Which of the following suggests ongoing hemolysis in a patient who has not had massive blood loss or
a. Reticulocyte production index (RPI) of 1
b. Reticulocyte count of 1.3%
c. Drop in hemoglobin of 1.3 g/dL in 1 week
d. Hemoglobin falling 0.5 g/dL
ANS: C
A drop in the hemoglobin by greater than 1 g/dL/week can signal ongoing hemolysis provided the clinician has ruled out hemorrhage and hemodilution.
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