RT Book, Section
A1 Hillman, Robert S.
A1 Ault, Kenneth A.
A1 Leporrier, Michel
A1 Rinder, Henry M.
SR Print(0)
ID 1127766892
T1 QUANTITATIVE AND QUALITATIVE DISORDERS OF NEUTROPHILS
T2 Hematology in Clinical Practice, 5e
YR 2016
FD 2016
PB McGraw-Hill Medical
PP New York, NY
SN 9780071626996
LK hemonc.mhmedical.com/content.aspx?aid=1127766892
RD 2024/04/19
AB CASE  HISTORY  •  Part  1A  54-year-old  woman  with  poorly  controlled  hypertension  while  on  a  beta-blocker  is  started  on  hydrochlorothiazide.  A  month  later  she  returns  for  a  blood  pressure  check  and  describes  several  days  of  a  sore  throat,  fever,  and  chills.  On  examination  she  has  a  temperature  of  39.5°C,  a  pharyngeal  exudate,  and  submaxillary  lymphadenopathy.  A  complete  blood  count  (CBC)  with  differential  is  ordered  STAT.CBC:  Hematocrit/hemoglobin  -  40%/13  g/dLWBC  -  4.1  ×  103/uLDifferential  -  Neutrophils  10%  Monocytes  15%  Lymphocytes  75%Platelet  count  -  150  ×  103/uLSMEAR  MORPHOLOGYNormocytic,  normochromic  red  cells  without  aniso-  or  poikilocytosis.  White  cells  are  sparse,  comprised  mostly  of  normal-appearing  lymphocytes,  with  a  few  normal-appearing  neutrophils;  no  early  neutrophil  precursors  (bands,  myelocytes,  or  blasts)  are  seen.  Platelets  are  normal.QuestionsGiven  the  CBC  findings,  what  are  the  absolute  numbers  for  each  of  the  white  cell  lines  and  what  abnormality  is  present?What  further  workup  is  needed—both  history  and  laboratory  testing?