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A 20-year-old female university student is seen in the student health clinic. She has a general feeling of sickness, an extremely sore throat and a swollen lymph nodes in her neck.
Blood is drawn for a CBC and her throat is swabbed for a rapid strep test and culture.
- Hemoglobin: 13.5 g/dL
- Red Cell Indices: All within normal limits
- White Cell Counts: 14.5 x 10 [to the power of] 9/L
- White Cell Differential:
- Neutrophils: 7%
- Lymphocytes: 89%
- Monocytes: 3%
- Eosinophils: 1%
- Basophils: 0%
Comments: Many reactive (variant) lymphocytes and basket cells seen
Platelet estimate: Normal with normal morphology
Rapid throat culture: Negative, culture pending
Study Guide Questions:
1. Based on the laboratory results provided, which of the following applies?
a. Absolute lymphocytes b. Absolute neutrophilia c.Leukocytosis d. both a & b
2. Which of the following leukocyte changes would you expect to find on a Wright-stained blood film from this patient?
a. Toxic granulation of neutrophils b. Hypersegmentation of neutrophils c. Variant lymphocyts d. Hypochromatic RBC
3. This patient’s quantitative platelet count is estimated at (all values times 10 to 12 power per L):
a. 50 to 100 b. 100 to 150 c. 150 to 350 d. more than 450
4. The estimated hematocrit for this patient would be:
a. 20-24 b. 25-29 c. 26-35 d. 36-39
5. This disease most likely exhibited by this patient is:
a. Infectious mononucleosis b. Leukemia c. Pneumonia d. Sore throat caused by group A beta hemolytic streptococci