This is a quiz question that was developed by Diana Quinn and used within a Medical Science course to develop graduate quality 1, the body of knowledge associated with the profession, and graduate quality 3, problem solving skills.
Points of interest
· No correct or incorrect answer options
· Language of learning incorporated in feedback to support personal development of understandings
· Developing relational understanding from uni-structural and multi-structural understandings (Biggs, 1999)
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Please select the most
likely option in response to this scenario. Three days after untreated acute
blood loss, a previously healthy 20 year old male has anaemia with
reticulocytosis and: |
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No answer marked as
correct |
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Feedback to option a I can see why you might
have chosen thrombocytopaenia. Thrombocytopenia means that the platelet
count is lower than the normal reference range. Immediately after
acute blood loss there is indeed a reduction in the absolute number platelets
within the blood. Whole blood (white cells, red cells and platelets) have
been lost in equivalent proportions. However, after three days, the
bone marrow of a previously healthy male has responded to the blood
loss. Erythropoietin (the hormone that triggers the production of
erythrocytes) has worked in the bone marrow to produce a reticulocytosis (increase
in the immature erythrocytes). Similarly, a simultaneous release of
thrombopoietin would have triggered a mild to moderate thrombocytosis.
Therefore, three days after untreated acute blood loss, if there is anaemia
and reticulocytosis, there is likely to also be thrombocytosis. |
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Feedback to option b Well done for suggesting
thrombocytosis - I agree that this is the most likely outcome to this
scenario! Immediately after
acute blood loss there logically would be a reduction in the absolute number
platelets. After three days, the bone marrow would have responded to
the blood loss through the action of erythropoietin (hence the reticulocytes)
and thrombopoietin to result in a mild to moderate thrombocytosis. However,
did you know that chemicals such as alcohol can depress bone marrow function?
If this 20 year-old male had consumed large amounts of alcohol immediately
before the accident that triggered the bleeding, than the bone marrow's
response would be significantly reduced! |
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Feedback to option c Platelet counts do tend
to fluctuate in response to stimuli. In this situation there may well be a
balance between the thrombocytopaenia triggered by be acute blood loss and
the recovery thrombocytosis, resulting in little change in the overall platelet
count. It is important to remember that other chemicals, such as alcohol and
other drugs, can also impact on the rate of cell division and thus bone
marrow function. We know little about these additional environmental impacts
within this scenario. What we do know however is that there is a
reticulocytosis, suggesting that the bone marrow is working satisfactorily in
response to the hormone erythropoietin. For this reason, it is likely for
thrombocytosis to also be present. |
J. Biggs, (1999) “Teaching
for Quality Learning at University: What the Student Does”. Open University
Press, UK.