Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

How did the lab help with the diagnosis?

• His hemoglobin and hematocrit were both low.
• Hgb = 8.6 gm/dL (12.5 - 16.5 gm/dL)
• Hct = 26.4% (42 - 51%)
• He had fewer than expected RBCs
• RBCs = 3.08 million/cumm (4 - 5.7 million/cumm)
• His cells were smaller than expected.
• MCV = 65 fl (80 - 100 fl)
• His cells contained less hemoglobin than expected.
• MCH = 22.4 pg (27 - 35 pg)
• Importantly, his reticulocyte count was down.
• Retic count = 0.2% (0.5 - 1.5%) of his RBCs.
• This tells us his bone marrow cannot respond to his need for more RBCs.
• He's anemic, because his bone marrow can't get it in gear.
• The bone marrow is either sick or lacks an essential nutrient.