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Studies of Biology of Diseases

Topic: Hematology case study

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Subject: Biology

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Hematology Case Study Assignment Answers for Nursing Students

Fifty-year-old Christina Markides was admitted to the Avon Orthopaedic Centre for an emergency Total Hip Replacement operation after she fell down the stairs at home and fractured the top of her left femoral shaft.

During the pre-op assessment she seemed a little confused and disorientated. Fortunately, her daughter had accompanied Mrs. Markides to the hospital and was able to tell the Registrar that her mother had complained of feeling tired and weak for a little while, and that her mother was often “a little forgetful”. Whenever she had suggested to her mother that she saw her GP to check things over, Mrs. Markides had said not to fuss and that it was all “stuff and nonsense”.

The Registrar then ascertained as reasonable a medical history as she could from the daughter. She reported that her mother was not on any medication other than some tablets she had from the chemist to help with her vertigo; had not had any major illness that she was aware of although she had been in hospital 5 years ago following a road traffic accident. She could remember that her mother had required a blood transfusion, but off hand could not remember how many units she had required.

Hematology Case Study with Question and Answers

The Registrar took a sample for a full blood count and also for a Group and Save in case any blood was required during the operation.

The following initial results came back from Haematology:

Investigation Result (reference range – female) Red cell count (x 1012/L) 3.0 (3.9 – 5.6) Haemoglobin (g/L) 100 (115 – 155) PCV (haematocrit) (%) 34 (36 – 48) MCV (fl or m3) 105 (80 – 95) MCH (pg/cell)

33 (27 – 34) White cell count (x 109/L) 5.6 (4.0 – 11.0) Platelet count (x 109/L) 197 (150 – 400)

The blood film reported macrocytic red cells with hyper-segmented neutrophils (Figure 1).

On receiving the results, the Registrar asked Mrs. Markides’ daughter if she was aware if any other members of her family had ever had ever presented with similar symptoms. She replied that although her parents had come over from Cyprus in the 1970s, they travelled back frequently and kept in regular contact with their extended family and as far as she was aware there was no family history of anaemia. In delving further into Mrs Markides’ background, her daughter mentioned that Christina was a strict vegetarian. The Registrar took further blood samples to determine serum B12 and red cell folate levels and to check for the presence of auto-antibodies.

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