Mary is a 70 kg. standard female who presents to the physician’s office with severe lethargy and splenomegaly. The patient work-up suggests a differential diagnosis. One of the possibilities is anemia.

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Mary is a 70 kg, standard female who presents to the physician's office with severe lethargy and splenomegaly. The patient work-up suggests a differential diagnosis. One of the possibilities is anemia. Extensive lab work is done and here are the results:

hematocrit = 27%

hemoglobin = 7 gm/dl

RBC = 3 million/mm³

WBC = 9,000/mm³

Reticulocyte count = 4%

a) Does the patient have anemia?

b) if yes, is it increased or decreased production?

c) if the spleen in is the cause, how do yo expect the RBC's to look under the microscope as far as color and size is concerned?

d) what is the physiologic (normal) function of the spleen as far as RBCs are concerned.

a)

Yes, the patient has anemia.

Low Hematocrit, hemoglobin and RBC count indicates that Mary is having anemia.

b)

It is decreased production.

Hematocrit level in a normal man and woman is in the range of 38.3 to 48.6 percent and 35.5 to 44.9 percent respectively

An anemic man has hemoglobin < 14 g/dL and RBC < 4.5 million/mcL

While an anemic woman has hemoglobin < 12 g/dL (120 g/L) and RBC < 4 million/mcL

c)

Splenic is narrower and shorter than capillaries and hence the RBC take the shape of dumbbell. The surface area changes reduces up to 7%

d)

Spleen filters the blood and also removes old and damaged RBC.

a. Cannon-Bard

Explanation: