PBL Sessions: Hematology Organ System - 2


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Page 3

History of Present Illness:

A CBC shows WBC count 8120/microliter with differential count of 65 segs, 4 bands, 20 lymphs, 10 monos, and 1 eos, Hgb 8.3 g/dL, Hct 24.1%, MCV 71 fL, and platelet count 108,000/microliter. Serum chemistries show sodium 144 mmol/L, potassium 4.3 mmol/L, chloride 106 mmol/L, CO2 26 mmol/L, creatinine 1.0 mg/dL, and glucose 72 mg/dL.

Figure 1: Peripheral blood smear

Further past history reveals that she is G1 P0 Ab 1. She had a cholecystectomy performed 4 years ago. The Pap smear shows a few clue cells.

A doppler ultrasound of her right leg is performed and reveals deep venous thrombosis.

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?

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