Patient A is a 35-year-old from Hull. She is 12 weeks pregnant and a strict vegan. Her full blood count shows a Low MCV 66fl, low Hb 100g/L, low MCH 24pg, normal red cell count 4.3×10^12/L. HPLC
shows no abnormal peaks. Blood film microcytic, hypochromic blood picture with pencil cells (Echinocytes)
Patient B is a 24-year-old post graduate student. He has returned to Hull having travelled in Zimbabwe for the last three months. His he pre holiday bloods showed no evidence of pathology. On
return he presented to hi GP (General Practitioner) with gastrointestinal discomfort and shortness of breath on excursion.
His full blood count shows a normal Low MCV 88fl, low Hb 11.0g/L, normal MCH 28pg, low red cell count 3.2×10^12/L. HPLC shows no abnormal peaks. Blood film shows a normocytic, normochromic anaemia.
1. From the details given for Patient A, comment as to the cause of these results (10 Marks)
2. What further investigations could you perform to confirm your findings (do not limit to hematological investigations) (10 Marks)
3. What changes could this patient make to her diet that is both compatible with veganism and healthy in terms of erythropoiesis? (10 Marks)
4. Would this patient benefit from a blood transfusion? Justify your answer (10 Marks)
5. From the details given for Patient B, identify the likely pathology. Justify your answer (10 Marks)
6. What are the benefits and limitations of employing a FOB (faecal occult blood) in this case? (10 Marks)
7. Could the cause of this condition have been prevented in this patient? How? (10 Marks)
8. What further complications may this patient suffer and what advice should be given to patient b regarding managing their condition? (10 Marks)
9. Design a table listing your results of two patients from practical 2. (10 Marks)
10. Name the pathology (or not) most compatible with the results you obtained (10 Marks)