I may have had all the, pardon, bloody theory on erythropoiesis but for some reason, this knowledge has never stuck in my head. Today, I broke through my plateau. We had a practical class today and searched for "fun stuff" in our blood smears. While my eyes were still perfectly functional, I looked into my smear as well as I could. And I found this cute reticulocyte.
ELI5: they're immature red blood cells. The mature ones are more or less round and pinkish with a lighter centre. These reticulocytes (in this stain) are usually more uniform in colour, kinda translucent, kinda whatever colour you get from mixing blue, purple and grey. Mine was barely visible - enough for my professor to literally tell me "chapeau bas", haha.
As minor of a thing as it is, it's given me a major confidence boost. I've recently experienced embarrassment after embarrassment. Sure feels good to get something right.
Is there an explanation for this observation
Background: 58M, 66”, 165 lbs, 9 years NED pancreatic cancer, post-Whipple, BRCA2, CAD, Plavix, statins, PPI.
Three years in a row, I've had high reticulocyte blood tests [absolute 119.9, 2.29%, Prod Index 2.3], without any evident trauma or blood loss. I have no historical normal reticulocyte counts to compare. Hemoglobin and iron levels remain normal.
My PCP is stumped. Oncologist is unconcerned in presence of normal hemoglobin. Unsure if I should keep pursuing this and if so, what type of doctor?
Nurses often overlook reticulocyte test and they request it during/ post blood transfusion over the last few months. 😅😅😅
1st Incident:
I had to talk to the Resident Physician who is doing the nurse a favor and still insisting to push through with the test. It took me half an hour to discuss things with him. Until... I asked the of the Senior Resident who took Medical Technology and overruled him.
2nd Incident:
The Attending Physician called the laboratory asking why do I refuse to get blood for Reticulocyte count. Well, I still need to tell him why but no further discussion needed. Apparently the nurse is saving his ass.
Most recent incident (this morning):
The nurse is asking me how many more hours does she has to wait before she can request for Reticulocyte count 🤷🏽♀️
Do not forget that as professionals, it is your duty to state weather your opinion on the test requested. In the end it is still the Attending Physician’s call but do not forget to exert effort so they can have an informed decision. Do not assume that they know the things we know... or at least remember.
Apparently, I might need a powerpoint presentation next time. Thoughts?
Uworld had a question describing a classic case of beta thalassemia. The labs, however, showed increased reticulocytes. How can this be possible? I was taught microcytic anemias have decreased reticulocyte count.
Am I missing something? Ty in advance <3
anyone have a list to memorize? I can't ever get this concept high: hemolysis, good marrow response low: marrow production issue, nutritional deficiencies(iron/folate/b12), thalasemias is that it?
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Citation: Can anyone please find me this article? Thank you
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**DOI/PMID/ISBN: PMID: 21689644 DOI: 10.1016/j.cca.2011.06.004
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[URL] http://www.sciencedirect.com/science/article/pii/S0009898111003160
Hello all. 22 year old male with no family history of blood illnesses. I've been seeing my Doc quite frequently over the last while due to general malaise (common low grade fever, fatigue, weight loss of 30 pounds, unilateral right side varicocele with pain), and have just got some blood work back. Ive been experiencing these symptoms for 4 months roughly with increasing severity in everything except for fatigue, which has remained constant. I eat well, don't drink ever, take no medication and am 6 foot 4 and 180 pounds.
My Hemoglobin has been high for several years, (hovers around 180/L) but this has been attributed to smoking by my doctor. Recent blood work showed hematocrit a sliver above normal.
My retic absolute count was 125, sitting at 2.3 %. I've been starting to feel much worse over the last few days, however my doctor seems stumped. It doesn't appear to be in response to anemia as my RBC count seems very healthy?
The last few days I've been very short of breath for the first time in my life which has been a little freaky. Lots of short shallow breathing, lungs feel okay but just like I'm not getting enough air. Heart rate fell to 45 (never falls under 80 for me typically) and I felt quite unwell.
My doctor seemed confused by my retic count and has referred me to a blood specialist, sent me for a chest x ray for the shortness of breath and recommended giving blood to thin things out.
Any advice or recommendations are greatly appreciated. Thanks for your time!
I don't get this index.
Why the reticulocyte % must be corrected? I don't get why it is corrected nor the rest of the formula, can someone explain?
I have been having trouble finding a good diagram or description on the interwebs that shows where in an erythrocyte's development being a nucleated RBC and reticulocyte is. I am especially interested in where in relation to marrow the development occurs. Or am I confused and nRBCs are just a catch all for anything through a reticulocyte?
I don't want to step on anybody's toes here, but the amount of non-dad jokes here in this subreddit really annoys me. First of all, dad jokes CAN be NSFW, it clearly says so in the sub rules. Secondly, it doesn't automatically make it a dad joke if it's from a conversation between you and your child. Most importantly, the jokes that your CHILDREN tell YOU are not dad jokes. The point of a dad joke is that it's so cheesy only a dad who's trying to be funny would make such a joke. That's it. They are stupid plays on words, lame puns and so on. There has to be a clever pun or wordplay for it to be considered a dad joke.
Again, to all the fellow dads, I apologise if I'm sounding too harsh. But I just needed to get it off my chest.
