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LOOKING FOR HELP WITH WITH THE  DXR CLINICIAN CASE STUDY : ERIC PORTER CHIEF COMPLAINT FATIGUE. Im having trouble interpreting diagnostic studies 

DIAGNOSTIC RESULTS

L-WBC 3,300/mm3 (4-10)
L-RBC 1.87 m/mm3
L-Hemoglobin 8.1 g/dL (14-18)
L-Hematocrit 24% (42-52)
N-MCV 115 fL (80-100)
N-MCH 43 pg (25-35)
N-MCHC 35%
RDW 16.5% (12-15)
L-Platelets 138,000/mm3
Bands 1% WBC count
Neutrophils 54% WBC count
Lymphocytes 29% WBC count
Eosinophils 6% WBC count
Monocytes 7% WBC count
Basophils 3% WBC count

Bone marrow biopsy

The low power view shows approximately normal distribution of fat and cells, to give an overall cellularity of 60%. Higher power views show approximately normal number and morphology of megakaryocytes, without evidence of focal accumulations of immature cells. There are no granulomas or lymphoid aggregates seen.
BONE MARROW ASPIRATE SMEAR:
The aspirate smear stained with Wright-Glemsa shows marked megaloblastosis and erythroid hyperplasia. There are both early and late nuclear maturation abnormalities in the erythroid series, including nuclear bud formation. Neutrophilic precursor cells appear to progress through the full maturation sequence and there is no increase in myeloblasts or promyelocytes.
BONE MARROW ASPIRATE IRON STAIN:
The Prussian blue stain at low power reveals normal iron stores. High powered views reveal sideroblasts with mildly increased cytoplasmic loading of iron, but no evidence of ringed sideroblasts.

 

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HEALTH SCIENCE
NURSING
NURSING MS ANP 650

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