General and Systemic Histopathology, C601&C602

    Virtual Slide: A 27-year-old black female with a fever

    This 27-year-old black woman was admitted with fever, renal failure and possible mental status changes. She was well until 3 days ago when she contract a 'mid cold'. Her fever began yesterday, her urine output has diminished markedly and family says she is profoundly depressed. Her past history is unremarkable and she taking no medication.

     Here are his labs:

    WBC   25 X 103   RBC    2.62 Macros   Mod
              Percent   HGB    5.5 Micros    Mod
    NE      93.5   HCT    18.3 Poik      Marked
    LY        4.4   MCH   21.1 Polychrome   Many
    MO       0.8   MCHC 30.3 Schistocytes   Many
    EO        0.3   RDW   27.5 Spherocytes    Many
    BA        1.0   PLT   115 X 103 nRBC   65/100 WBC
        MPV    7.2 Retic Ct   17.1
          Bilirubin (T/I)  2.0/1.8
    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.
    • Abnormality in the peripheral blood smear?
    • Possible etiologies?
    • Examples of conditions with these changes?
    • Your differential and what labs help make the real diagnosis?

    Next patient is a 56-year-old man with frostbite.

    LDH  448 IU/L PT  11.5 secs
    BUN  60 PTT  28.0 secs
    Creatinine   3.5 Fibrinogen  350
    Coombs direct:   Neg FSP   20-40
    Coombs indirect  Neg  

                                         Reference values?


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