A patient is suspected of having HS. However, there appear to be <1 spherocytes on the peripheral blood smear, and the osmotic fragility test is normal. What test could be performed to increase the sensitivity of testing for HS?
a. Incubated osmotic fragility test
b. Immunophenotyping for CD55 and CD59
c. Sucrose hemolysis test
d. Ham test
Question 2
Mary, a 7-year-old, was admitted to the hospital after experiencing severe anemia following a respiratory infection. Her father has a history of RBC membrane abnormality and recently underwent a splenectomy to help alleviate the problem.
Upon examination, it was revealed that Mary had hepatosplenomegaly and slight bruising on her forearms. A CBC was ordered, with the following results:
HGB 9.0 g/dL
HCT 24
WBC 11 109/L
RBC 3.8 1012/L
MCV 102 fl
MCH 25 pg
MCHC 40
PLT 275 109/L
Peripheral smear: moderate macrocytes and stomatocytes
Which of the following is most consistent with a presumptive diagnosis in this case?
a. PNH
b. HS
c. DHS
d. HE
Nurses possess a wide variety of experiences which they take into each patient encounter.
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