A 19-year-old male visits his primary care physician with a sore throat, swollen lymph nodes, and extreme fatigue. During the visit, the nurse finds that he has a fever. The patient reports that he is attending his second year of college at a local university. The physician performs a physical examination, which confirms large, swollen, painful lymph nodes. He decides to send the patient to the office laboratory for blood work. He orders a complete blood count (CBC) and viral and bacterial studies. Reference Range Reference Range WBC 13.3 × 103/uL 4.8–10.8 × 103/uL Neutrophils 40% 60%–70% RBC 4.5 × 109/L 4.7–6.1 × 109/L Lymphocytes 53% *20% of lymphocytes are atypical 20%–30% Hgb 14.1 g/dL 14–18 g/dL Monocytes 7% 5%–10% Hct 42% 42%–52% Eosinophils 0 0%–5% MCV 92 fL 80–100 fL Basophils 0 0%–2% MCH 27 pg 27–31 pg Absolute neutrophils 5.32 1.4–6.5 × 103/uL MCHC 33% 32% –36% Absolute lymphocytes 7.05 1.2–3.4 × 103/uL RDW 14.3% 11.5%–14.5% Absolute monocytes 0.93 0.1–0.6 × 103/uL Plt 325 × 109/L 150–450 × 109/L Absolute eosinophils 0 0–0.5 × 103/uL MPV 9.5 fL 7.4–10.4 fL Absolute basophils 0 0–0.2 × 103/uL Question: Based on the information obtained thus far, what does the laboratory analysis indicate? Explain your answer.

Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ

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Question

A 19-year-old male visits his primary care physician with a sore throat, swollen lymph nodes, and extreme fatigue. During the visit, the nurse finds that he has a fever. The patient reports that he is attending his second year of college at a local university. The physician performs a physical examination, which confirms large, swollen, painful lymph nodes. He decides to send the patient to the office laboratory for blood work. He orders a complete blood count (CBC) and viral and bacterial studies.

		Reference Range			Reference Range
WBC	13.3 × 10³/uL	4.8–10.8 × 10³/uL	Neutrophils	40%	60%–70%
RBC	4.5 × 10⁹/L	4.7–6.1 × 10⁹/L	Lymphocytes	53% *20% of lymphocytes are atypical	20%–30%
Hgb	14.1 g/dL	14–18 g/dL	Monocytes	7%	5%–10%
Hct	42%	42%–52%	Eosinophils	0	0%–5%
MCV	92 fL	80–100 fL	Basophils	0	0%–2%
MCH	27 pg	27–31 pg	Absolute neutrophils	5.32	1.4–6.5 × 10³/uL
MCHC	33%	32% –36%	Absolute lymphocytes	7.05	1.2–3.4 × 10³/uL
RDW	14.3%	11.5%–14.5%	Absolute monocytes	0.93	0.1–0.6 × 10³/uL
Plt	325 × 10⁹/L	150–450 × 10⁹/L	Absolute eosinophils	0	0–0.5 × 10³/uL
MPV	9.5 fL	7.4–10.4 fL	Absolute basophils	0	0–0.2 × 10³/uL

Question:

Based on the information obtained thus far, what does the laboratory analysis indicate? Explain your answer.
The patient’s symptoms of fever and painful, swollen lymph nodes are caused by what innate immune mechanisms? Explain your answer
About 50% of patients with chronic viral infection develop splenomegaly. Based on what you know about the organs of the immune system, why would this condition develop?

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