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Home>Homework Answsers>Nursing homework helpa year ago27.01.202420Report issuefiles (3)CaseStudy1and2Dueendofweek3.docxCaseStudy2_AIDS5.pdfCaseStudy1_Iron-Deficiency_Anemia2.pdfCaseStudy1and2Dueendofweek3.docxCase Study 1 and 2 Due end of week 3 – Saturday at 23:59Completion requirementsOpened:Sunday, January 21, 2024, 12:01 AMDue:Saturday, January 27, 2024, 11:59 PMStudents much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.Case Study 1 & 2 topics change every semester. Topics will be determined at due time for this semesterThe answers must be in your own words with reference to the journal or book where you found the evidence to your answer. Do not copy-paste or use a past students work as all files submitted in this course are registered and saved in turn it in program.Turn it in Score must be less than 25 % or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25 %. Copy-paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.All answers to case studies must-have reference cited in the text for each answer and a minimum of 2 Scholarly References (Journals, books) (No websites)  per case StudyLate Assignment PolicyAssignments turned in late will have 1 point taken off for everyday assignment is late, after 7 days assignment will get a grade of 0 (zero). No exceptionsCaseStudy2_AIDS5.pdfCopyright © 2018 by Elsevier Inc. All rights reserved.Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th EditionAIDS (Acquired Immunodeficiency Syndrome)Case StudiesThe patient, a 30-year-old homosexual man, complained of unexplained weight loss, chronicdiarrhea, and respiratory congestion during the past 6 months. Physical examination revealedright-sided pneumonitis. The following studies were performed:Studies ResultsComplete blood cell count (CBC), p. 156Hemoglobin (Hgb), p. 251 12 g/dL (normal: 14–18 g/dL)Hematocrit (Hct), p. 248 36% (normal: 42%–52%)Chest x-ray, p. 956 Right-sided consolidation affecting the posteriorlower lungBronchoscopy, p. 526 No tumor seenLung biopsy, p. 688 Pneumocystis jiroveci pneumonia (PCP)Stool culture, p. 797 Cryptosporidium murisAcquired immunodeficiency syndrome(AIDS) serology, p. 265p24 antigen PositiveEnzyme-linked immunosorbent assay(ELISA)PositiveWestern blot PositiveLymphocyte immunophenotyping, p. 274Total CD4 280 (normal: 600–1500 cells/L)CD4% 18% (normal: 60%–75%)CD4/CD8 ratio 0.58 (normal: >1.0)Human immune deficiency virus (HIV)viral load, p. 26575,000 copies/mLDiagnostic AnalysisThe detection of Pneumocystis jiroveci pneumonia (PCP) supports the diagnosis of AIDS. PCP isan opportunistic infection occurring only in immunocompromised patients and is the mostcommon infection in persons with AIDS. The patient’s diarrhea was caused by Cryptosporidiummuris, an enteric pathogen, which occurs frequently with AIDS and can be identified on a stoolculture. The AIDS serology tests made the diagnoses. His viral load is significant, and hisprognosis is poor.The patient was hospitalized for a short time for treatment of PCP. Several months after he wasdischarged, he developed Kaposi sarcoma. He developed psychoneurologic problems eventuallyand died 18 months after the AIDS diagnosis.Case StudiesCopyright © 2018 by Elsevier Inc. All rights reserved.2Critical Thinking Questions1. What is the relationship between levels of CD4 lymphocytes and the likelihood ofclinical complications from AIDS?2. Why does the United States Public Health Service recommend monitoring CD4counts every 3–6 months in patients infected with HIV?3. This is patient seems to be unaware of his diagnosis of HIV/AIDS. How would youapproach to your patient to inform about his diagnosis?4. Is this a reportable disease in Florida? If yes. What is your responsibility as aprovider?.CaseStudy1_Iron-Deficiency_Anemia2.pdfCopyright © 2018 by Elsevier Inc. All rights reserved.Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th EditionIron-Deficiency AnemiaCase StudyA 72-year-old man developed chest pain whenever he was physically active. The pain ceased onstopping his activity. He has no history of heart or lung disease. His physical examination wasnormal except for notable pallor.Studies ResultElectrocardiogram (EKG), p. 485 Ischemia noted in anterior leadsChest x-ray study, p. 956 No active diseaseComplete blood count (CBC), p.156Red blood cell (RBC) count, p.3962.1 million/mm (normal: 4.7–6.1 million/mm)RBC indices, p. 399Mean corpuscular volume(MCV)72 mm
3
(normal: 80–95 mm3
)Mean corpuscular hemoglobin(MCH)22 pg (normal: 27–31 pg)Mean corpuscular hemoglobinconcentration (MCHC)21 pg (normal: 27–31 pg)Red blood cell distribution width(RDW)9% (normal: 11%–14.5%)Hemoglobin (Hgb), p. 251 5.4 g/dL (normal: 14–18 g/dL)Hematocrit (Hct), p. 248 18% (normal: 42%–52%)White blood cell (WBC) count, p.4667800/mm
3
(normal: 4,500–10,000/mcL)WBC differential count, p. 466 Normal differentialPlatelet count (thrombocytecount), p. 362Within normal limits (WNL) (normal: 150,000–400,000/mm
3
)Half-life of RBC 26–30 days (normal)Liver/spleen ratio, p. 750 1:1 (normal)Spleen/pericardium ratio <2:1 (normal)Reticulocyte count, p. 407 3.0% (normal: 0.5%–2.0%)Haptoglobin, p. 245 122 mg/dL (normal: 100–150 mg/dL)Blood typing, p. 114 O+Iron level studies, p. 287Iron 42 (normal: 65–175 mcg/dL)Total iron-binding capacity(TIBC)500 (normal: 250–420 mcg/dL)Transferrin (siderophilin) 200 mg/dL (normal: 215–365 mg/dL)Transferrin saturation 15% (normal: 20%–50%)Case StudiesCopyright © 2018 by Elsevier Inc. All rights reserved.2Ferritin, p. 211 8 ng/mL (normal: 12–300 ng/mL)Vitamin B12, p. 460 140 pg/mL (normal: 100–700 pg/mL)Folic acid, p. 218 12 mg/mL (normal: 5–20 mg/mL or 14–34 mmol/L)Diagnostic AnalysisThe patient was found to be significantly anemic. His angina was related to his anemia. Hisnormal RBC survival studies and normal haptoglobin eliminated the possibility of hemolysis..His RBCs were small and hypochromic. His iron studies were compatible with iron deficiency.His marrow was inadequate for the degree of anemia because his iron level was reduced.On transfusion of O-positive blood, his angina disappeared. While receiving his third unit ofpacked RBCs, he developed an elevated temperature to 38.5°C, muscle aches, and back pain.The transfusion was stopped, and the following studies were performed:Studies ResultsHgb, p. 251 7.6 g/dLHct, p. 248 24%Direct Coombs test, p. 157 Positive; agglutination (normal: negative)Platelet count, p. 362 85,000/mm 3Platelet antibody, p. 360 Positive (normal: negative)Haptoglobin, p. 245 78 mg/dLDiagnostic AnalysisThe patient was experiencing a blood transfusion incompatibility reaction. His direct Coombstest and haptoglobin studies indicated some hemolysis because of the reaction. His platelet countdropped because of antiplatelet antibodies, probably the same ABO antibodies that caused theRBC reaction.He was given iron orally over the next 3 weeks, and his Hgb level improved. A rectalexamination indicated that his stool was positive for occult blood. Colonoscopy indicated a right-side colon cancer, which was removed 4 weeks after his initial presentation. He tolerated thesurgery well.Critical Thinking Questions1. What was the cause of this patient's iron-deficiency anemia?2. Explain the relationship between anemia and angina.3. Would your recommend B12 and Folic Acid to this patient? Explain your rationale forthe answer4. What other questions would you ask to this patient and what would be your rationale forthem?CaseStudy1_Iron-Deficiency_Anemia2.pdfCopyright © 2018 by Elsevier Inc. All rights reserved.Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th EditionIron-Deficiency AnemiaCase StudyA 72-year-old man developed chest pain whenever he was physically active. The pain ceased onstopping his activity. He has no history of heart or lung disease. His physical examination wasnormal except for notable pallor.Studies ResultElectrocardiogram (EKG), p. 485 Ischemia noted in anterior leadsChest x-ray study, p. 956 No active diseaseComplete blood count (CBC), p.156Red blood cell (RBC) count, p.3962.1 million/mm (normal: 4.7–6.1 million/mm)RBC indices, p. 399Mean corpuscular volume(MCV)72 mm 3 (normal: 80–95 mm3 )Mean corpuscular hemoglobin(MCH)22 pg (normal: 27–31 pg)Mean corpuscular hemoglobinconcentration (MCHC)21 pg (normal: 27–31 pg)Red blood cell distribution width(RDW)9% (normal: 11%–14.5%)Hemoglobin (Hgb), p. 251 5.4 g/dL (normal: 14–18 g/dL)Hematocrit (Hct), p. 248 18% (normal: 42%–52%)White blood cell (WBC) count, p.4667800/mm 3 (normal: 4,500–10,000/mcL)WBC differential count, p. 466 Normal differentialPlatelet count (thrombocytecount), p. 362Within normal limits (WNL) (normal: 150,000–400,000/mm 3 )Half-life of RBC 26–30 days (normal)Liver/spleen ratio, p. 750 1:1 (normal)Spleen/pericardium ratio <2:1 (normal)Reticulocyte count, p. 407 3.0% (normal: 0.5%–2.0%)Haptoglobin, p. 245 122 mg/dL (normal: 100–150 mg/dL)Blood typing, p. 114 O+Iron level studies, p. 287Iron 42 (normal: 65–175 mcg/dL)Total iron-binding capacity(TIBC)500 (normal: 250–420 mcg/dL)Transferrin (siderophilin) 200 mg/dL (normal: 215–365 mg/dL)Transferrin saturation 15% (normal: 20%–50%)Case StudiesCopyright © 2018 by Elsevier Inc. All rights reserved.2Ferritin, p. 211 8 ng/mL (normal: 12–300 ng/mL)Vitamin B12, p. 460 140 pg/mL (normal: 100–700 pg/mL)Folic acid, p. 218 12 mg/mL (normal: 5–20 mg/mL or 14–34 mmol/L)Diagnostic AnalysisThe patient was found to be significantly anemic. His angina was related to his anemia. Hisnormal RBC survival studies and normal haptoglobin eliminated the possibility of hemolysis..His RBCs were small and hypochromic. His iron studies were compatible with iron deficiency.His marrow was inadequate for the degree of anemia because his iron level was reduced.On transfusion of O-positive blood, his angina disappeared. While receiving his third unit ofpacked RBCs, he developed an elevated temperature to 38.5°C, muscle aches, and back pain.The transfusion was stopped, and the following studies were performed:Studies ResultsHgb, p. 251 7.6 g/dLHct, p. 248 24%Direct Coombs test, p. 157 Positive; agglutination (normal: negative)Platelet count, p. 362 85,000/mm 3Platelet antibody, p. 360 Positive (normal: negative)Haptoglobin, p. 245 78 mg/dLDiagnostic AnalysisThe patient was experiencing a blood transfusion incompatibility reaction. His direct Coombstest and haptoglobin studies indicated some hemolysis because of the reaction. His platelet countdropped because of antiplatelet antibodies, probably the same ABO antibodies that caused theRBC reaction.He was given iron orally over the next 3 weeks, and his Hgb level improved. A rectalexamination indicated that his stool was positive for occult blood. Colonoscopy indicated a right-side colon cancer, which was removed 4 weeks after his initial presentation. He tolerated thesurgery well.Critical Thinking Questions1. What was the cause of this patient's iron-deficiency anemia?2. Explain the relationship between anemia and angina.3. Would your recommend B12 and Folic Acid to this patient? Explain your rationale forthe answer4. What other questions would you ask to this patient and what would be your rationale forthem?CaseStudy1and2Dueendofweek3.docxCase Study 1 and 2 Due end