Hemolytic anemia, myelodysplasia, and liver disease may each fit this peripheral blood picture. Each of these conditions can display peripheral blood macrocytosis. It is easy to observe the overall larger size of the red blood cells in this image compared to the normal lymphocyte also present.
When macrocytes are present, they should be examined for their shape (round vs. oval), the hemoglobin content (central pallor), and whether or not there are any inclusions present in the cell.
Iron deficiency would not be the correct answer in this case, since this condition is associated with microcytosis instead.
The complete blood count was obtained from a patient recently admitted to the emergency room. The red blood cell indices obtained revealed an MCV of 115 femtoliters (fL) (normal range 80 - 90 fL). The patient met the criteria for a peripheral blood smear examination. A representative field is shown on the right.
Which of the following conditions may be indicated by the results seen on this peripheral blood smear?
Fibers can be mistaken for casts on occasion, especially hyaline casts. Fibers, however, are usually thinner and appear less uniform in structure than casts do.
Urinalysis & Other Body Fluids
Which of the following artifacts may be mistaken for casts?
The correct response is option B: The Hepatitis B "e" Antigen (HBeAg). This antigen indicates the virus is actively replicating and therefore the patient is very infectious. The hepatitis B "e" antigen is present when the virus is actively replicating. In cases of unintentional needlesticks, infectivity is of highest concern. The risk for infection is greatest during phases of increased HBeAg serology. The Hepatitis B surface antigen is the first detectable marker, but if the patient is known to have Hepatitis B already, it would be relatively unhelpful to confirm the condition with another HBsAG test. The core antigen is not detectable because it is covered by the nuclear envelope. Antibody response patterns would not be very helpful either as the patient has already been diagnosed with acute Hepatitis B. IgG antibodies would indicate recovery, which is not the case for this patient and IgM antibodies indicating a recent or acute infection would only confirm what is already known.
Recall, in cases of unintentional needlesticks, infectivity is of highest concern.
A phlebotomist at a local hospital recently had an accidental needle stick while drawing blood from a patient being treated for acute hepatitis B. Which serological marker from the patient would be of most value to the physician evaluating the phlebotomist's possible infection status?
Antibodies in the Rh system typically exhibit which one of the following characteristics?
Haemophilus influenzae is both X and V factor dependent for growth, and is the most common cause of obstructive laryngitis and epiglottitis. H. parainfluenzae is only V-factor dependent and causes only mild pharyngitis, rarely obstructive in nature. H. aphrophilus can be part of the normal upper respiratory flora in humans, does not cause pharyngitis, and is not X or V-factor dependent for growth. Although H. haemolyticus is both X and V-factor dependent, it is beta hemolytic on blood agar and is generally considered non pathogenic.
Acute obstructive epiglottitis, both in adults and children, is caused by the bacterial species shown in this split screen photograph. The colonies recovered on chocolate agar (upper frame) required both hematin and NAD, (as shown by colony growth only between the X and V strips in the lower frame). The most likely identification is:
