General and Systemic Histopathology, C601&C602

    Virtual Slide: A 22-year-old black man with abdominal pain.

    This 22-year-old black man complains of severe abdominal pain and fever. He has a history of similar episodes, some requiring hospitalization. He also believes he has some form of 'kidney' problem.

    Physical exam reveals a slight man of small stature who is in considerable distress. No significant physical findings are present, and no spleen is palpated.  Here are his labs:

    WBC  12,400   RBC  3.2 Sickle Dex  +
        Percent     Abs   HGB  9.3 Electrophoresis (click it)
    NE    71.8     8.9   HCT   27.5  
    LY     21.6     2.7   MCV  85.7 Reference values?
    MO     4.7      0.6   MCH  28.9  
    EO      0.4   L  0   MCHC 33.7 Look at his spleen
    BA      1.5   H  0.2   RDW  15.7  
    nRBC  5/100 wbc   PLT  304  
        MPV  7.7  
    Click the green box in the smear above to see the slide using the virtual microscope. Describe what you see and then answer the following questions.
    • What is the basic defect with this man's red blood cells?
    • Expected clinical course of homozygous and heterozygous states
    • Additional laboratory tests?

    The next patient is a 19-year-old college student.

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