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Old 09-15-2012
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Question hematology Q 2

Q) a 32 yr female known hereditary spherocytosis pt. with mild anemia comes to physician for newly developed fever and malaise..she looks pale and fatigue..her hematocrit dropped to 27%,RBC morphology is normal with no reticulocytes,bilirubin level normal..which is the primary cause for it..?

a) devt. of anti red cell antibodies
b) DIC
c) accelerated extravascular hemolysis of spleen
d) reduced erythropoiesis from parvovirus infection
e) superimposed iron deficiency


i copied this question from other forum coz i liked it...so, i only know the answer without explanation..but, i'll try to give a reasonable explanation..
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Old 09-15-2012
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Default DD...pure RBC aplasia

a 32 yr female known hereditary spherocytosis pt. with mild anemia comes to physician for newly developed fever and malaise..she looks pale and fatigue..her hematocrit dropped to 27%,RBC morphology is normal with no reticulocytes,bilirubin level is normal..which is the primary cause for it..?

a) devt. of anti red cell antibodies
b) DIC
c) accelerated extravascular hemolysis of spleen
d) reduced erythropoiesis from parvovirus infection
e) superimposed iron deficiency

???
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Old 09-15-2012
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Old 09-15-2012
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Embarrassed D?

I will go with D
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Old 09-15-2012
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Default d) reduced erythropoiesis from parvovirus infection

Quote:
Originally Posted by venky2600 View Post
Q) a 32 yr female known hereditary spherocytosis pt. with mild anemia comes to physician for newly developed fever and malaise..she looks pale and fatigue..her hematocrit dropped to 27%,RBC morphology is normal with no reticulocytes,bilirubin level normal..which is the primary cause for it..?

a) devt. of anti red cell antibodies- as no extravascular hemolysis
b) DIC- case histroy doesn't seems so
c) accelerated extravascular hemolysis of spleen- normal bilirubin
d) reduced erythropoiesis from parvovirus infection
e) superimposed iron deficiency- no reticulocytes (but this superimposed is confusing me)


i copied this question from other forum coz i liked it...so, i only know the answer without explanation..but, i'll try to give a reasonable explanation..
d) reduced erythropoiesis from parvovirus infection- can cause RBC aplastic crisis.
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Old 09-16-2012
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Default my answer :)

d) reduced erythropoiesis from parvovirus infection
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Old 09-16-2012
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Thumbs Up D is right

yes, the correct answer is D) reduced erythropoiesis from parvo virus

hereditary spherocytosis is RBC membrane defect generally leads to extravascular hemolysis..but here the pt. developed fever and malaise

c) accelerated extravascular hemolysis----if this was correct, then the pt. would have presented with unconjugated hyperbilirubinemia leading to jaundice

e) superimposed iron deficiency----if this was correct answer then there would be reticulocytosis depicting rbc formation present but iron is deficient to bind to it..

b) DIC----generally it presents with intravascular hemolysis with hemoglobinopathies..in hereditary spherocytosis extravascular hemolysis is seen..and also DIC symptoms vary with severity

this leaves....A and D.......i know many one would choose D because it's obvious that parvo virus cause aplastic crisis leading to bone marrow aplasia...leading to erythropoetic deficiency with no reticulocytosis

but i'm stuck with A ..why can't it be the answer...if anyone knows please explain it to me.....anyways the correct answer is D
thank you
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Old 09-16-2012
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d) reduced erythropoiesis from parvovirus infection
becz parvovirus 19 causes aplastic anemia in HS patients
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