Charley Banks: Lab Tests
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| CBC Results | ||
|---|---|---|
| Patient | Normal Range | |
| RBC Count | 3.8 million/mm³ | 3.8-5.5 million/mm³ |
| Hemoglobin | 9.2 g/dL | 11-16 g/dL |
| Hct | 26% | 31%-43% |
| MCV | 80 mm³ | 80-95 mm³ |
| MCH | 28 pg | 27-31 pg |
| MCHC | 34g/dL | 32-35 g/dL |
| Hemoglobin electrophoresis | ||
|---|---|---|
| Patient | Normal Range | |
| Hgb F | 20% | <1% |
| Hgb A2 | 3% | 2% |
| Hgb S | 77% | 0 |
| Hgb A1 | 0 | 95%-98% |
Results of a Sickle Cell test were positive (normal: negative).
Examination of the peripheral smear shows marked poikilocytosis and anisocytosis with numerous sickled erythrocytes.
Questions:
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- 1. Look at the patient's CBC results. What values, if any, are outside the normal range? What clues do these values give to the patient's condition?
- 2. How do Charley's low hemocrit and total hemoglobin correspond to his enlarged liver?
- 3. Now look at the WBC and differential counts. Are they normal? Do these values rule out any disorders that we have studied? If so, what are they?
- 4. Which of the following conditions might be indicated by these results?
- Hemolytic anemia
- Hemophilia
- Leukemia
- Thalassemia
- 5. The hemoglobin electrophoresis detected abnormal forms of Hgb in Charley's blood. What do these results tell you about Charley's condition? Explain the relationship between Charley's levels of Hgb A1, Hgb F, and Hgb S.
- . Describe how the presence of hemoglobin S impairs the function of RBC's
- 7. What environmental factor would cause his RBC's to collapse?
- 8. How would Charley's abnormal hemoglobin explain his symptoms?
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