Approach to anemia (destruction and sequestration) Quiz: Ace Your Exams
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A 24-year-old man presents to the clinic with a 1-week history of fatigue, pallor, dizziness, headaches, and episodes of fever with chills that occur every 48-72 hours. He reports intermittent yellow discoloration of his skin. He recently returned from a research trip to Malawi. His family history is unremarkable. Temperature is 38.5°C (101.3°F), heart rate is 105/min, blood pressure is 125/78 mm Hg, respiratory rate is 16/min, and oxygen saturation is 96% on room air. The patient appears pale. Examination reveals jaundice and mild splenomegaly. Cardiovascular examination reveals tachycardia. Pulmonary and neurologic examinations are unremarkable. Initial laboratory tests are shown below. Which of the following blood smear findings would be expected in this patient?
| Laboratory test | Results |
| Hemoglobin (Hb) | 9.2 g/dL |
| Hematocrit (Hct) | 26% |
| White Blood Cells (WBC) | 11,500/mm3 |
| Platelets (Plt) | 400,000/mm3 |
| Reticulocyte Count | 9% |
| Mean Corpuscular Volume (MCV) | 88 fL |
| Total Bilirubin | 3.4 mg/dL |
| Unconjugated Bilirubin | 3.1 mg/dL |
| Lactate dehydrogenase (LDH) | 220 U/L |
| Haptoglobin | 10 mg/dL (Reference value 50-220 mg/dL) |
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