I’ll create clinical cases across multiple medical departments based on CBC interpretation. These cases will cover Pediatrics, Gynecology, Geriatrics, Emergency Medicine, and Surgery for a broader understanding of CBC use in real-world scenarios.
🩸 Clinical Cases in Different Medical Specialties Using CBC
🔹 Case 1: Pediatric – Severe Anemia in a Toddler (Beta-Thalassemia Major)
Patient Presentation
- Age/Sex: 2-year-old male
- Symptoms: Pallor, failure to thrive, irritability, hepatosplenomegaly
- History: Recurrent infections, family history of anemia in Mediterranean descent
CBC Findings
| Parameter | Result | Normal Range (Pediatric) |
|---|---|---|
| Hemoglobin (Hb) | 5.2 g/dL | 11.5-14.5 g/dL |
| Hematocrit (Hct) | 18% | 36-44% |
| MCV | 65 fL | 70-86 fL |
| MCH | 21 pg | 24-30 pg |
| RDW | 18% | 11.5-14.5% |
| WBC | 14,000/µL | 6,000-15,000/µL |
| Platelets | 510,000/µL | 150,000-450,000/µL |
Interpretation & Diagnosis
🔹 Severe microcytic anemia with high RDW & hepatosplenomegaly → Suggests Beta-Thalassemia Major
🔹 Confirmatory test: Hemoglobin electrophoresis (↑ HbF, ↓ HbA)
Next Steps
✅ Hemoglobin Electrophoresis → Confirms diagnosis
✅ Management:
- Regular blood transfusions
- Iron chelation therapy (to prevent iron overload)
- Consider bone marrow transplant for cure
🔹 Case 2: Obstetrics & Gynecology – Postpartum Hemorrhage (PPH) with DIC
Patient Presentation
- Age/Sex: 30-year-old female (postpartum)
- Symptoms: Severe bleeding after delivery, hypotension, tachycardia
- History: Prolonged labor, placental abruption
CBC Findings
| Parameter | Result | Normal Range (Pregnancy) |
|---|---|---|
| Hemoglobin (Hb) | 7.0 g/dL | 11-14 g/dL |
| Hematocrit (Hct) | 23% | 33-39% |
| MCV | 88 fL | 80-100 fL |
| Platelets | 50,000/µL | 150,000-450,000/µL |
| WBC | 22,000/µL | 6,000-16,000/µL |
| PT/INR | 1.8 | <1.2 |
| Fibrinogen | 90 mg/dL | 200-400 mg/dL |
| D-Dimer | High | Normal: <0.5 µg/mL |
Interpretation & Diagnosis
🔹 Severe thrombocytopenia, elevated INR, ↓ fibrinogen, ↑ D-Dimer → Suggests Disseminated Intravascular Coagulation (DIC)
🔹 Likely cause: Postpartum hemorrhage
Next Steps
✅ Emergency Management:
- Massive transfusion protocol: RBCs, platelets, FFP, cryoprecipitate
- Uterine massage & uterotonics (oxytocin, misoprostol)
- Possible hysterectomy if bleeding persists
🔹 Case 3: Geriatrics – Pancytopenia in an Elderly Male (Myelodysplastic Syndrome)
Patient Presentation
- Age/Sex: 75-year-old male
- Symptoms: Fatigue, easy bruising, frequent infections
- History: Long history of smoking
CBC Findings
| Parameter | Result | Normal Range (Elderly) |
|---|---|---|
| Hemoglobin (Hb) | 8.0 g/dL | 12-16 g/dL |
| Hematocrit (Hct) | 26% | 36-46% |
| MCV | 105 fL | 80-100 fL |
| WBC | 2,500/µL | 4,000-11,000/µL |
| Platelets | 80,000/µL | 150,000-450,000/µL |
Interpretation & Diagnosis
🔹 Macrocytic anemia + Leukopenia + Thrombocytopenia = Pancytopenia
🔹 Likely Myelodysplastic Syndrome (MDS), common in elderly smokers
Next Steps
✅ Bone Marrow Biopsy → Confirms MDS with dysplastic cells
✅ Management:
- Supportive care with erythropoietin
- Consider hypomethylating agents (azacitidine)
- Bone marrow transplant in select cases
🔹 Case 4: Emergency Medicine – Sepsis with Septic Shock
Patient Presentation
- Age/Sex: 50-year-old male
- Symptoms: High fever, hypotension (BP 85/50), tachycardia, confusion
- History: Diabetes mellitus, recent UTI
CBC Findings
| Parameter | Result | Normal Range |
|---|---|---|
| Hemoglobin (Hb) | 10.2 g/dL | 13-17 g/dL |
| Hematocrit (Hct) | 32% | 39-50% |
| MCV | 88 fL | 80-100 fL |
| WBC | 22,000/µL | 4,000-11,000/µL |
| Neutrophils | 85% | 40-75% |
| Platelets | 90,000/µL | 150,000-450,000/µL |
| Lactate | 4.5 mmol/L | <2.0 mmol/L |
Interpretation & Diagnosis
🔹 Leukocytosis with neutrophilia, thrombocytopenia, and high lactate → Sepsis with evolving DIC
🔹 Likely source: Urosepsis
Next Steps
✅ Sepsis Management Protocol:
- IV fluids (30 mL/kg crystalloid)
- Broad-spectrum antibiotics (meropenem if MDR risk)
- Vasopressors (norepinephrine if hypotension persists)
🔹 Case 5: Surgery – Acute Abdomen with Peritonitis (Perforated Peptic Ulcer)
Patient Presentation
- Age/Sex: 45-year-old male
- Symptoms: Sudden severe abdominal pain, rigid abdomen
- History: Chronic NSAID use, peptic ulcer disease
CBC Findings
| Parameter | Result | Normal Range |
|---|---|---|
| Hemoglobin (Hb) | 13.5 g/dL | 13-17 g/dL |
| Hematocrit (Hct) | 40% | 39-50% |
| MCV | 86 fL | 80-100 fL |
| WBC | 19,000/µL | 4,000-11,000/µL |
| Neutrophils | 90% | 40-75% |
| Platelets | 320,000/µL | 150,000-450,000/µL |
Interpretation & Diagnosis
🔹 Leukocytosis with neutrophilia + Acute abdomen → Perforated Peptic Ulcer with Peritonitis
Next Steps
✅ Emergency Surgery (Laparotomy & Repair)
✅ IV Antibiotics (Piperacillin-Tazobactam)
✅ PPI Therapy (IV Pantoprazole)