DrS
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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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| frontal
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Low iron  ?
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| achilles
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low iron...but i am not sure
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| drkpp
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low iron???
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| achilles
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what's the answer DrS...could you also pls post the explanation...
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| DrS
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Well done!! All of you got it right!
The correct choice is
A. 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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| achilles
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phew ! that was a teaser for me atleast...i got a little foxed by normochromic...i was expecting hypochromic and microcytic...but then there were other pointers...
good question DrS...keep posting more
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" it's not whether you get knocked down, it's whether you get up"
" i have miles to go before i sleep "
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