Thoughtful Thursday: Ruby Requests Rest (Case 1)

 

Photo of Professor Pocky taken by Dr. Haus

Click For Explanation of Case Flow

 

Click for Test Case Tuesday:  Ruby Requests Rest

 

Diagnostic Testing Results:

CBC:

Red Blood Cells - LOW

Reticulocytes - LOW

 

Direct Coombs Test:

Positive

🧪

Diagnosis:

🌌IMMUNE-MEDIATED HEMOLYTIC ANEMIA🌌

 

Pathophysiological Point:

Ruby is suffering from a disease where her own body is producing antibodies AGAINST her own red blood cells.  This means her own body is destroying her red blood cells.

 

 Questions:

Level 1 Questions:

1.  Explain why Ruby has a low number of red blood cells on her CBC.  (See Pathophysiological Point above for a hint)
   
   
2.  Why is having a low number of red blood cells in the body bad for a patient?
   
   
3.  Challenge question, why is Ruby icteric on physical exam?  (Hint:  Icterus)
   

 

Level 2 Questions:

1.  Given Ruby's disease process (see above), describe what is occurring at a cellular level to both the immune system cells and Ruby’s red blood cells.  Please be sure to address in your answer:
   
   • All blood cells involved in Ruby’s disease process (and how they are involved)
   • How the cellular changes are leading to her large and painful spleen
   
   
2.  Explain pathophysiologically why Ruby is icteric on physical exam.
   
   
3.  Challenge question, explain why Ruby has both low red blood cells AND low reticulocytes.  (HINT:  Think about her disease process)
   

    
   

Level 3 Questions:

1.   Describe the treatment plan you would recommend for Ruby and why you are recommending each part of your treatment plan.  Please answer this question as if you are speaking to a professional colleague.
   
   
2.  Describe your recommended treatment plan and why you are recommending each part of your treatment plan.  Please answer this question as if you are explaining it to a client/patient without a scientific background.
   
   
3.  Explain the pathophysiology of at least TWO (2) different etiologies of Immune-Mediated Hemolytic Anemia.
   

  

Day 2 Conclusion

Before Conclusion Caturday think about your...

❓Answers to the above questions

📚 Review Material Related to Ruby's Case

 

Conclusion Caturday:  Ruby Requests Rest (link will go live Saturday, 10/21/2023)