Parameter

Result

Reference range

Haemoglobin

95 g/L

130-180 g/L

Red blood cell count

2.92  x 10¹²/L

4.50-6.50 x 10¹²/L

Haematocrit

0.271

0.40-0.54

Mean cell volume

92.8 fL

80-100 fL

Mean cell haemoglobin

32.5 pg

26.5-33.0 pg

MCHC

351 g/L

310-360 g/L

Reticulocyte count

1.26 x 10⁹/L

20-80 x 10⁹/L

White cell count

3.2 x 10⁹/L

3.5-11.0 x 10⁹/L

Platelet count

51 x 10⁹/L

150-400 x 10⁹/L

Blood film

1. Describe the morphology of the cells in the top corners of the field. (1 mark)

2. Describe the morphology of the cell in the bottom corner of the film (1 mark)

3. What is your provisional diagnosis based on the clinical presentation, the FBC results and the WBC morphology? (1 mark)

4. What further tests should be performed immediately on this patient and why? (2 marks)