Mrs. R has come in for a checkup, and you notice that she looks different. The s

Question

Mrs. R has come in for a checkup, and you notice that she looks different. The shape of her face seems to have changed a little, and her skin is yellowish. When you check her abdomen, you see that her spleen is enlarged.

The doctor is worried about this, and orders a complete blood count. "I want to see her reticulocyte count and hematocrit," he says.

Put the terms into position to explain how Mrs. R's thalassemia could cause the signs you observed, and the problems the doctor thinks may appear in her blood analysis.

Terms: erythropoietin, bone marrow, reticulocytes, spleen, bile, low, macrophages, erythrocytes, high, oxygen, kidneys, hemoglobin, bilirubin, liver

1. Mrs M's red blood cells contains abnormal ______ so the _____ in the ______ destroy them causing them to have anemia, or a ____________ hematocrit. The overworked _______ become enlarged.

2. The _________ is making ________ faster than the ___________ can convert it into _______. The _____ settles in her skin causing the yellow color called jaundice.

3. Miss M's ___________ hematocrit causes a decrease in the amount of _______ delivered to her _______. They secrete more _______.

4. The constant _____ causes the ________ to make more and more ______ and to release them early when they are still _______. The _____ begins to enlarge making the bones change shape.

Explanation / Answer

1. Mrs M's red blood cells contains abnormal reticulocytes so the macrophages in the liver destroy them causing them to have anaemia or a low hematocrit. The overworked spleen become enlarged.

2. The liver is making bilirubin fastervthan spleen can convert it into bile. The bile settles in her skin causing the yellow color called jaundice.

3. Miss M's low hematocrit causes a decrease in the amount of oxygen delivered to her kidneys. They secreteemore t more erythropoietin.

4. The constant low causes the bone marrow to make more and more erythrocytes and release them early when they are stil reticulocytes. The bone marrow begins to enlarge making the bones change shape.

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