General and Systemic Histopathology, C601&C602

    Virtual Slide: A 19-year-old college students complains of ease of fatigue.

    This 19-year-old white college student complains can no longer complete his daily 10 mile jog. He develops extreme at about 5 miles. He's also noted bruises around his ankle and has recently had several nosebleeds. In retrospect, he feels his symptoms have slowly been coming on for about 2 months.

    Physical exam reveals a pale, slender well developed man with scattered petechiae, but no adenopathy or arganomegaly. His labs:

    WBC   0.5  X 103   RBC   2.61 Anti-HBsAg  +
           Percent    Abs   HGB    8.2 TIBC  350 ug/dl
    NE     2.3       0   HCT    23.2 FE   180 ug/dl
    LY    96.5      0.5   MCV   89.2 Ferritin  100 ng/ml
    MO    0.7       0   MCH   31.5  
    EO    0.5        0   MCHC  35.3  
    BA      0         0   RDW  13.1  
        PLT   23 X 103        Reference values?
        MPV  10.2  
    Click the red '+'  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 abnormality in this peripheral smear?
    • Possible etiologies?
    • Criteria for diagnosis?
    • How would the bone marrow biopsy help with the diagnosis? 

    The next patient is a 27-year-old black woman.


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