Labs
Pathophysiology
Clinical Course
Clinical Presentation
USMLE
100
The following lab values and peripheral smear are classic of this disorder.
Megaloblastic Vitamin B12 deficiency anemia
100
Vitamin B12 with the aid of intrinsic factor is absorbed in this location.
Terminal ileum
100
Which anemia presents at approximately 4-6 months of age to due the transition of hemoglobin subunit type?
Sickle cell anemia
100
What disease might be suspected in a patient who presents with severe pain and swelling in the hands and feet?
Sickle Cell Disease
100
A 32 year old female presents to her primary care physician with increasing fatigue, a drop in weight (10lbs), and intolerance to her normal workout routines. The patient also states that she has had stomach pain ongoing since her teen years when eating gluten, eats a healthy diet and is otherwise healthy. She lives in a newer house, and has clean water. The following is her CBC and peripheral smear results. What is the most likely diagnosis for this patient’s anemia?
RBC-Low
Hct- Low
MCV - Low
Reticulocyte - Low
Anemia of Chronic Disease
200
The following lab values are most indicative of this disorder, which is typically accompanied by hyperchromatic RBC’s on peripheral blood smear.
hereditary spherocytosis
200
ACD and CKD will show high levels of this, which cause inhibition of EPO release.
Inflammatory cytokines like IL-6
200
Which anemia has decreased life expectancy due to the complications of chronic hypoxia and iron overload, including cardiomyopathies?
Beta thalassemia major
200
A mother brings her 3 year old son into the ER. She left him to nap for three hours and returned to find him drowsy, complaining of dizziness and nausea. While in the exam room he vomits and the doctor notices that his lips are very red. What is causing his symptoms?
Carbon monoxide poisoning
200
A 65 year old man presents to the emergency department with increasing fatigue, slight pallor, tingling in his fingers and toes and overall feeling of being unwell. Reports that he eats a normal vegan diet because his wife makes him, and in the past he’s been pretty healthy. He does have an elevated methylmalonic acid level. What is the likely cause of this patient’s anemia?
RBC - Low
Hct - Low
MCV - High
Reticulocytes - Low
VItamin B12 Deficiency
300
The name for the fragmented cells shown in this peripheral blood smear.
schistocytes
300
This condition is caused due to a mutation in the ankyrin gene.
Hereditary Spherocytosis
300
In this anemia, hemolysis begins 1-3 days after oxidant damage with resulting reticulocytosis.
G6PD deficiency induced anemia
300
A patient presents with an HR of 105, and reports fatigue and frequent headaches for the past two months. She has noted swelling in her legs and ankles and reports gradual changes in her urine output over the last six months. What might be causing the fatigue, elevated HR, and frequent headaches?
Anemia associated with chronic renal failure
300
A patient present to the clinic with the classic signs of anemia, including fatigue and intolerance to exercise. They also state that they noticed a change in color of their skin and tongue, they cant remember eating anything blue in color but want to have i checked out. It is determined that they have methemoglobinemia, an increase in methemoglobin. You give the patient methylene blue for treatment (and to see if they turn blue like a smurf). What is the enzyme that is responsible for ensuring that methemoglobin doesn’t?
Methemoglobin reductase
400
The abnormal looking cell in the middle of the smear is a key identifier of this disorder caused by an enzymatic insufficiency.
glucose 6 phosphate dehydrogenase deficiency
400
In Beta Thalassemia, aggregates of this are extremely toxic to cells and cause either cell death or extravascular hemolysis.
alpha globin
400
In this type of anemia, a splenectomy can relieve the symptoms of anemia but does not treat the underlying condition causing the anemia.
Hereditary spherocytosis
400
A 5 year old presents with severe abdominal pain, vomiting and diarrhea. The mother reports that the child had nothing to eat that morning except for cereal, and was in perfect health until 2 hours earlier. What could be causing these symptoms?
Iron intoxication
400
A young patient presents to the emergency department after a short 5 min walk to the beach (not here in VT, because we don’t get good sun), the patient is complaining of sores and blisters all over their arms and legs that suddenly appeared. The physician performs a neurological exam, and it is normal. The physician requests a urine sample from the patient, along with a full dermatological exam. The following is what is found. What is the most likely cause of this patient’s symptoms?
Congenital Erythropoietic Porphyria