Virtual Slide: 56-year-old man with frostbite.

This 56-year-old, chronic alcoholic, man is brought to the emergency room with hypothermia and frostbite involving his toes and fingers. He was found down in the street with no shoes or coat. It is mid January and the outside temperature is 18oF. He smells strongly of alcohol.  Here are his labs: WBC  3.3 X 103   RBC    2.22 Retic    1.0 %        Percent    Abs   HGB    8.5 Bilirubin (T/D)  1.8/0.2 NE    38.5      L 1.3   HCT    23.7 LDH  10,000 LY     44.4      H 1.4   MCV   126.8 Fe   200ug/dl MO    16.7      H 0.6   MCH     38 Blood alcohol  286mg% EO      0.3      L  0   MCHC   35.7   BA      0.1          0   RDW     16.4       PLT     109 X 103       MPV     8.0 Reference values?

Click the little red +  in the bone marrow smear above to see the slide using the virtual microscope. Describe what you see and then answer the following questions. Why does this man have macrocytes? What's with the LDH What other tests do you need? See how a bone marrow is done.   Next is a 70-year-old man complaining of fatigue.

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