# A Case Study Of Patient Blood Condition

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Question: Discuss about the Case Study of Patient Blood Condition.     Answer: Introduction: Fbc Values According to Full Blood Count: The Test (2016), the following are the full blood count values for oxygen status, immune status, and haemostasis. Oxygen Status Total red cells- total red cells per litre of blood. Red blood cell count that is low causes anaemia. Haemoglobin concentration refers to grams of haemoglobin per decilitre of blood. Low haemoglobin reveals that the patient is anaemic Haematocrit-the portion of blood composed of red blood cells- low haematocrit signifies anaemia Mean corpuscular volume-Determines average size of each red blood cell. Low signifies microcytic anaemia while high is a sign of macrocytic anaemia Mean corpuscular haemoglobin-Determines average haemoglobin content in every red blood cell. Low MCH depicts hypochromic anaemia. Red blood cell distribution width- determines how the red blood cells vary in their size. A high RDW suggest anisocytosis. Immune Status Neutrophils-raised numbers of neutrophils (Neutrophilia) as a result of bacterial infection and acute viral infections. Neutropenia(Neutrophils Decreased) in immune suppression. Lymphocytes-Raised number of lymphocytes (lymphocytosis) in some viral infections including glandular fever but decreased in case of immune suppression including HIV infection. Monocytes –Raised number of monocytes (monocytosis) in bacterial infection and some types of cancers Eosinophil’s-Eosinophilia in case of allergic reaction and parasitic infections Basophils- Basophilia (raised number of basophils) occurs when there is an allergic reaction, the onset of viral and bacterial infection, endocrinopathy and inflammation conditions. Haemostasis (Blood Clotting) Platelet Count- Low count indicatethrombocytopenia while high indicates thrombocytosis. Decreased levels due to haemophilia bleeding or other condition causing blood loss, Increase in certain infection Mean Platelet Volume- determine the mean size of platelets to determine any form of variation in size. 2.Abnormalities and physiological symptoms Abnormalities in WBC According to Full Blood Count: The Test (2016), the following are the abnormalities of WBC and the physiological signs they cause: High WBC count (leukocytosis) causes an immune reaction resulting in problems like allergy, asthma, and other autoimmune diseases. Harold had leukocytosis as his WBC count was 12.1*1000cells/ul which is above the upper limit 10.8*1000cells/ul, he developed an immune reaction against certain food causing resulting to vomiting, heartburn, and indigestion. Neutrophilia (raised number of neutrophils) causes necrosis and inflammation of a tissue. Harold had neutrophilia as his neutrophils were 8.5*1000cells/ul which are above the upper limit 8.3*1000cells/ul. Chronic atrophic gastritis is a form of inflammation and is therefore linked to neutrophilia. Basophilia physiological symptoms are allergy and inflammation of the tissues-Harold had basophilia as his basophils were 1100 cells/ul which is above the upper limit of reference range that is 200cells/ul. Basophilia may be the cause of his inflammation in the lining of the stomach and allergic reactions like nausea, heartburn and indigestion.    Abnormalities In Rbc  According to The Basics of Anaemia (2016), Low Red blood cell count (2.6 that is below 4.7), low haemoglobin (10.6 that is below 13), low hematocrit (31.6 that is below 42) and high mean red blood cell volume (118.4 that is above 90) results in several physiological signs including a high fast rate, dizziness, fatigue and tiredness, pale skin, headache and shortness of breath. Harold experienced symptoms like headaches, tachycardia, and dizziness, fatigue and breathing difficulties due to abnormalities in RBCs. Anaemia Anaemia-A disease condition that results in decreased delivery of oxygen to the tissues. The disease is as a result of decreased red blood cells or abnormalities in the red blood cells (“The Basics of Anaemia”, 2016).The full blood count evidence are: RBC count- the Red blood cell count is below the normal ranges (2.6 that is below 4.7) which is a sign of which result to anaemia. Haematocrit-Low hematocrit level (31.6 that is below 42) signifies low levels of red blood cells in the blood hence causing anaemia. The haemoglobin-low