PBL Sessions: Hematology Organ System - 1

Page 5

History of Present Illness:

She has decreasing mental status. She develops an irregular heart rate.

Figure 5: Representative appearance of the myocardium

She has further laboratory findings that show serum creatinine 2.9 mg/dL and urea nitrogen 30 mg/dL. Representative gross and microscopic appearances of the disease process involving her kidneys is shown in figures 6 and 7.

Figure 6: Representative gross appearance of the kidneys

Figure 7: Representative microscopic appearance of the kidneys

You delve more deeply into the medical record of her deceased husband and discover that, at the time of his death, he had a CBC that showed Hgb 10.6 g/dL, Hct 31.9%, MCV 91 fL, platelet count 181,000/microliter, and WBC count 3350/microliter with differential count 85 segs, 4 bands, 6 lymphs, and 5 monos.

Tasks

• What do these findings indicate?

• What hypotheses explain these findings?

• Explain your reasoning for the hypotheses you choose.

• Is there anything that can tie these findings together?

• What do you think was the underlying cause of death listed on the autopsy report?

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