Question

A 55-year-old Cambodian man, who “has never seen a doctor”, was found to be mildly anemic at the time of establishing care with a community-based family medicine physician. His CBC showed: hemoglobin 11.8 g/dL, RBC 5.9 x10⁶/µL, MCV 65 fL, MCH 20 pg, MCHC 29.3 g/dL, reticulocytes 176 x10³/µL, WBC normal, platelets normal. The most likely diagnosis is:

Iron deficiency anemia

Sickle cell trait

Aplastic anemia

Thalassemia minor

Answer 1

The Abnormal Results in this case are

a.Low Hb Count - 11.8 g/dL (Normal : 13.5 to 17.5 grams /deciliter ) which indicates anemia

b.Low MCV- 65 fL (Normal: 80 and 96 femtoliters )-Which lndicates Low volume of Red cells--Which suggest microcytic Anemia

c.High reticulocyte count :176*10³( 25-75 x 10³ /µL )-Which indicates Hemolytic Anemia.

Reticulocyte Count indicates the rate of production of fast red blood cells called reticulocytes , by the bone marrow .

Low Reticulocyte count is scene in conditions where only fewer RBCs are made by the bone marrow like-

1.Aplastic anemia

2.Iron deficiency Anemia

3.Thalassemia

Hence Option a,c & d are false.

High reticulocyte is seen in conditions of Bleeding,when Bone marrow produce more Red blood cells.

For example Hemolytic anemia

In Sickle cell trait which leads to Sickle cell Disease,There is a sickling of RBC,which can cause Bleeding & Increased production of RBC by bone marrow which can cause High reticulocyte Count.

Hence Option B is the correct answer