PBL Sessions: Hematology Organ System - 1


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Page 3

History of Present Illness:

A CBC shows WBC count 5470/microliter with differential count of 60 segs, 2 bands, 23 lymphs, 11 monos, and 2 eos, Hgb 12.7 g/dL, Hct 38.0%, MCV 85 fL, and platelet count 98,000/microliter. Serum chemistries show sodium 141 mmol/L, potassium 4.6 mmol/L, chloride 103 mmol/L, CO2 26 mmol/L, creatinine 1.3 mg/dL, and glucose 71 mg/dL.

Figure 1: Peripheral blood smear

Further past history reveals that she is G2 P1 Ab 1. She had a cholecystectomy performed 2 years ago. The Pap smear shows a few trichomonads.

A head CT scan is performed. The findings are those represented by the gross appearance shown here [Image courtesty of Jeannette J. Townsend MD, University of Utah]

Figure 2: Head CT scan

Tasks

  • What do these findings indicate?

  • What hypotheses explain these findings?

  • Explain your reasoning for the hypotheses you choose.

  • What learning issues are being identified?

  • What additional information might you request?

Stop !! Complete discussions and tasks before moving to the next page.