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Chapter 20, Problem 2CCS
Summary Introduction
Introduction:
A man in his late 20s (Andrew Hutchinson) met with an accident on his right arm. He has undergone surgery to repair it. Theproportion of lymphocytes and total leukocyte count found very low on a routine complete blood count checkup. His right finger was paining after some days of surgery. On examination, it was found that his right hand has redness, warmth, and edematous. Red streaks, radiating proximally on his right forearm, was visible. The doctor has prescribed a very high dose of antibiotics and the sling was prescribed, so a sling is applied. Nurses are advised to wear gowns and gloves while attending him.
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Mr. Johnson, age 57, presented to his physician with marked fatigue, nausea with occasional diarrhea, and a sore, swollen tongue. Lately he also has been experiencing a tingling feeling in his toes and a feeling of clumsiness. Microscopic examination of a blood sample indicated a reduced number of erythrocytes, many of which are megaloblasts, and a reduced number of leukocytes, including many large, hypersegmented cells. Hemoglobin and serum levels of vitamin B12 were below normal. Additional tests confirm pernicious anemia.
Discussion Questions
Discuss the treatment available and the limitations.
Mr. Johnson, age 57, presented to his physician with marked fatigue, nausea with occasional diarrhea, and a sore, swollen tongue. Lately he also has been experiencing a tingling feeling in his toes and a feeling of clumsiness. Microscopic examination of a blood sample indicated a reduced number of erythrocytes, many of which are megaloblasts, and a reduced number of leukocytes, including many large, hypersegmented cells. Hemoglobin and serum levels of vitamin B12 were below normal. Additional tests confirm pernicious anemia.
Discussion Questions
Discuss how the gastric abnormalities contribute to vitamin B12 and iron deficiency and how vitamin B12 deficiency causes complications associated with pernicious anemia. (See Pernicious Anemia—Pathophysiology, Etiology.)
Mr. Alvis, age 57, presented to his physician with marked fatigue, nausea with occasional diarrhea, and a sore, swollen tongue. Lately he also has been experiencing a tingling feeling in his toes and a feeling of clumsiness. Microscopic examination of a blood sample indicated a reduced number of erythrocytes, many of which are megaloblasts, and a reduced number of leukocytes, including many large, hypersegmented cells. Hemoglobin and serum levels of vitamin B12 were below normal. Additional tests confirm pernicious anemia.
Discuss other tests that could be performed to diagnose this type of anemia.
Chapter 20 Solutions
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