Case 8, Answer 7c
Excellent! What Misou really needs at this time is intravenous phosphorus to try and stop the hemolysis. The hemolysis is secondary to low phosphorus and subsequent reduction in ATP levels in the red blood cell membrane, which makes red blood cells fragile. At a packed cell volume of 18%, a transfusion of packed red blood cells would also help stabilize her while you treat the metabolic derangements.
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