A urine sediment stains with Prussian blue. The patient probably has:
a. Hemoglobinemia
b. A membrane defect
c. Compensated hemolysis
d. Extravascular hemolysis
ANS: A
When the amount of free hemoglobin exceeds the capacity of plasma salvage systems (e.g., haptoglobin, hemopexin), free hemoglobin can be found in plasma. This hemoglobin is filtered through the kidney; some of the iron will be released and taken up by renal tubular cells that are eventually sloughed off into the urine. The iron can be detected in these renal tubular epithelial cells by giving a positive Prussian blue stain.
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