Question

List the adult reference range for the following tests:   use your book and don’t forget labtestsonline.org as a resource

Reticulocyte %

Serum Iron

Serum ferritin

            Male

            Female

TIBC

Transferrin saturation %

Complete the following chart for the differential diagnosis of Microcytic/Hypochromic Anemias

Anemia	Fe Level	Ferritin	TIBC	% Saturation	Reticulocyte
Iron Deficiency
Iron deficiency with treatment for 12 days
Anemia
Beta Thalassemia Minor
Hereditary Hemochromatosis
Sideroblastic Anemia

Explain ferritin levels replace the necessity of performing bone marrow aspirations on cases of suspected iron deficiency anemia.

Explain how hemoglobin electrophoresis is performed.  (page 124)

Explain the results seen in hemoglobin electrophoresis on Thalassemia patients.

Answer 1

1.The reticulocyte count is used to estimate the degree of effective erythropoiesis ,which can be reported as absolute reticuloyte count or as a reticulocyte percentage .

The reference range of te reticulocyte percentage in adults is 0.5%-1.5%

2. serum iron is measured in micrograms of iron per deciliter of blood (mcg/dL)  

normal range -60 to 170 mcg/dL. Total iron binding capacity ;240 to 450mcg/d

3.Normal ferritin level range from 12 to 300 nanogramsper milliliter of blood(ng/mL) -Males

12 to 150ng/mL -Females

4.TIBC normal range-240to450 micrograms per deciliter(mcg/dL)

5.Transferrin saturations of less than 20% indicate iron deficiency ,while transferrin saturations of more than 50% suggest iron overlord

a bone marrow aspirate stained for iron can be diagnostic of iron deficiency , provided that spicules are present in the smear and that control specimen containing iron is performed at the same time .although the test has largely been displaced by serum iron ,TIBC and serum ferritin testing ,the absence of stainable iron ina bone marrow aspirate is te criterion standard for the diagnosis of iron deficiency.

in the laboratory ,a process called electrophoresis passes an electrical current through the hemoglobin in blood sample .this causes the different types of heamoglobin to separate into different bands . then blood sample is then compared to a healthy sample to determine which type of hemoglobin are present

how it performed ; 1. go to a lab to have your blood drawn .at the lab the health are provider takes a sample of blood from arm or hand

2first clean the site with a swab of rubbing alcohol .then they insert a small needle with atube attached to collect blood .

3. when enough blood has been drawn ,they remove the needle and cover te site with gauze pad then send the sample for laboratory analysis

4.in laboratory a process called electrophoresis passes electrical current through the heamoglobin in blood sample .this cause the different types of hb to seperate into different bands .

5then blood sample is compared to a healthy sample to determine which types of heamoglobin are present .

in thalassemia patient depending on the type and severity ,a physical examination might also help for diagnosis .

the distinguishing finding beta thalassemia is a hemoglobin electrophooresis with the finding of elevated Hgb and F .both will incresed in beta thalassemia trait without iron defficiency ,and will be normal or decresed in alpha thalassemia and isolated iron deficiency anemia .