Case study (29)  History  Following a vaginal birth, a term male neonate presented with the early signs of disturbed post-natal adaptation during his first post-natal day. Early onset of sepsis was suspected.  CBC:  RBC:4.32 X 106/μL (4-5.5 X 106/μL)  HGB:147 g/dL (120-174 g/dL)  HCT: 44 % (36-52%) MCV: 102 fL (76–96 fL) MCH: 34 pg (27-32 pg) MCHC: 334 g/L (300-350 g/L)  RDWsd:54.3 fL (20-42 fL)  RDWcv: 16.1 % (0-16 %)  WBC: 22.95 X103/ μL (5–10 X 103/ μL)  Neutrophils: 16.43 X 103/μL (2-7.5 X 103/μL)  Lymphocytes: 4.73 X 103/μL ..read more

Case study (28)  History  A 50-year-old woman contacted the physician due to high fever (38.8 °C), and cough. Her physical exam revealed rales and crackles over the right lung upon examination. She also complained about dyspnea and fatigue.  CBC:  RBC:4.42 X 106/μL (4-5.5 X 106/μL)  HGB:139 g/dL (120-174 g/dL)  HCT: 41.3 % (36-52%) MCV: 93.4 fL (76–96 fL) MCH: 31.5 pg (27-32 pg) MCHC: 337 g/L (300-350 g/L)  RDWsd:39 fL (20-42 fL)  RDWcv: 14.5 % (0-16 %)  WBC: 21.91 X103/ μL (5–10 X 103/ μL)  Neutrophils: 18.21 X 103/μL (2-7.5 X 103/μL)&n ..read more

Case study (27)  History  Three days following a Cesarean section a 35-year-old woman experienced chills and high fever (39.3 °C). Her general status quickly deteriorated. Physical exam revealed tenderness of the uterus.  CBC:  RBC:4.08 X 106/μL (4-5.5 X 106/μL)  HGB: 137 g/dL (120-174 g/dL)  HCT: 40.6 % (36-52%) MCV: 99.7 fL (76–96 fL) MCH: 33.5 pg (27-32 pg) MCHC: 336 g/L (300-350 g/L)  RDWsd:47.2 fL (20-42 fL)  RDWcv: 14.9 % (0-16 %)  WBC: 24.46 X103/ μL (5–10 X 103/ μL)  Neutrophils: 19.13 X 103/μL (2-7.5 X 103/μL)  Lymphocytes ..read more

Preparation of blood smear  Blood film  • A blood film or peripheral blood smear is a thin layer of blood smeared on a microscope slide and then stained in such a way to allow the various blood cells to be examined microscopically.  The objective of blood smear  • Blood films are usually examined to investigate hematological problems (disorders of the blood) and, occasionally, to look for parasites within the blood such as malaria and filaria.  • Examination of thin blood films is important in the investigation and management of anemia, infections, and other co ..read more

  Case study (26) History Two days after cholecystectomy a 50-year-old man experienced periodic chills and fever (39.7°C). CBC: RBC:2.85 X 106/μL (4-5.5 X 106/μL) HGB: 76 g/dL (120-174 g/dL) HCT: 25.5 % (36-52%) MCV: 89.4 fL (76–96 fL) MCH: 26.8 pg (27-32 pg) MCHC: 300 g/L (300-350 g/L) RDWsd:37.7 fL (20-42 fL) RDWcv: 14.7 % (0-16 %) WBC: 5.41 X103/ μL (5–10 X 103/ μL) Neutrophils: 5.02 X 103/μL (2-7.5 X 103/μL) Lymphocytes: 0.35 X 103/μL (1.08–3.17 X 103/μL) Monocytes: 0.02 X 103/μL (0.15-0.7 X 103/μL) Eosinophils: 0.00 X 103/μL (0-0.5 X 103/μL) Basophils: 0.03 X 103/μL (0-0.15 X 103/μL ..read more

