Identify three clinical blood test results from Table 892 th

Identify three clinical blood test results from Table 89.2 that were elevated and briefly explain why the are elevated

CASE STUDY 89 SICKLE CELL ANEMIA For the Disease Summary for this case study see the CD-ROM PATIENT CASE s Chief Complaints My arms and legs hurt a lot more than usual today. The ibuprofen has stopped working and I need something stronger. I may have overdone it at the gym.\" History I.T. is an 18-year-old African American male with sickle cell anemia who presents with a one day history of increasing pain localized to his arms and legs. His pain has not been relieved with 400-mg ibuprofen every 6 hours for the past 24 hours. He rates his current pain inten- sity level as 8 out of 10. He reports that he always seems to have some pain in his arms, legs and back, but the pain intensified approximately 36 hours after a workout at the gym that was more vigorous than usual. \"I know that I shouldn\'t have done that,\" he confesses, \"but the guys needed a 6th player for a game of 3-on-3. And, on top of that, I forgot to take my water bottle to the gym The patient was diagnosed with homozygous Hbs disease at age 11 months. He first pre sented with a severe case of dactylitis at 10% months with significant swelling and pain in both hands and feet. Electrophoresis revealed a hemoglobin proportion of 86.5% Hbs, 11.3% HbF, and 2.2% HbA At age 16 months, the patient was hospitalized with acute sequestration syndrome and splenomegaly, treated, and released. At age 30 months and again at age 34 months, the patient was hospitalized for Streptococcus pneumoniae pneumonia, treated with IV antibi- otics, and released. He also experienced one episode of acute staphylococcal osteomyelitis of the left knee at age 13. Since the age of 3 years, the patient has averaged three painful crises per year but has had as many as 10 attacks in a year. He has experienced chronic low-grade pain in his arms, legs, and back since becoming a teenager but has been able to cope by tak ing ibuprofen when needed. Other medical conditions and surgeries of note include Born with hypospadias, which was surgically corrected at 8 months of age Tonsillectomy as a child

Solution

The three blood test results that were not within the normal range are:

Hb = 10.9g/dl

Hct = 28.1 %

Bilurubin total = 1.4 mg/dl

The sickle cells are cleared fast leading to altered Hb level in Sickle cell anemia condition.

The folic acid level is increased at 515ng/ml as the patient might have been administered folic acid, which is required for the formation of red blood cells.

The Hematocrit (Hct) Levels which is a ratio of the volume of red cells to the volume of white cells is altered as the deformed red cells are cleared soon from the system.

the retic range is out of range and increased at 6.4%

The retic range i.e. the reticulocyte count is high as the blood cells are destroyed and cleared by the system in case of sickle cell anemia