A patient sample comes off an automated cell counter with a failure of the red cell "rule of three." The red count is lower than expected given the hemoglobin.The MCV,MCH,and MCHC are elevated.Which of the following is the most likely reason for this failure?
A)megaloblastic anemia
B)lyse-resistant red cells
C)cold agglutinin
D)lipemia

Question

Quizplus · Accepted Answer

The red count is lower than expected for the data;this suggests a cold agglutinin is present.The red cells are thus clumped at room temperature,and the clumps are being counted as one large cell.This lowers the red count and raises the MCV and MCHC.The only red cell parameter that is probably valid is the hemoglobin measurement.

A Patient Sample Comes Off an Automated Cell Counter with a Failure