Si kle ell

Apuntes

Si kle ell disease A 9-year-old boy is brought to the physician by his parents because of right-sided shoulder pain for 1 day. He has not had chills or sweating. At the age of 3 and 4, he was treated twice in the emergency department for painful swelling of his hands and feet. He emigrated with his family from Kenya 2 years ago. His temperature is 37.4°C (99.3°F), pulse is 96/min, and blood pressure is 123/82 mm Hg. Physical examination shows no tenderness, erythema, or joint swelling of the shoulder. Laboratory studies show: Hemoglobin 7 g/dL Mean corpuscular volume 88 μm3 Reticulocyte count 9% Leukocyte count 12,000/mm3 A peripheral blood smear is most likely to show which of the following abnormalities? A) Ring-shaped inclusions in erythrocytes b) Teardrop-shaped erythrocytes c) Nuclear remnants in erythrocytes D) Fragmentation of erythrocytes f) Erythrocytes with no central pallor c) Nuclear remnants in erythrocytes Peripheral blood smear (Giemsa stain) Nuclear remnants in erythrocytes (i.e., Howell-Jolly bodies, HJBs) appear as small basophilic spots in the periphery of circulating red blood cells. Normally, HJBs are removed by the spleen. Patients with sickle cell disease typ...