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Review Question - QID 214364

Autoimmune Hemolysis STUDIES Two types of Coombs test QID: 214364 (M2.OMB.1)
In scope icon M 6 A
QID 214364 (Type "214364" in App Search)
A 20-year-old man presents to his primary care physician for worsening fatigue for the past 4 days. He has been sleeping 11 hours a day and feels short of breath with exertion. Approximately 2 weeks ago, he took oral penicillin for streptococcal pharyngitis. His temperature is 99°F (37.2°C), blood pressure is 110/80 mmHg, pulse is 100/min, and respirations are 18/min. Physical examination is notable for conjunctival pallor and delayed capillary refill. Laboratory studies are shown:

Hemoglobin: 11 g/dL
Platelet count: 250,000/mm^3
Mean corpuscular volume: 88 µm^3
Reticulocyte count: 4%
Total bilirubin: 2 mg/dL
Direct bilirubin: 0.3 mg/dL
Lactate dehydrogenase: 150 U/L
Haptoglobin: 0.1 g/L (normal 0.5-2.2 g/L)
Urinalysis: Positive for blood

A peripheral blood smear is shown in Figure A. Which of the following is the most appropriate diagnostic test?
  • A
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  • A