Pathological Sciences 2 Hematology question.
A 34 year-old female with inflammatory bowel disease presents to her GP with easy bruising, slight tachycardia and feeling light-headed. Her GP requests a series of tests, some of which are reported below.
Table 1: Initial results obtained from GP request
| Parameter | Result | Reference range |
| Red cell count | 3.2 | 3.9-5.0 x1012/L |
| Haemoglobin | 97 | 118-148 g/L |
| MCV | 87 | 77-98 fL |
| White cell count | 3.8 | 4.0-10.0 x 109/L |
| Platelets | 74 | 143-400 x 109/L |
| ESR | 23 | <10mm/hour |
| Prothrombin Time | 13 | 11-14 s |
| Activated Partial Thromboplastin Time | 32 | 24-34 s |
Table 2: Blood film findings following initial full blood count
| Principal blood film findings |
| Dimorphic red cell population. Occasional pencil cells and hypersegmented neutrophils. |
Based upon these results, a number of relevant biochemistry reflex tests were requested. These are outlined below.
Table 3: A selection of relevant reflex test results following initial GP request
| XXXXX A | 190 | 160-925 ng/mL |
| XXXXX B | 1.2 | >3μg/L |
| XXXXX C | 10.5 | 7.5-224μg/L |
| XXXXX D | 97 | 55-81 μmol/L |
- Using the correct terminology (as appropriate), describe the results in table 1.
- Correlate the results in table 1 with the patient’s clinical details and presentation.
- Consider the results in tables 1 and 2 and accurately predict the identity of the unnamed analytes (A, B, C and D) in table 3. In the context of the data presented in tables 1 and 2, interpret the results. [Hint, consider the books in the module reading list]
- Propose suitable therapeutic intervention for this patient.
