Question

(6) You are monitoring the progress of 3 patients (Bill, Greg, and Joan). Joan is a 37 yr old non- preg female suffering from a chronic folate deficiency anemia, Bill (33 yr old male) is recovering from surgery after a traumatic motorcycle accident, while Greg (40 yr old male) is being monitored following the accidental, potent Folate antagonist, but this was almost 2 months ago. (27 pts) ingestion (over a 5-week period) of a You have the data sets below. Unfortunately, the patient codes were not attached. Based on these data sets, deduce which describes the condition and thus identify the likely patient for that data set. Data set A RDW (%) 19 5 high 12.5 4.02 414 Based on the above information, fill out the tables below Answer (with units) MCV MCH MCHC Answer Based on these values, is the patient anemic? (Yes/No) Based on: Low Hct / Low HgB / Both Low / Both Normal (choose one) Describe his/her current RBC Morphology (circle all that apply): microcytic hypochromic normochromic Use MCHC when determining morphology Serum folateRBC folate (nmol/L) Serum MMA Serum Hcy (amol/L) pmol/L.) 87 (nmol/L) 13.3 337 12.7 Based on your answers and the additional results shown above, write the probable patient in the white box Data set B HCT (%) LRDw (%) 93 2.86314 16.3 Based on the above information, fill out the tables below Answer (with units)

Answer 1

	Calculation	Answer with units
MCV	MCV = Hct% X 10 / RBC X 1012 /L MCV = 41.4 X 10 / 4.02 X 1012 /L = 102.98fL	102.98fL
MCH	MCH = Hb g/dL X 10 / RBC X 1012 L MCH = 12.5 X 10 / 4.02 = 31.09	31.09pg
MCHC	MCHC = Hbg/dL X 100 / HCt% MCHC = 12.5 X 100 / 41.4 MCHC = 30.19	30.19g/dL

• Yes. Based on the values the patient is anemic.
• The patient has low HgB

.RBC Morphology.

• High MCV value denotes red cells are larger than normal - Macrocytic
• Low MCHC value denotes red blood cells have less hemoglobin - Hypochromic

The patient is having High RDW and High MCV value. The patient probable to have Vitamin B12 deficiency, folate deficiency, Immune hemolytic anemia.