phuluong2k
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A 45-year-old man undergoes a routine examination. While the physical examination is unrevealing, a hematocrit performed in the physician's office gives a value of 25%. Review of the peripheral smear reveals smaller-than-normal erythrocytes. The cells vary in size, and some have abnormal shapes. The cells do not appear paler than normal. Reticulocytes are decreased. Assuming that this patient has only a single cause for his anemia, which of the following is most likely to be seen on further evaluation?
A. Low iron
B. Low iron binding capacity
C. Low folate
D. Low mean corpuscular hemoglobin concentration (MCHC)
E. Low vitamin B12
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| DrS
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B?
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| chemamr
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B. Low TIBC
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| ARJ
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B. Low iron binding capacity
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| DrS
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Why do you say B?
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| phuluong2k
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This patient has a microcytic, normochromic anemia and is not obviously ill on physical examination. The overwhelmingly most likely diagnosis is iron-deficiency anemia, which is, in turn, almost always due to bleeding in adults on a typical American diet. Occult GI bleeding is a common source in both men and women. Menstrual disorders are also important causes of iron deficiency in women.
Low iron binding capacity (choice B) is seen in the anemia of chronic disease.
Low folate (choice C) produces a megaloblastic anemia.
Low mean corpuscular hemoglobin concentration (MCHC; choice D) is seen in hypochromic anemias.
Low vitamin B12 (choice E) produces a megaloblastic anemia.
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| phuluong2k
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Low mean corpuscular hemoglobin concentration (MCHC; choice D) is seen in hypochromic anemias.
Why this happens ? Anyone can explain
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| DrS
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How can you explain the cells not being paler than normal in iron deficiency anaemia?
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| phuluong2k
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You have reason DrS, This Q is unclear, i can't explain
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