Laboratory for diagnosis, symptom and illness management

  case 1 Mosby’s Manual of Diagnostic and Laboratory Tests, 6th Edition Iron-Deficiency Anemia Case Study A 72-year-old man developed chest pain whenever he was physically active. The pain ceased on stopping his activity. He has no history of heart or lung disease. His physical examination was normal except for notable pallor. Studies Result Electrocardiogram (EKG), p. 485 Ischemia noted in anterior leads Chest x-ray study, p. 956 No active disease Complete blood count (CBC), p. 156 Red blood cell (RBC) count, p. 396 2.1 million/mm (normal: 4.7–6.1 million/mm) RBC indices, p. 399 Mean corpuscular volume (MCV) 72 mm3 (normal: 80–95 mm3 ) Mean corpuscular hemoglobin (MCH) 22 pg (normal: 27–31 pg) Mean corpuscular hemoglobin concentration (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. 466 7800/mm3 (normal: 4,500–10,000/mcL) WBC differential count, p. 466 Normal differential Platelet count (thrombocyte count), p. 362 Within normal limits (WNL) (normal: 150,000– 400,000/mm3 ) 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. 287 Iron 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 Studies Copyright © 2018 by Elsevier Inc. All rights reserved. 2 Ferritin, 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 Analysis The patient was found to be significantly anemic. His angina was related to his anemia. His normal 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 of packed 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 Results Hgb, p. 251 7.6 g/dL Hct, p. 248 24% Direct Coombs test, p. 157 Positive; agglutination (normal: negative) Platelet count, p. 362 85,000/mm3 Platelet antibody, p. 360 Positive (normal: negative) Haptoglobin, p. 245 78 mg/dL Diagnostic Analysis The patient was experiencing a blood transfusion incompatibility reaction. His direct Coombs test and haptoglobin studies indicated some hemolysis because of the reaction. His platelet count dropped because of antiplatelet antibodies, probably the same ABO antibodies that caused the RBC reaction. He was given iron orally over the next 3 weeks, and his Hgb level improved. A rectal examination indicated that his stool was positive for occult blood. Colonoscopy indicated a rightside colon cancer, which was removed 4 weeks after his initial presentation. He tolerated the surgery well. 

Critical Thinking Questions 

1. 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 for the answer 4. What other questions would you ask to this patient and what would be your rationale for them

 Case 2 Studies The patient, a 30-year-old homosexual man, complained of unexplained weight loss, chronic diarrhea, and respiratory congestion during the past 6 months. Physical examination revealed right-sided pneumonitis. The following studies were performed: Studies Results Complete blood cell count (CBC), p. 156 Hemoglobin (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 posterior lower lung Bronchoscopy, p. 526 No tumor seen Lung biopsy, p. 688 Pneumocystis jiroveci pneumonia (PCP) Stool culture, p. 797 Cryptosporidium muris Acquired immunodeficiency syndrome (AIDS) serology, p. 265 p24 antigen Positive Enzyme-linked immunosorbent assay (ELISA) Positive Western blot Positive Lymphocyte immunophenotyping, p. 274 Total 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. 265 75,000 copies/mL Diagnostic Analysis The detection of Pneumocystis jiroveci pneumonia (PCP) supports the diagnosis of AIDS. PCP is an opportunistic infection occurring only in immunocompromised patients and is the most common infection in persons with AIDS. The patient’s diarrhea was caused by Cryptosporidium muris, an enteric pathogen, which occurs frequently with AIDS and can be identified on a stool culture. The AIDS serology tests made the diagnoses. His viral load is significant, and his prognosis is poor. The patient was hospitalized for a short time for treatment of PCP. Several months after he was discharged, he developed Kaposi sarcoma. He developed psychoneurologic problems eventually and died 18 months after the AIDS diagnosis. Case Studies Copyright © 2018 by Elsevier Inc. All rights reserved. 

 Critical Thinking Questions

 1. What is the relationship between levels of CD4 lymphocytes and the likelihood of clinical complications from AIDS?

 2. Why does the United States Public Health Service recommend monitoring CD4 counts 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 you approach to your patient to inform about his diagnosis?

 4. Is this a reportable disease in Florida? If yes. What is your responsibility a provider


Students must 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.  Topic TBD

The 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 past students’ work as all files submitted in this course are registered and saved in turn it in the program.

Answers must be scholarly and be 3-4 sentences in length with rationale and explanation. No Straight forward / Simple answer will be accepted.  

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 Study

Calculate your paper price
Pages (550 words)
Approximate price: -

Why Choose Us

Quality Papers

We value our clients. For this reason, we ensure that each paper is written carefully as per the instructions provided by the client. Our editing team also checks all the papers to ensure that they have been completed as per the expectations.

Professional Academic Writers

Over the years, our Acme Homework has managed to secure the most qualified, reliable and experienced team of writers. The company has also ensured continued training and development of the team members to ensure that it keep up with the rising Academic Trends.

Affordable Prices

Our prices are fairly priced in such a way that ensures affordability. Additionally, you can get a free price quotation by clicking on the "Place Order" button.

On-Time delivery

We pay strict attention on deadlines. For this reason, we ensure that all papers are submitted earlier, even before the deadline indicated by the customer. For this reason, the client can go through the work and review everything.

100% Originality

At Buy An Essay, all papers are plagiarism-free as they are written from scratch. We have taken strict measures to ensure that there is no similarity on all papers and that citations are included as per the standards set.

Customer Support 24/7

Our support team is readily available to provide any guidance/help on our platform at any time of the day/night. Feel free to contact us via the Chat window or support email:

Try it now!

Calculate the price of your order

We'll send you the first draft for approval by at
Total price:

How it works?

Follow these simple steps to get your paper done

Place your order

Fill in the order form and provide all details of your assignment.

Proceed with the payment

Choose the payment system that suits you most.

Receive the final file

Once your paper is ready, we will email it to you.

Our Services

Buy An Essay has stood as the world’s leading custom essay writing services providers. Once you enter all the details in the order form under the place order button, the rest is up to us.


Essay Writing Services

At Buy An Essay, we prioritize on all aspects that bring about a good grade such as impeccable grammar, proper structure, zero-plagiarism and conformance to guidelines. Our experienced team of writers will help you completed your essays and other assignments.


Admission and Business Papers

Be assured that you’ll definitely get accepted to the Master’s level program at any university once you enter all the details in the order form. We won’t leave you here; we will also help you secure a good position in your aspired workplace by creating an outstanding resume or portfolio once you place an order.


Editing and Proofreading

Our skilled editing and writing team will help you restructure you paper, paraphrase, correct grammar and replace plagiarized sections on your paper just on time. The service is geared toward eliminating any mistakes and rather enhancing better quality.


Technical papers

We have writers in almost all fields including the most technical fields. You don’t have to worry about the complexity of your paper. Simply enter as much details as possible in the place order section.