Describe the morphologic appearance of the red cells given the ...

[sam.t96]

Describe the morphologic appearance of the red cells given the following results.
 
  RBC: 1.89  1012/L
  Hemoglobin: 7.5 g/dL
  Hematocrit: 21.0
  RDW: 18.5
 
  a. Macrocytic with anisocytosis
  b. Normocytic normochromic with anisocytosis
  c. Microcytic hypochromic with little anisocytosis
  d. Macrocytic with most cells the same size

Question 2

Which of the following disorders would be consistent with the previously mentioned parameters?
 
  a. Anemia of chronic disease
  b. Aplastic anemia
  c. Vitamin B12 deficiency
  d. Thalassemia

[mariahkathleeen]

Answer to Question 1

ANS: A
The red cell indices are calculated as follows: MCV = (7.5/1.89)  10 = 111 fL; mean cell hemoglobin (MCH) = (7.5/1.89)  10 = 40 pg; mean cell hemoglobin concentration (MCHC) = (7.5/21)  100 = 36. The red cells are thus macrocytic (high MCV) and normochromic (normal MCHC). The RDW is elevated at 18.5, so an increased variation in size exists. This then is a macrocytic anemia with anisocytosis.

Answer to Question 2

ANS: C
Vitamin B12 deficiency leads to a macrocytic anemia with significant variation in size (therefore an increased RDW). Aplastic anemia is normocytic normochromic with a normal RDW; the anemia of chronic inflammation (disease) is either normocytic (MCV low normal) or slightly microcytic but normochromic and a normal or only a mildly elevated RDW. Thalassemia is a microcytic normochromic or hypochromic anemia with a normal RDW.

[sam.t96]

TYSM

[epscape]

Excellent