of week 3 - Saturday at 23:59Completion requirementsOpened:Sunday, January 21, 2024, 12:01 AMDue:Saturday, January 27, 2024, 11:59 PMStudents much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.Case Study 1 & 2 topics change every semester. Topics will be determined at due time for this semesterThe answers must be in your own words with reference to the journal or book where you found the evidence to your answer. Do not copy-paste or use a past students work as all files submitted in this course are registered and saved in turn it in program.Turn it in Score must be less than 25 % or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25 %. Copy-paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.All answers to case studies must-have reference cited in the text for each answer and a minimum of 2 Scholarly References (Journals, books) (No websites)  per case StudyLate Assignment PolicyAssignments turned in late will have 1 point taken off for everyday assignment is late, after 7 days assignment will get a grade of 0 (zero). No exceptionsCaseStudy2_AIDS5.pdfCopyright © 2018 by Elsevier Inc. All rights reserved.Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th EditionAIDS (Acquired Immunodeficiency Syndrome)Case StudiesThe patient, a 30-year-old homosexual man, complained of unexplained weight loss, chronicdiarrhea, and respiratory congestion during the past 6 months. Physical examination revealedright-sided pneumonitis. The following studies were performed:Studies ResultsComplete blood cell count (CBC), p. 156Hemoglobin (Hgb), p. 251 12 g/dL (normal: 14–18 g/dL)Hematocrit (Hct), p. 248 36% (normal: 42%–52%)Chest x-ray, p. 956 Right-sided consolidation affecting the posteriorlower lungBronchoscopy, p. 526 No tumor seenLung biopsy, p. 688 Pneumocystis jiroveci pneumonia (PCP)Stool culture, p. 797 Cryptosporidium murisAcquired immunodeficiency syndrome(AIDS) serology, p. 265p24 antigen PositiveEnzyme-linked immunosorbent assay(ELISA)PositiveWestern blot PositiveLymphocyte immunophenotyping, p. 274Total CD4 280 (normal: 600–1500 cells/L)CD4% 18% (normal: 60%–75%)CD4/CD8 ratio 0.58 (normal: >1.0)Human immune deficiency virus (HIV)viral load, p. 26575,000 copies/mLDiagnostic AnalysisThe detection of Pneumocystis jiroveci pneumonia (PCP) supports the diagnosis of AIDS. PCP isan opportunistic infection occurring only in immunocompromised patients and is the mostcommon infection in persons with AIDS. The patient’s diarrhea was caused by Cryptosporidiummuris, an enteric pathogen, which occurs frequently with AIDS and can be identified on a stoolculture. The AIDS serology tests made the diagnoses. His viral load is significant, and hisprognosis is poor.The patient was hospitalized for a short time for treatment of PCP. Several months after he wasdischarged, he developed Kaposi sarcoma. He developed psychoneurologic problems eventuallyand died 18 months after the AIDS diagnosis.Case StudiesCopyright © 2018 by Elsevier Inc. All rights reserved.2Critical Thinking Questions1. What is the relationship between levels of CD4 lymphocytes and the likelihood ofclinical complications from AIDS?2. Why does the United States Public Health Service recommend monitoring CD4counts every 3–6 months in patients infected with HIV?3. This is patient seems to be unaware of his diagnosis of HIV/AIDS. How would youapproach to your patient to inform about his diagnosis?4. Is this a reportable disease in Florida? If yes. What is your responsibility as aprovider?.CaseStudy1_Iron-Deficiency_Anemia2.pdfCopyright © 2018 by Elsevier Inc. All rights reserved.Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th EditionIron-Deficiency AnemiaCase StudyA 72-year-old man developed chest pain whenever he was physically active. The pain ceased onstopping his activity. He has no history of heart or lung disease. His physical examination wasnormal except for notable pallor.Studies ResultElectrocardiogram (EKG), p. 485 Ischemia noted in anterior leadsChest x-ray study, p. 956 No active diseaseComplete blood count (CBC), p.156Red blood cell (RBC) count, p.3962.1 million/mm (normal: 4.7–6.1 million/mm)RBC indices, p. 399Mean corpuscular volume(MCV)72 mm
