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Old 09-12-2012
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Arrow Belindalimm Daily Questions: Pathology #9

A 20-year-old male is brought to the ER because of fever, headache, and neck stiffness. He rapidly deteriorates and starts to bleed from the venous access sites. His blood pressure is 80/50mmHg, pulse is 112/min, temperature is 38.7C(101.6F), and respirations are 26. Spinal fluid analysis shows elevated protein and low glucose. Spinal fluid and blood cultures grow gram-negative diplococci. His peripheral smear would most likely show which of the following?

A. Spherocyte
B. Schistocytes
C. Bite cells
D. Target cells
E. Acanthocytes
F. Teardrop cells
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Old 09-12-2012
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Default N.meningitis inf?

Bb..DIC induced microangiopathic hemolysis
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Old 09-12-2012
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Originally Posted by belindalimm View Post
A 20-year-old male is brought to the ER because of fever, headache, and neck stiffness. He rapidly deteriorates and starts to bleed from the venous access sites. His blood pressure is 80/50mmHg, pulse is 112/min, temperature is 38.7C(101.6F), and respirations are 26. Spinal fluid analysis shows elevated protein and low glucose. Spinal fluid and blood cultures grow gram-negative diplococci. His peripheral smear would most likely show which of the following?

A. Spherocyte
B. Schistocytes
C. Bite cells
D. Target cells
E. Acanthocytes
F. Teardrop cells
Would go with B(fragmented RBC'c) disseminated meningococcemia may be associated with DIC. Schistocytes may alos seen in HUS and TTP.
A is associated with hereditary spherocytosis.
C is associated with G 6 P D.
D associated with Sickle cell anemia, liver disease.
E seen in Abetelipoproteinemia.
F is seen in thalassemia major and myelofibrosis.
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Old 09-12-2012
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Smile B-

B- DIC due to N.meningitis.
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  #5  
Old 09-13-2012
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Default Yes, the answer is Schistocytes

Blood culture and spinal fluid reveals gram-negative diplococci, indicating N. Meningitis. Endotoxin from Neisseria triggers DIC. Those mesh-like fibrin thrombus will trap red blood cells when they're floating through blood vessel, leading to red blood cell breaking down, forming Schistocytes.
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Old 09-13-2012
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Yes B is the correct one
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