A patient with a small number of spherocytes, increased reticulocytes, and increased MCHC has a normal osmotic fragility. Select the best course of action
a. Dismiss the spherocytes as an artifact.
b. Repeat the osmotic fragility after incubating the blood at 37° C for 24 hours.
c. Check the cell counter for errors in the MCHC.
d. Collect a new blood sample.
ANS: B
Incubating the blood at 37° C for 24 hours can increase the sensitivity of the osmotic fragility so that a previously normal result becomes abnormal. During this incubation period, red cells become metabolically deprived and tend to lose membrane surface because of their relative membrane instability.
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