A 25-year-old woman presents with fatigue and pallor. Her laboratory results are as follows: Hemoglobin (Hgb): 8.0 g/dL Hematocrit (Hct): 24% Reticulocyte Count: 5% RBC Count: 2.8 x 10⁶/µL Reticulocyte Maturation Factor: 2.0 (adjusted for anemia, for Hct

Combined with the relative reticulocyte count, which index can provide the greatest insight into activity of the bone marrow during treatment for an anemia? 

You are performing a differential for a patient with absolute leukocytosis and lymphocytosis. The following peripheral blood picture under the microscope should prompt you to do which of the following?

Hypersegmentation of neutrophilic nuclei is hallmark of which disorder?

Hypochromic, microcytic anemia is found in which stage of iron deficiency?

A 9-year-old girl has bruising noted on the extremities and back, reportedly recurrent for one month duration. Lab results show a Hgb 7.1 g/dL, Hct 22.8%, MCV 89 fL, platelet count 63,000/µL, WBC count 19,128/µL. BM biopsy shows 100% cellularity with replacement by primitive cells with large nuclei, delicate chromatin; indistinct nucleoli with scanty cytoplasm. These cells mark for CD10 (CALLA) antigen. Which of the following is the most likely diagnosis?

A patient’s hemoglobin electrophoresis on cellulose acetate shows a prominent band in the position of Hemoglobin S. However, the sickle solubility test is negative (image, middle). What is the most appropriate next step to confirm the identity of the hemoglobin variant?    

A 62-year-old patient presents with complaints of fatigue, pallor, and occasional shortness of breath. On examination, he has pale conjunctiva and mild glossitis. A CBC reveals the following results: Hemoglobin: 8.5 g/dL  MCV: 115 fL WBC: 3.2 x 10⁹/L  Platelets: 95 x 10⁹/L  Reflex Tests Ordered: Serum Vitamin B12: Low Serum Folate: Normal Serum Iron: Normal Bone Marrow Biopsy: Hypercellular with dysplasia in all three cell lines. Based on the clinical findings and laboratory results, which is the most likely diagnosis, and what features differentiate this diagnosis?    

A 55-year-old male consulted his physician because of weakness, lightheadedness, vertigo, and angina. The patient also complained of sores on his tongue. The physical examination revealed jaundice. The pulse rate was increased, and the spleen and liver were slightly enlarged. The tongue appeared smooth and bright red in color. Family history revealed no clues. Neurological exam revealed quickening of reflex responses. Patient history indicated a total gastrectomy five years earlier for stomach cancer and intermittent heart problems that had not required surgery. The physician ordered the following tests: TEST                    RESULTSWBC                    3.1 × 109/LRBC                      2.45 × 1012/LHGB                     10.5 gm/dLHCT                     29.0%MCV                    118 fl MCH                    42.8 pg MCHC                 36.2 gm/dLRDW                    15.7PLT                       83 × 109/L Differential: Segs     49%Bands   6%Lymphs 30%Mono   8%Eos        5%Basos    2% Peripheral blood: macro-ovalocytes What is (are) the most appropriate reflex test(s)?

A patient reports to the lab for annual blood work. The CBC shows moderate anemia, which is reported to the physician. Morphologically, the RBCs are of normal size and shape. A reticulocyte count is reflexed and reported to be 0.7%, with a RPI = 1. Which cause of anemia is suggested?