3
(normal: 80–95 mm3
)Mean corpuscular hemoglobin(MCH)22 pg (normal: 27–31 pg)Mean corpuscular hemoglobinconcentration (MCHC)21 pg (normal: 27–31 pg)Red blood cell distribution width(RDW)9% (normal: 11%–14.5%)Hemoglobin (Hgb), p. 251 5.4 g/dL (normal: 14–18 g/dL)Hematocrit (Hct), p. 248 18% (normal: 42%–52%)White blood cell (WBC) count, p.4667800/mm
3
(normal: 4,500–10,000/mcL)WBC differential count, p. 466 Normal differentialPlatelet count (thrombocytecount), p. 362Within normal limits (WNL) (normal: 150,000–400,000/mm
3
)Half-life of RBC 26–30 days (normal)Liver/spleen ratio, p. 750 1:1 (normal)Spleen/pericardium ratio <2:1 (normal)Reticulocyte count, p. 407 3.0% (normal: 0.5%–2.0%)Haptoglobin, p. 245 122 mg/dL (normal: 100–150 mg/dL)Blood typing, p. 114 O+Iron level studies, p. 287Iron 42 (normal: 65–175 mcg/dL)Total iron-binding capacity(TIBC)500 (normal: 250–420 mcg/dL)Transferrin (siderophilin) 200 mg/dL (normal: 215–365 mg/dL)Transferrin saturation 15% (normal: 20%–50%)Case StudiesCopyright © 2018 by Elsevier Inc. All rights reserved.2Ferritin, p. 211 8 ng/mL (normal: 12–300 ng/mL)Vitamin B12, p. 460 140 pg/mL (normal: 100–700 pg/mL)Folic acid, p. 218 12 mg/mL (normal: 5–20 mg/mL or 14–34 mmol/L)Diagnostic AnalysisThe patient was found to be significantly anemic. His angina was related to his anemia. Hisnormal RBC survival studies and normal haptoglobin eliminated the possibility of hemolysis..His RBCs were small and hypochromic. His iron studies were compatible with iron deficiency.His marrow was inadequate for the degree of anemia because his iron level was reduced.On transfusion of O-positive blood, his angina disappeared. While receiving his third unit ofpacked RBCs, he developed an elevated temperature to 38.5°C, muscle aches, and back pain.The transfusion was stopped, and the following studies were performed:Studies ResultsHgb, p. 251 7.6 g/dLHct, p. 248 24%Direct Coombs test, p. 157 Positive; agglutination (normal: negative)Platelet count, p. 362 85,000/mm 3Platelet antibody, p. 360 Positive (normal: negative)Haptoglobin, p. 245 78 mg/dLDiagnostic AnalysisThe patient was experiencing a blood transfusion incompatibility reaction. His direct Coombstest and haptoglobin studies indicated some hemolysis because of the reaction. His platelet countdropped because of antiplatelet antibodies, probably the same ABO antibodies that caused theRBC reaction.He was given iron orally over the next 3 weeks, and his Hgb level improved. A rectalexamination indicated that his stool was positive for occult blood. Colonoscopy indicated a right-side colon cancer, which was removed 4 weeks after his initial presentation. He tolerated thesurgery well.Critical Thinking Questions1. What was the cause of this patient's iron-deficiency anemia?2. Explain the relationship between anemia and angina.3. Would your recommend B12 and Folic Acid to this patient? Explain your rationale forthe answer4. What other questions would you ask to this patient and what would be your rationale forthem?CaseStudy1and2Dueendofweek3.docxCase Study 1 and 2 Due end of week 3 - Saturday at 23:59Completion requirementsOpened:Sunday, January 21, 2024, 12:01 AMDue:Saturday, January 27, 2024, 11:59 PMStudents much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.Case Study 1 & 2 topics change every