Which of the following could account for the red cell indices on Mary Jones reviewing Questions 13
a. Determining a likely cause is not possible.
b. An error in the hemoglobin probably has been made.
c. An error in the red cell count probably has been made.
d. An error in the microhematocrit probably has been made.
ANS: B
The MCV, which uses the hematocrit and red cell count for its calculation, appears to be reasonable. However, both the MCH and MCHC are extremely elevated, suggesting the parameter in error is common to both of them. This is the hemoglobin. A falsely increased hemoglobin will elevate both the MCH and MCHC because hemoglobin is in the numerator for both calculations.
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