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robin082006
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12/07/06 - 02:25 PM       #1

A 42-year-old white female, who has a long history of dysfunctional uterine bleeding, presented with exertional shortness of breath. On examination, she appears very pale and there is a pulmonic flow murmur heard over the second intercostal space. Her vitals are: BP: 130/80mm of Hg; HR: 80/min and regular; RR: 16/min; Temperature 36.7C(98F). Initial evaluation reveals hemoglobin of 8.2 gm/dl. WBC count is within normal limits. You are suspecting an iron deficiency anemia secondary to excessive bleeding. Which one of the following studies is most definite for the diagnosis of iron deficiency anemia?


A. A low serum ferritin level.
B. Increased total iron binding capacity.
C. A low serum iron concentration.
D. Bone marrow iron staining.
E. Total iron content of the gastric epithelial cells.

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saadtazjam
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12/08/06 - 07:12 PM       #2

D?

Guptashutosh
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12/09/06 - 03:22 AM       #3

A low sr ferritin

ed222
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12/09/06 - 05:39 AM       #4

I think is B necause when there is low iron there is a high transferin trying to bind the most to the scarce iron. I think is like is hypothyroidism low T3 high TSH

star1
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12/09/06 - 06:16 AM       #5

D. Bone marrow iron staining.

webjeee
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12/20/06 - 10:27 PM       #6

A ferritin value less than 30 mcg/L is a highly reliable indicator of iron deficiency.

Current Medical Dx & Tx >
Hematology Charles A. Linker, MD


.....

BUT,

The absence of stainable iron on bone marrow aspirate establishes the diagnosis without other tests.

Current Emergency Medicine > Section IV. Nontrauma Emergencies >
Chapter 39. Hematologic Emergencies J. Stephan Stapczynski, MD, & Geoffrey A. Martin, MD

BUT,

Although RE cell iron stores can also be estimated from the iron stain of a bone marrow aspirate or biopsy, the measurement of serum ferritin has largely supplanted bone marrow aspirates for determination of storage iron (Table 90-3). The serum ferritin level is a better indicator of iron overload than the marrow iron stain.

Harrison's Internal Medicine > Part 5. Oncology and Hematology > Section 2. Hematopoietic Disorders >
Chapter 90. Iron Deficiency and Other Hypoproliferative Anemias John W. Adamson

Sorry, for the confusion that may cause, according to harrison, the answer is The serum ferritin level.


Edited by webjeee on 12/20/06 - 10:36 PM

robin082006
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12/20/06 - 10:39 PM       #7

answer is D

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prathapdoctor
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12/20/06 - 10:45 PM       #8

i think the answer is D only.its given in harrison.

prathapdoctor
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12/20/06 - 10:46 PM       #9

prathapdoctor wrote:
i think the answer is A only.its given in harrison.











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