semester. Topics will be determined at due time for this semesterThe answers must be in your own words with reference to the journal or book where you found the evidence to your answer. Do not copy-paste or use a past students work as all files submitted in this course are registered and saved in turn it in program.Turn it in Score must be less than 25 % or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25 %. Copy-paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.All answers to case studies must-have reference cited in the text for each answer and a minimum of 2 Scholarly References (Journals, books) (No websites)  per case StudyLate Assignment PolicyAssignments turned in late will have 1 point taken off for everyday assignment is late, after 7 days assignment will get a grade of 0 (zero). No exceptionsCaseStudy2_AIDS5.pdfCopyright © 2018 by Elsevier Inc. All rights reserved.Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th EditionAIDS (Acquired Immunodeficiency Syndrome)Case StudiesThe patient, a 30-year-old homosexual man, complained of unexplained weight loss, chronicdiarrhea, and respiratory congestion during the past 6 months. Physical examination revealedright-sided pneumonitis. The following studies were performed:Studies ResultsComplete blood cell count (CBC), p. 156Hemoglobin (Hgb), p. 251 12 g/dL (normal: 14–18 g/dL)Hematocrit (Hct), p. 248 36% (normal: 42%–52%)Chest x-ray, p. 956 Right-sided consolidation affecting the posteriorlower lungBronchoscopy, p. 526 No tumor seenLung biopsy, p. 688 Pneumocystis jiroveci pneumonia (PCP)Stool culture, p. 797 Cryptosporidium murisAcquired immunodeficiency syndrome(AIDS) serology, p. 265p24 antigen PositiveEnzyme-linked immunosorbent assay(ELISA)PositiveWestern blot PositiveLymphocyte immunophenotyping, p. 274Total CD4 280 (normal: 600–1500 cells/L)CD4% 18% (normal: 60%–75%)CD4/CD8 ratio 0.58 (normal: >1.0)Human immune deficiency virus (HIV)viral load, p. 26575,000 copies/mLDiagnostic AnalysisThe detection of Pneumocystis jiroveci pneumonia (PCP) supports the diagnosis of AIDS. PCP isan opportunistic infection occurring only in immunocompromised patients and is the mostcommon infection in persons with AIDS. The patient’s diarrhea was caused by Cryptosporidiummuris, an enteric pathogen, which occurs frequently with AIDS and can be identified on a stoolculture. The AIDS serology tests made the diagnoses. His viral load is significant, and hisprognosis is poor.The patient was hospitalized for a short time for treatment of PCP. Several months after he wasdischarged, he developed Kaposi sarcoma. He developed psychoneurologic problems eventuallyand died 18 months after the AIDS diagnosis.Case StudiesCopyright © 2018 by Elsevier Inc. All rights reserved.2Critical Thinking Questions1. What is the relationship between levels of CD4 lymphocytes and the likelihood ofclinical complications from AIDS?2. Why does the United States Public Health Service recommend monitoring CD4counts every 3–6 months in patients infected with HIV?3. This is patient seems to be unaware of his diagnosis of HIV/AIDS. How would youapproach to your patient to inform about his diagnosis?4. Is this a reportable disease in Florida? If yes. What is your responsibility as aprovider?.CaseStudy1_Iron-Deficiency_Anemia2.pdfCopyright © 2018 by Elsevier Inc. All rights reserved.Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th EditionIron-Deficiency AnemiaCase StudyA 72-year-old man developed chest pain whenever he was physically active. The pain ceased onstopping his activity. He has no history of heart or lung disease. His physical examination wasnormal except for notable pallor.Studies ResultElectrocardiogram (EKG), p. 485 Ischemia noted in anterior leadsChest x-ray study, p. 956 No active diseaseComplete blood count (CBC), p.156Red blood cell (RBC) count, p.3962.1 million/mm (normal: 4.7–6.1 million/mm)RBC indices, p. 399Mean corpuscular volume(MCV)72 mm