level of haemoglobin (10.6 that is below 13) is an abnormality of red blood cells which lead to less oxygen being transported to the tissues as haemoglobin bind oxygen. Mean red blood cell volume- The high mean red blood cell volume (118.4 that is above 90) is an indication of macrocytic red blood cells which is a red blood cells abnormality. Gastritis And Vitamin B-12 The Harold’s gastritis may cause reduced levels of vitamin B-12 in the blood. Chapter 5. Vitamin B12 (2016) explains that the lining of the stomach produce an intrinsic factor which is vital as it allows the absorption of vitamin B-12 by the cells of the body. Chronic gastritis impairs the production of the intrinsic factor by the lining of the stomach which in turn results to reduced level of vitamin B-12 in the blood (vitamin B-12 deficiency) Folic Acid Deficiency Anaemia (Pernicious Anaemia) Harold peripheral blood smear is an evidence of folic acid deficiency anaemia. The folic acid deficiency interferes with how the red blood cells are formed and hence results to their abnormality (“Chapter 5. Vitamin B12”, 2016). The red blood cells for Harold are larger than the normal red blood cells hence are macrocytic red blood cells which are a major characteristic of a peripheral blood film prepared from a patient with folic acid deficiency. The cells also have a large central pallor which signifies low haemoglobin levels. The Harold’s red blood cells are also reduced in number compared to a healthy individual. Irregularly shaped RBC in the peripheral blood film confirms that he is deficient in folic acid. The full blood count is also vital in the diagnosis of folic acid anaemia. The most important full blood count index is mean corpuscular volume which is increased as the red blood cell increases in size when folic acid is deficient. The others are low hematocrit concentrations, low haemoglobin concentration and low red blood cell count (“Chapter 5. Vitamin B12”, 2016). Treatment Of Harold’s Symptoms The cause of Harold’s blood condition has been due to chronic atrophic gastritis which has resulted in the rise in white blood cells count and less red blood cells count with abnormalities due to vitamin-12 deficiency (“Atrophic Gastritis Treatment & Management: Medical Care, Prevention, Long-Term Monitoring”, 2016). The best treatment of Harold symptoms is by first diagnosing the cause of his chronic atrophic gastritis. The major cause of chronic atrophic gastritis is an infection caused by H. Pylori. The other cause is autoimmune antibodies that are responsible for the destruction of the lining of the stomach cells. According to Atrophic Gastritis Treatment & Management: Medical Care, Prevention, Long-Term Monitoring (2016), the treatment will involve eliminating the cause of atrophic gastritis. The treatment will, therefore, use antibiotics against H. Pylori if H. Pylori is the cause of atrophic gastritis or use of vitamin B-12 injections if the gastritis is as a result of autoimmune antibodies that destroy the cells of the stomach lining. The doctor should also prescribe medication that neutralizes stomach acid as less acid environment promotes the healing of the stomach lining faster. Tachycardia And Chronic Atrophic Gastritis Chronic atrophic gastritis is the cause of Harold’s condition while Tachycardia is the sign of his condition. The chronic atrophic gastritis interferes with the production of an intrinsic factor responsible for the absorption of vitamin B-12 by the body. The vitamin B-12 is important as it assist in the production of adequate and healthy red blood cells in the body. The insufficient and abnormal red blood cells produce a physiological sign that includes Tachycardia (“The Basics of Anaemia,” (2016).    References Atrophic Gastritis Treatment & Management: Medical Care, Prevention, Long-Term Monitoring. (2016). Emedicine.medscape.com. Retrieved 18 July 2016, from https://emedicine.medscape.com/article/176036-treatment Chapter 5.Vitamin B12.(2016). Fao.org. Retrieved 18 July 2016, from https://www.fao.org/docrep/004/Y2809E/y2809e0b.htm Full Blood Count: The Test. (2016). Labtestsonline.org.uk. Retrieved 18 July 2016, from https://labtestsonline.org.uk/understanding/analytes/fbc/tab/test/ The Basics of Anaemia. (2016).WebMD. Retrieved 18 July 2016, from https://www.webmd.com/a-to-z-guides/understanding-anemia-basics.

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