RT Book, Section
A1 Hillman, Robert S.
A1 Ault, Kenneth A.
A1 Leporrier, Michel
A1 Rinder, Henry M.
SR Print(0)
ID 1127765304
T1 MARROW-DAMAGE ANEMIA
T2 Hematology in Clinical Practice, 5e
YR 2016
FD 2016
PB McGraw-Hill Medical
PP New York, NY
SN 9780071626996
LK accessbiomedicalscience.mhmedical.com/content.aspx?aid=1127765304
RD 2024/04/24
AB CASE  HISTORY  •  Part  1A  27-year-old  auto  mechanic  presents  with  a  1-month  history  of  increasing  fatigue,  shortness  of  breath  with  strenuous  exertion,  easy  bruising,  and  gum  bleeding.  His  past  history  is  negative,  except  for  hepatitis  A  as  a  teenager.  His  occupation  does  involve  the  use  of  cleaning  solvents  on  auto  parts.  Examination  reveals  a  well-muscled  male  with  pale  conjunctiva,  petechiae  limited  to  the  ankle  areas,  and  hand  and  forearm  bruises.  No  lymphadenopathy  or  hepatosplenomegaly.CBC:  Hematocrit/hemoglobin  -  20%/6  g/dLMCV  -  91  fL  MCH  -  32  pg  MCHC  -  33  g/dLRDW-CV  -  13%SMEAR  MORPHOLOGYNormochromic/normocytic  red  cells  with  ±  anisocytosis  and  the  rare  polychromatic  macrocyte.  Platelets  and  neutrophils  markedly  decreased  without  blast  cells.  Lymphocytes  appear  normal.Table  Graphic  Jump  Location|Download  (.pdf)|PrintReticulocyte  count/index  -  <1%/<0.5White  blood  cell  count  -  1,600/μLAbsolute  differential:Neutrophils  -  <200/μLLymphocytes  -  1,200/μLMonocytes  -  320/μLPlatelet  count  -  9,000/μLQuestionsHow  should  the  anemia  be  classified?What  tests  should  be  ordered?