Virtual Slide: A 69-year-old man with hematuria.


    		 This 69-year-old man complains of gross hematuria of several days duration. He claims to have had bloody urine several times over the past 3 years, but nothing like he is experiencing now. He also has arthritis and claims to take up to 8 aspirin a day. Here are his labs:

    WBC  17,800   RBC  2.90 Unrinalysis
        Percent    Abs   HGB  7.1    Pink/cloudy
    NE  86.5    H  11.0   HCT  21.6    9.030 sg
    LY    7.3     L  0.9   MCV  74.5    1+ protein
    MO   4.4         0.6   MCH  24.5    pH 5
    EO    0.4     L  0.1   MCHC  32.9    3+ Hgb
    BA    1.4     H  0.2   RDW   21.0    RBC: many
        PLT  484    WBC: many
        MPV  8.0  
    Click the green box in the smear above to see the slide using the virtual microscope. Describe what you see and then answer the following questions.
    • Likely cause of his anemia?
    • What kind of anemia?
    • RBC morphology?
    • Other labs?
    • Why is the stool occult blood positive?
    PT = 11.5 sec Ferritin = 5 ng/ml
    PTT = 28 sec Stool hemoccult +
    ESR = 114 mm/hr  
    FE = 17  
    TIBC = 470 ug/dl Reference values?

              

             Next patient is a 22-year-old black man.

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