The children of a 76-year-old man when visiting him noticed that he was more forgetful and...

The children of a 76-year-old man when visiting him noticed that he was more forgetful and had

trouble walking. Concerned that he had suffered a stroke,

they insisted that he visit his doctor. The doctor diagnosed him with peripheral neuropathy

that his ability to walk affected him. In addition, the doctor noticed that he was pale, a

little yellow, and I order a CBC and some additional tests.

1. What findings at the CBC told the doctor to order vitamin tests?

2. Was the response in number of reticulocytes adequate to compensate for the degree of anemia? Explain

3. Does the patient present a hemolytic picture? Yes or no, explain your answer based on the results.

4. in the results, what concludes about the cause of anemia?

5. What additional tests could help diagnose the specific cause of the patient's anemia?

Expert Solution

1. CBC of blood can reveal anaemia and also the type of anaemia. LEvels of hemoglobin and hematocrit value can be studied. PErsons deficient in B12 will have low hemoglobin levels, low hematocrit value. Mean corpuscular volume is higher and is more than 100. Number of reticulocytes will also be higher. So all these findings in the CBC indicate deficiency in B12. This can be confirmed by further tests done.

2. Reticulocyte count increases whenever there is anaemia. The bone marrow tries to compensate for the loss of blood or for the hemolysis of blood cells due to some disease or deficiency. When the number of reticulocytes are more it can compensate to some extent deficiency of hemoglobin. But the reticulocytes survive in the blood for 1 to 2 days only after which they mature to become RBCs. As the RBCs formed are hemolysed earlier than their life span, the increased reticulocyte count does not compensate fully the loss of RBCs.

3. Pale and yellow coloration is indication of anemia and hemolysis. The RBCs are destroyed and hemoglobin is carried to liver. In the liver the hemoglobin is converted in to bile pigments blirubin and biliverdin. These are called bile pigments which are excreted from the body. Yellowing of the body is due to the presence of higer levels of bilirubin in the blood. Such a condition is indication of the hemolysis.

4. Increased reticulocyte numbers, low hemoglobin levels, macrocytic anemia and increased bilirubin levels are the indications of the hemolytic anaemia.

gladiator answered 1 year ago

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