Case study (25)  History  An 85-year-old woman was admitted to the Department of Medicine with a terminal stage of lung cancer with multiple metastases.  CBC:  RBC:5.00X 106/μL (4-5.5 X 106/μL)  HGB: 151 g/dL (120-174 g/dL)  HCT: 47.8 % (36-52%) MCV: 95.7 fL (76–96 fL) MCH: 30.3 pg (27-32 pg) MCHC: 316 g/L (300-350 g/L)  RDWsd:63.3 fL (20-42 fL)  RDWcv: 20.0 % (0-16 %)  WBC: 68.54 X103/ μL (5–10 X 103/ μL)  Neutrophils: 64.91 X 103/μL (2-7.5 X 103/μL)  Lymphocytes: 2.40 X 103/μL (1.08–3.17 X 103/μL)  Monocytes: 0.82 X 103 ..read more

Alloimmune Hemolytic Anemia  • Antibody (Ab) develops to an RBC Antigen (Ag) that the individual lacks.  – Individuals are exposed to transfused RBCs from another person.  – Ags on transfused cells is lacking on RBCs of recipients.  – Stimulate the production of Ab (alloAb)  • Ab develops to an RBC Ag that the individual lacks.  – Abs react only with cells that possess the Ag.  ▪ Not the individual's own RBC  • Ab develops to an RBC Ag that the individual lacks.  – Detected by Ab screen (indirect AHg test)  – Seen in transfusion reac ..read more

Case study (24)  History  The 75-year-old female patient with cancer presented at the hospital with symptoms of general sickness and unproductive cough.  CBC:  RBC:3.62 X 106/μL (4-5.5 X 106/μL)  HGB: 115 g/dL (120-174 g/dL)  HCT: 36.8 % (36-52%) MCV: 101.8 fL (76–96 fL) MCH: 31.8 pg (27-32 pg) MCHC: 312 g/L (300-350 g/L)  RDWsd:46.6 fL (20-42 fL)  RDWcv: 14.3 % (0-16 %)  WBC: 28 X103/ μL (5–10 X 103/ μL)  Neutrophils: 26.18 X 103/μL (2-7.5 X 103/μL)  Lymphocytes: 1.23 X 103/μL (1.08–3.17 X 103/μL)  Monocytes: 0.45 X 103 ..read more

Case study (23) History A 35-year-old man was diagnosed with schizophrenia 10 years ago. He is also a known drug user. He suffered multiple traumas in an accident. CBC: RBC:3.48 X 106/μL (4-5.5 X 106/μL) HGB: 100 g/dL (120-174 g/dL) HCT: 33.7 % (36-52%) MCV: 96.9 fL (76–96 fL) MCH: 28.7 pg (27-32 pg) MCHC: 296 g/L (300-350 g/L) RDWsd:55.2 fL (20-42 fL) RDWcv: 17.4 % (0-16 %) WBC: 13.08 X103/ μL (5–10 X 103/ μL) Neutrophils: 9.78 X 103/μL (2-7.5 X 103/μL) Lymphocytes: 2.04 X 103/μL (1.08–3.17 X 103/μL) Monocytes: 0.86 X 103/μL (0.15-0.7 X 103/μL) Eosinophils: 0.31 X 103/μL ..read more

Autoimmune Hemolytic Anemias (AIHA) • Immune tolerance normally prevents the formation of autoantibodies – Autoimmune diseases occur because: ▪ Genetic predisposition ▪ Exposure to infectious agents (molecular mimicry) ▪ Defects in the regulation of immune tolerance • Immune tolerance normally prevents the formation of autoantibodies – Subcategories ▪ Warm vs cold autoantibodies –Further categorized as primary vs secondary AIHA Warm AIHA • Accounts for ~ 70% of cases AIHA –Optimal reactivity at 37°C – Usually IgG (rarely IgM, IgA) – Most Abs react with "Rh protein" complex ▪ Do ..read more