Answer: Q3) A woman attends for a pre-operative review in preparation for gynaecological surgery. Routine blood tests are performed, including a full blood count. On examination she looks mildly jaundiced. Her lab results: Hb 7.6 g/l, White cell count 2.5 x 109/l, Platelets 275x109/l, MCV 109fl, MCHC 30 fl, Haematocrit 21%, Reticulocytes >15% The blood film shows polychromasia with numerous microspherocytes and occasional normoblasts. There is a slight increase in neutrophils. What is the most likely diagnosis? a) Acute myeloid leukaemia b) Aplastic anaemia c) Haemolytic anaemia d) Iron-deficiency anaemia e) Pernicious anaemia Correct Answer: c) Haemolytic anaemia. Pernicious anaemia is the potentially difficult differential diagnosis in this situation but reticulocytes are not generally increased in pernicious anaemia until treatment is commenced. Less than 2% of circulating red blood cells are reticulocytes. Nucleated red blood cells (normoblasts) are not normally seen in the peripheral circulation.
Posted on: Wed, 18 Jun 2014 03:00:55 +0000
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