. Iron deficiency
2. thalassemia
3. sideroblastic anemia, lead poisoning.

Question 2

• Normocytic (MCV 80-100 µ3):

Answer 2

1. Acute blood loss (hemorrhage or acute hemolysis )
2. chronic disease
3. hypersplenism
4. bone marrow failure

Question 3

• Macrocytic (MCV >100 µ3):

Answer 3

1. B12 or folate deficiency,
2. hypothyroidism
3. MDS.

Question 4

Case:

• A 13-year-old girl presents with jaundice,
marked hepatosplenomegaly, and prominent
frontal bossing. Both parents are immigrants
from Thailand.
• CBC
• Hgb (g/L) Low , MCV Low
• Reticulocyte Count High
• WBC Normal
• Platelet Normal
• Bilirubin High and Serum Ferritin high
• What is your diagnosis ???

Answer 4

Thalassemia

Question 5

Management of Thalassemia

Answer 5

• 1-blood transfusion
• 2- iron chelation therapy
• 3- folic acid

Question 6

Case:
• A 5-year-old boy presents with exquisitely 
painful fingers and toes. The family emigrated 
from West Africa 6 months ago.
• CBC
• Hgb (g/L) Low
• MCV Normal
• Reticulocyte Count High
• WBC Normal
• Platelet Normal
• What is your diagnosis????

Answer 6

Sickle cell anemia

Question 7

• A 12-year-old Egyptian-Canadian male presents with a 3-day history of extreme fatigue and weakness, and “cola”-colored urine. His comments that his skin and eyes have also become increasingly yellow. The patient has always been in good health, apart from severe acne for which he started taking sulfacetamide 5 or 6 days ago. He remarks that his brother had similar symptoms .
• CBC Hgb (g/L) Low , MCV Normal
• Reticulocyte Count High
• WBC Normal Platelet Normal
• bilirubin is high mainly unconjugated
• What is your diagnosis??

Answer 7

G6PD deficiency

Question 8

• A 5-years -old boy of Mediterranean descent is brought in by his father as she appears pale and has not been gaining weight. The child also has enlargement in her upper left abdomen
• On physical examination, the boy is noted to be lethargic. His skin is pale and his sclera has a tinge of yellow. The zygomatic bones are disproportionably larger than the rest of her facial bones. The spleen is palpable 5 cm below the left costal margin.

CBC
- Hgb (g/L) Low
- MCV Low
- RBC count High
- Reticulocyte Count High
- WBC Normal
- Platelet  Normal
- OTHER LABORATORY FINDINGS
- HbA2 Increased
- HbF Increased
What is your diagnosis??

Answer 8

Thalassemia

Question 9

A 60-year-old male complains of frequent episodes of headache and dizziness that are gradually worsening in severity. Three months prior he stopped playing golf with his friends as he became increasingly dyspneic from walking, and his vision often became blurred.

On physical examination, the patient’s body appears quite erythematous, and his face is noted to be red and swollen. His spleen is firm, non-tender, and palpable 6 cm below the left costal margin.

CBC

• Hgb ( 20 g/L) High
• RBC High
• MCV Low
• WBC Normal
• Platelet Normal
• What is your diagnosis ???????????

Answer 9

POLYCYTHEMIA

Question 10

mention 3 Diseases CAUSING jaundice

Answer 10

• THALASSEMIA
• G6PGD
• SICKLE CELL ANEMIA