new_n_lost
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B. Chloramphenicol toxicity ???
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| seem.bh
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c. chronic autoimmune gastritis??
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| angel23
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C. chronic autoimmune gastritis.....
this is an iron def anemia....with decreased MCV,iron,ferritin....Hb
increased transferrin.....
RBC count is also less....normal is 4-6 million /mm3
picture of thalassemia and iron def is same sometimes but in thalassemias RBC count is normal or increased.....
so i think C is correct
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| jerker
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E. Uterine leiomyomas
bleeding from uterine leiomyoma causes menorrhagia.blood loss--->>iron def.
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| Tiff
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Agree - Definitely E - iron deficiency anemia. Megaloblastic anemia is not due to iron deficiency and here it clearly states decreased iron and decreased ferritin - therefore it's microcytic - iron deficiency. A woman with leiomyomas would have heavy blood loss with menses causing this deficiency.
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| new_n_lost
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jerker wrote:
E. Uterine leiomyomas
bleeding from uterine leiomyoma causes menorrhagia.blood loss--->>iron def.
Yup u are right i missed it by a mile
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| jerker
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correct:
E. Uterine leiomyomas
bleeding from uterine leiomyoma causes menorrhagia.blood loss--->>iron def.
A. Beta-thalessemia minor ----->>>all given values fit except Iron.serum iron will go up.
B. Chloramphenicol toxicity---->>>BONE MARROW SUPPRESSION.nothing to do with iron level.
C. Chronic autoimmune gastritis ----->>>loss of parietal cells>>intrinsic factor>>>pernicious anemia>>>megaloblastic change(B12).nothing to do with iron.
D. Rheumatoid arthritis-------->>>anemia of ch disease.serum iron will go up.
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| angel23
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80%of the iron absorbed is in ferric form .....for absorption it shud b converted to ferrous form....iron is reabsorbed in duodenum....so its reduction occurs in stomach...
so in case of autoimmune gastritis it presents with hypochlorrhydria...
so impaired reduction
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| angel23
Forum Guru
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i know the answer shud b E but hav a look at this....
http://www.meddean.luc.edu/depts/cme/MRCME-Iron%2...
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| jerker
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ACCORDING TO USMLE.ORG many options in question may look right but there must be a one that is the best.hypochlorrhydia definitely converts into ferrous but this in all medicine books is least or not to be considered cause of iron deficiency.
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| silver
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Correct Answer: E. Uterine leiomyoma
The lab values indicate that there is microcytic anemia. This type of anemia is associated with decreased mean cell volume of erythrocytes (microcytosis). By itself, microcytic anemia can be due to a number of factors, including iron deficiency and disorders of globin synthesis. When anemia is caused by iron deficiency, serum levels of iron and serum ferritin are decreased, whereas transferrin (plasma protein acting as iron carrier) is increased. Thus, this case is due to iron deficiency, and uterine leiomyoma is the logical answer. These tumors arise from the smooth muscle of the uterus and often manifest with pain and abundant blood loss during menstruation. Any chronic blood loss leads to depletion of reserve iron and then to decreased synthesis of hemoglobin, i.e. anemia. Maturation of erythrocytes is relatively unimpaired, but reduced synthesis of hemoglobin leads to smaller (microcytic) and paler (hypochromic) RBCs. Remember in Western countries, chronic blood loss is the most common cause of iron deficiency anemia.
Beta-Thalassemia is due to mutations leading to a complete block or reduction in the synthesis of the beta-globin chain. Blood smear shows variable degrees of hypochromasia and microcytosis. This condition must be distinguished from iron deficiency anemia. Accumulation of iron in beta-thalassemia minor leads to normal or increased plasma iron or ferritin, and reduced transferrin.
Chloramphenicol toxicity may result in severe aplastic anemia. This is the inability of the bone marrow to produce erythrocytes and manifests with a reduced number of circulating erythrocytes, which are normochromic and normocytic. Most common causes of aplastic anemia are drugs.
Chronic autoimmune gastritis is due to autoimmune destruction of gastric mucosa. Autoantibodies blocking binding between vit. B12 and intrinsic factor are present in 75% of cases. Impaired vit. B12 absorption leads to megaloblastic anemia. Defective cellular maturation and division occur, with abnormally large erythroid precursors and circulating erythrocytes that have MCV of up to 120 cubic um. Circulating neutrophils are larger than normal and hypersegmented.
Rheumatoid arthritis, and many other chronic diseases, may cause a form of anemia due to defective utilization of iron. This is referred to as anemia of chronic disease and it may mimic iron deficiency anemia. However, anemia of chronic disease is associated with increased iron stores, reflected by elevated serum ferritin, reduced transferrin, and increased iron deposits in the bone marrow.
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| Ig F
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answer is E...uterine leiomyoma...as there is mennorhagia.....which leadz to iron def anemia....
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