Answer Happy

Part II - The Test Results Dr. Stephens receives the lab reports and decides to refer Nikoleta to a hematologist. The results are as follows: Hb (hemoglobin) RBC (red blood cell count) MCV (mean corpuscular volume) WBC (white blood cell count) Platelet count Value 5g/dL 4.6 x 106 cells/ml 65 15,000 cells/ml 250,000 @0 ? 2,000 NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE 8.0 Mr. and Mrs. Stamos bring little Nikoleta into the hematologist's office and Nikoleta has her blood drawn. After a few minutes, the hematologist returns to speak with the parents. Even with just a few moments looking at the sample, he knows that there is something wrong. The hematologist reports that he observed severe hypochromia and microcytosis (lightly colored and small cells), fragmented and nucleated RBCs. The blood sample taken in the office appears as follows: Normal Male: 13.5-16.5 g/dL Female: 12.0-15.0 g/dL Male: 4.5-5.5 x 106 cells/ml Female: 4.0-4.9 x 106 cells/ml 80-100 4500-10,000 cells/ml 100,000-450,000 "It's All Greek to Me: Physiology Edition" by Leslie Gale Wooten-Blanks Figure 1A. Nikoleta's red blood cells Figure 1B. Normal red blood cells The hematologist meets with the Stamos family in the exam room. "Mr. and Mrs. Stamos, there are some things that do not look normal in Nikoleta's blood. I am not sure of the cause, but I do know that Nikoleta's red blood cells aren't shaped correctly and they are not the right color. The red blood cells should be very red under the microscope and her red blood cells are light pink." Mrs. Stamos asks, "Does it matter if her red blood cells aren't red?" 00 The hematologist replies, "Yes, it does matter. Healthy red blood cells are very red and carry oxygen. Nikoleta's red blood cells aren't able to carry much oxygen to her tissues. I have an additional concern as well. Sometimes disorders like anemia can have a genetic basis. I would like to have both of you to give a sample of blood for a complete blood count." The findings from both parents are mild hypochromia and macrocytic (lightly colored and large cells) anemia. The hematologist gives a diagnosis of erythroblastic anemia for both Mr. and Mrs. Stamos. Questions 5. Are the lab results of the CBC normal? Which values are normal and which are not? Page 2 NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE 6. Why are there different normal values for hemoglobin levels and RBC count in males and females? 7. Do red blood cells normally have nuclei? 8. Why was an analysis of Mr. and Mrs. Stamos' blood ordered? 9. Would a picture of Mr. Stamos' red blood cells look like Nikoleta's red blood cells? 10. What is erythroblastic anemia?