A 34-year-old man comes to the physician for a follow-up examination. One month ago, he underwent splenectomy after being involved in a motor vehicle collision. He recovered uneventfully and was discharged. He received the recommended vaccinations after her surgery and currently feels well. Physical examination shows no abnormalities. A peripheral blood smear reveals many red blood cells of a specific morphology as indicated by the arrow below. An increase in which of the following features best explains the presence of these abnormal cells?

Question

A 34-year-old man comes to the physician for a follow-up examination. One month ago, he underwent splenectomy after being involved in a motor vehicle collision. He recovered uneventfully and was discharged. He received the recommended vaccinations after her surgery and currently feels well.  Physical examination shows no abnormalities.  A peripheral blood smear reveals many red blood cells of a specific morphology as indicated by the arrow below.  An increase in which of the following features best explains the presence of these abnormal cells?

Quizplus · Accepted Answer

Eductional Objective: Target cells can be found on the peripheral blood smears of patients with asplenia, thalassemia, liver disease, HbC disease, and sickle cell disease. Normally, red blood cells (RBCs) undergo splenic conditioning, which removes excess cholesterol and phospholipids from the cellular membrane. If splenic conditioning does not occur, this excess membrane results in a bell-shaped RBC, in which a central area of hemoglobin is surrounded by an area of pallor, with a rim of hemoglobin adjacent to the inner cell membrane, lending it the appearance of a target. In addition to conditioning RBCs, splenic macrophages remove abnormal RBCs from the circulation.

A 34-Year-Old Man Comes to the Physician for a Follow-Up