A 55-year-old male consulted his physician because of weakne…
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)?
Read DetailsA 9-year-old girl has bruising noted on the extremities and…
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?
Read DetailsA patient’s hemoglobin electrophoresis on cellulose acetate…
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?
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