3
(normal: 80–95 mm3
)Mean corpuscular hemoglobin(MCH)22 pg (normal: 27–31 pg)Mean corpuscular hemoglobinconcentration (MCHC)21 pg (normal: 27–31 pg)Red blood cell distribution width(RDW)9% (normal: 11%–14.5%)Hemoglobin (Hgb), p. 251 5.4 g/dL (normal: 14–18 g/dL)Hematocrit (Hct), p. 248 18% (normal: 42%–52%)White blood cell (WBC) count, p.4667800/mm
3
(normal: 4,500–10,000/mcL)WBC differential count, p. 466 Normal differentialPlatelet count (thrombocytecount), p. 362Within normal limits (WNL) (normal: 150,000–400,000/mm
3
)Half-life of RBC 26–30 days (normal)Liver/spleen ratio, p. 750 1:1 (normal)Spleen/pericardium ratio <2:1 (normal)Reticulocyte count, p. 407 3.0% (normal: 0.5%–2.0%)Haptoglobin, p. 245 122 mg/dL (normal: 100–150 mg/dL)Blood typing, p. 114 O+Iron level studies, p. 287Iron 42 (normal: 65–175 mcg/dL)Total iron-binding capacity(TIBC)500 (normal: 250–420 mcg/dL)Transferrin (siderophilin) 200 mg/dL (normal: 215–365 mg/dL)Transferrin saturation 15% (normal: 20%–50%)Case StudiesCopyright © 2018 by Elsevier Inc. All rights reserved.2Ferritin, p. 211 8 ng/mL (normal: 12–300 ng/mL)Vitamin B12, p. 460 140 pg/mL (normal: 100–700 pg/mL)Folic acid, p. 218 12 mg/mL (normal: 5–20 mg/mL or 14–34 mmol/L)Diagnostic AnalysisThe patient was found to be significantly anemic. His angina was related to his anemia. Hisnormal RBC survival studies and normal haptoglobin eliminated the possibility of hemolysis..His RBCs were small and hypochromic. His iron studies were compatible with iron deficiency.His marrow was inadequate for the degree of anemia because his iron level was reduced.On transfusion of O-positive blood, his angina disappeared. While receiving his third unit ofpacked RBCs, he developed an elevated temperature to 38.5°C, muscle aches, and back pain.The transfusion was stopped, and the following studies were performed:Studies ResultsHgb, p. 251 7.6 g/dLHct, p. 248 24%Direct Coombs test, p. 157 Positive; agglutination (normal: negative)Platelet count, p. 362 85,000/mm 3Platelet antibody, p. 360 Positive (normal: negative)Haptoglobin, p. 245 78 mg/dLDiagnostic AnalysisThe patient was experiencing a blood transfusion incompatibility reaction. His direct Coombstest and haptoglobin studies indicated some hemolysis because of the reaction. His platelet countdropped because of antiplatelet antibodies, probably the same ABO antibodies that caused theRBC reaction.He was given iron orally over the next 3 weeks, and his Hgb level improved. A rectalexamination indicated that his stool was positive for occult blood. Colonoscopy indicated a right-side colon cancer, which was removed 4 weeks after his initial presentation. He tolerated thesurgery well.Critical Thinking Questions1. What was the cause of this patient's iron-deficiency anemia?2. Explain the relationship between anemia and angina.3. Would your recommend B12 and Folic Acid to this patient? Explain your rationale forthe answer4. What other questions would you ask to this patient and what would be your rationale forthem?123Bids(70)Miss DeannaDr. Ellen RMMathProgrammingDr. Aylin JMMISS HILLARY A+abdul_rehman_Prof Double RYoung NyanyaSTELLAR GEEK A+ProWritingGuruSheryl HoganDr. Adeline ZoeMukul5078Dr M. Michellesherry proffTutor Cyrus KenWIZARD_KIMnicohwilliamDr CloverIsabella HarvardShow All Bidsother Questions(10)for excel_profmkt 421math homeworkWK 11 ETHICS. KIM WOOD ONLYHWA+ AnswersFortune 500CIS105 Introduction to Information Systems OYO 21-2week 6 discussionBUS 680 Week 6 DQ 2 Final Paper Summary

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