Case 8

The next morning (day 3), Misou looks pale. Her packed cell volume has dropped to 18%, and her total solids are 6.9 g/dl (reference range = 4.5 to 9.5 g/dl). Her phosphorus concentration is 1 mg/dl, and her serum looks more icteric.

QUESTION 6

What is the most likely reason for Misou's continued drop in packed cell volume?

a) Hemodilution after fluid therapy

b) Blood loss

c) Hemolytic anemia secondary to hypophosphatemia

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