Labs
Pathophysiology
Clinical Course
Clinical Presentation
USMLE Style
800
This disorder, indicated by the lab values below, results in markedly hypochromatic RBC’s on peripheral smear.
iron deficiency anemia
800
What is the name of insoluble aggregates that accumulate due to persistent methemoglobin?
Heinz bodies
800
This virus is extremely dangerous for people with anemia because it induces an aplastic crisis where bone marrow ceases erythropoiesis for approximately a week.
Parvovirus B19
800
A man presents with fatigue, shortness of breath, and tingling in his fingertips. He reports having undergone gastrectomy surgery 2 months prior and takes iron pills prescribed to him by his naturopath. What is his most likely diagnosis?
Pernicious anemia
800
An older woman presents to the emergency department with a fever for several days, splenomegaly, and fatigue. The patient states that she had a UTI that she treated herself with cranberry juice about two weeks ago and she thought it had went away. Other notable symptoms are many bruises on her body and an increase in bleeding from mucosal membranes lately. She has an elevated bilirubin and a decreased haptoglobin level. Her CBC is shown below. What is the most likely cause of her anemia?
RBC - Low
Hct - Low
MCV - Low
Reticulocytes - Low
microangiopathic anemia due to DIC
1000
This disorder is readily identified with a peripheral blood smear, however a “HPLC” test is required for a confirmatory diagnosis.
sickle cell disease
1000
In Hereditary Spherocytosis, the life of RBCs is shortened from 100-120 days to what range?
10-20 days
1000
In Sickle Cell disease, patients are much more susceptible to infections by encapsulated bacteria. What complication of Sickle Cell anemia is responsible for this increased risk?
Autosplenectomy or infarction of spleen
1000
An infant Sudanese girl is brought to the local health clinic. Her mother is concerned that she is smaller than her siblings were at that age, and seems listless and irritable. The physician notes a slightly enlarged spleen on examination as well as slight scleral icterus. The family lives in an apartment complex built in the 1940s. Specifically, what do you think is wrong with her?
B thalassemia major
1000
A 8 year old male from Greece presented to the emergency department with severe lethargy, weakness and pallor two days after starting a sulfa medication for a UTI. His mother states that something similar to this happened the last time he was prescribed this medication. He has a slightly elevated LDH, Bilirubin and a decreased haptoglobin. His lab values and smear are seen below. What is the most likely cause of this patient’s anemia?
RBC - low
Hct - Low
MCV - normal
Reticulocytes - High
G6PD deficiency
1600
The following lab values would make you most suspect this disorder.
anemia of chronic inflammation/disease
1600
This is the total number of alpha globin chain alleles.
Four
1600
The treatment of vitamin B12 deficiency cannot always be treated with oral supplementation of the vitamin alone because a cofactor is necessary to absorb the nutrient. How is supplemental vitamin B12 administered in the most common anemia type associated with B12 deficiency?
Via intramuscular injection
1600
A man presents with a HR of 115, and reports lethargy, shortness of breath, and dark urine. His physician notes that his spleen is enlarged and that there is some scleral icterus on exam. The patient reports that he had returned from a photography assignment in the DRC 2 days before and that he had been taking prophylactic antimalarials during his trip. He wonders whether he might have contracted a tropical disease, but notes that his maternal grandfather had a similar episode 15 years prior and had recovered. What is the most likely cause of this man’s symptoms?
G6PD deficiency anemia
1600
A 3 year old child is brought to the emergency department by his mother stating that she is concerned he may have ingested something he shouldn’t have. She states that she isn’t really sure what it was, because she gets her supplements from the herbal natural store down the road and they don’t have labels on them, she only knows what they are based on the order they are displayed on her counter. The child is the older of two children, the youngest being just a month old. The child presents with with extreme stomach pain, and vomiting. A radiograph is done on the child and radiopaque tablets are seen in the stomach. What is the best choice of medication to counteract the ingestion?
Iron intoxication
2000
A peripheral smear such as the following would strongly indicate this disorder
beta-thalassemia
2000
This rare inherited type of aplastic anemia affects all lineages of blood cells (marrow aplasia).
Fanconi
2000
Which alpha deletion pattern is most common in African thalassemia carriers and produces a 0% risk of passing a 4 deletion alpha thalassemia on to offspring?
A-/A- mutations are the most common deletion patterns in those of african descent because it confers protection against Malaria . In asian populations, the aa/-- mutation is the most common and may contribute to the increased risk of fetal demise.
2000
A patient presents with fatigue and dizziness. The physician notes a number of bruises on the patient’s arm and the patient reports that a deep paper cut from the previous day won’t stop bleeding. Previous medical history is unremarkable but the physician notes a recent viral infection in the chart. What is the most likely diagnosis?
Aplastic anemia
2000
A woman presents to the emergency department in full labor, she is rushed to the Labor and Delivery unit of the hospital where she is hooked up to fetal monitoring devices. A few hours later she delivers a baby, who is very pale, very edematous in the extremities and hydrocephalus, unfortunately the baby passed away before birth. The following CBC parameters were measured prior to the infant passing away. What is the cause of the patients untimely death and anemia?
RBC - Normal
Hct - Low
MCV - Low
Reticulocyte - Normal
Four deletion alpha thalassemia (hydrops fetalis)