QuestionSBA
QuestionChoice
No, this is not the correct answer. If this patient had disseminated intravascular coagulation, they would have a reduced platelet count, and would be systemically more unwell.
10007866
b
Microangiopathic haemolytic anaemic secondary to disseminated intravascular coagulation
QuestionChoice
No, this is not the correct answer. Alpha thalassaemia is likely to cause microcytic anaemia, and this patient's MCV is normal.
10007869
e
Alpha thalassaemia
QuestionChoice
No, this is not the correct answer. Schistocytes can formed due to osmotic damage, however this does not match the patient's symptoms or history.
10007868
d
Osmotic damage
QuestionChoice
No, this is not the correct answer. Although sickle cell disease results in red cell fragments known as Howell-Jolly bodies, this is generally detected in childhood and presents with episodes of acute pain.
10007867
c
Sickle cell anaemia
QuestionChoice
Yes, this is the correct answer. The blood film shows the presence of schistocytes. These are fragments of red blood cells that form due to mechanical damage to the red blood cells. This can be caused by aortic valve stenosis. As the patient has experienced episodes of syncope and angina (due to reduced perfusion of the aorta and coronary arteries), this is the most likely explanation. Schistocytes can be formed as the red blood cells pass through the stenosed aortic valve.
10007865
a
Microangiopathic haemolytic anaemia secondary to aortic valve stenosis
Concept
Chapter
2693
4220
Haemolytic anaemia
Topic
157
Haematology
14120
Picture
1523
Schistocytes.jpg
images/v33v9aeq1682329946395.jpg
images/v33v9aeq1682329946395_256.jpg
images/v33v9aeq1682329946395_512.jpg
8RcCBoCvyneDZXZ4iZeIl5mHE5DDBVg=
Topic
157
Haematology
A 70-year-old man presents to the GP with shortness of breath, fatigue, and lethargy. He also reports having several recent episodes of fainting and chest pain.


A full blood count and blood film is taken.


||||
|--------------|:-------:|---------------|
|Haemoglobin|83 g/L|(M) 130 - 170, (F) 115 - 155|
|Mean Cell Volume (MCV)|93 fL|80 - 96|
|Platelets|312x10<sup>9</sup>/L|150 - 400|


The blood film is also shown below [lightgallery]


He smokes and drinks alcohol regularly, but is otherwise fit and well with no known medical conditions or regular medications.


Which of the following is the likely cause of the patient's blood film results?
a