HEMATOLOGY I MTAP II

MANILA CENTRAL UNIVERSITY

CASE STUDY

1 WHOLE YELLOW PAPER (Copy and Answer)

1. A 42-year-old premenopausal woman has emphysema. This lung disease impairs the ability
to oxygenate the blood, so patients experience significant fatigue and shortness of breath. To alleviate
these symptoms, oxygen is typically prescribed, and this patient has a portable oxygen tank she carries
with her at all times, breathing through nasal cannula. Before she began using oxygen, her red blood
cell (RBC) count was 5.8 3 1012/L. After oxygen therapy for several months, her RBC count dropped
to 5.0 3 1012/L.

A. What physiologic response explains the elevation of the first RBC count?

B. What hormone is responsible? How is its production stimulated?

What is the major way in which it acts?

C. What explains the decline in RBC count with oxygen therapy for this patient?

2. Hemoglobin and hemoglobin fractionation and quantification using high performance liquid
chromatography (HPLC) were performed on a mother and her newborn infant, both presumed
to be healthy. The assays were part of a screening program to establish reference intervals.

 The mother’s hemoglobin concentration was 14 g/dL, and the newborns was 20 g/dL.
 The mother’s hemoglobin fractions were quantified as 97% Hb A, 2% Hb A2, and 1% Hb F
by HPLC and newborn’s results were 88% Hb F and 12% Hb A.

A. Were these hemoglobin results within expected reference intervals?

B. Why were the mother’s and the newborn’s hemoglobin concentration so different?

C. What is the difference between the test to determine the hemoglobin concentration
and the test to analyze hemoglobin by HPLC?

D. Why were the mother’s and newborn’s hemoglobin fractions so different?

3. A 5-year-old girl presents with shortness of breath and wheezing. The patient gives a history
of similar symptoms in the last 6 months. After the patient was given albuterol to control her acute
symptoms, long-term control of her disease was achieved through the use of corticosteroids,
along with monoclonal antibodies to IL-5.

A. Which leukocytes are important in mediating the clinical symptoms in this patient?

B. A complete blood count with differential was performed on this patient.

What are the typical findings in such patients?

C. How did monoclonal antibodies to IL-5 help in controlling her disease?

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Michelle Pabion, RMT