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A young adult has mild anemia, jaundice, splenomegaly, and a strong family history of gallstones and splenectomy. The blood film shows numerous spherocytes, the MCHC is raised, and the direct antiglobulin test (DAT) is negative. Which diagnosis and confirmatory test are most appropriate?

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Oct 25
A laboratory information system flags a potassium result of 3.1 mmol/L because the same patient had a result of 5.9 mmol/L six hours earlier. What is the name and purpose of this check?
Closed
Oct 24
During a supervised fast, a patient becomes hypoglycemic (glucose 2.2 mmol/L). At that moment insulin is markedly elevated and C-peptide is also elevated, and a sulfonylurea screen is negative. What is the most likely cause?
Closed
Oct 23
A urine dipstick from a patient with dysuria is positive for nitrite and leukocyte esterase. What does a positive nitrite result specifically indicate?
Closed
Oct 22
A sputum specimen submitted for bacterial culture shows more than 25 squamous epithelial cells and fewer than 10 neutrophils per low-power field on Gram stain screening. What is the appropriate laboratory action?
Closed
Oct 21
A patient treated for syphilis five years ago has a reactive treponemal test (Treponema pallidum particle agglutination) and a nonreactive RPR. Which interpretation is most appropriate?
Closed
Oct 20
Two sets of blood cultures are drawn from separate venipuncture sites in a patient with fever. One set grows a coagulase-negative staphylococcus after 4 days; the other set remains negative. How should this result most likely be interpreted?
Closed
Oct 19
A coagulation sample arrives in a 3.2% sodium citrate tube that is only half filled, and the PT and aPTT are both prolonged in a patient with no bleeding history. What is the most likely explanation?
Closed
Oct 18
An automated blood count on an EDTA sample reports hemoglobin 12.0 g/dL, red cell count 2.0 x 10^12/L, MCV 118 fL, and MCHC 42 g/dL. The film shows red cell agglutinates. What is the most likely cause, and how should the sample be handled?
Closed
Oct 17
A patient has an isolated prolonged prothrombin time (PT) with a normal activated partial thromboplastin time (aPTT), a normal platelet count, and normal fibrinogen. Which single-factor deficiency is most consistent with this pattern?
Closed
Oct 16
A patient presents with severe epigastric pain that began three days ago. Which serum enzyme is preferred for diagnosing acute pancreatitis in this situation, and why?
Closed
Oct 15
A patient in hyperglycemic crisis has a plasma glucose of 700 mg/dL and a measured sodium of 128 mmol/L. Using the common correction of 1.6 mmol/L per 100 mg/dL of glucose above 100 mg/dL, what does this sodium result actually indicate?
Closed
Oct 14
A patient presents with fatigue, weight loss, and skin hyperpigmentation. Laboratory results show sodium 128 mmol/L, potassium 5.8 mmol/L, a low 8 a.m. cortisol, and a markedly elevated plasma ACTH. What is the most likely diagnosis?
Closed
Oct 13
Urine microscopy from a patient with hypertension, edema, and hematuria shows numerous red blood cell casts. What is the significance of red blood cell casts?
Closed
Oct 12
A dehydrated patient with vomiting has a rising creatinine. Urine sodium is 10 mmol/L, the fractional excretion of sodium (FENa) is 0.5%, and urine osmolality is 600 mOsm/kg. Which type of acute kidney injury do these findings support?
Closed
Oct 11
A patient with chronic diarrhea and weight loss has a negative tissue transglutaminase IgA (tTG-IgA) result, yet the clinician still strongly suspects celiac disease. Which additional laboratory result would most justify further testing with IgG-based celiac serology?
Closed
Oct 10
A young woman arrives with life-threatening hemorrhage and no prior blood group on record. Red cells are needed immediately, before a group and crossmatch can be completed. Which red cell units should be issued?
Closed
Oct 9
A hepatitis B panel shows HBsAg negative, total anti-HBc positive, and anti-HBs positive. How should this serologic pattern be interpreted?
Closed
Oct 8
On a chemistry analyzer, the level 1 glucose control reads +2.3 SD from its mean, and the next run's level 1 control reads +2.4 SD. Under the Westgard multirule scheme, which rule is violated and what type of error does it suggest?
Closed
Oct 7
Cerebrospinal fluid from a febrile patient with neck stiffness shows 2,000 white cells per microliter, 90% neutrophils, protein 2.5 g/L, and glucose 1.0 mmol/L with a paired serum glucose of 6.0 mmol/L. Which process do these findings most strongly suggest?
Closed

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