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aneima

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A 29-year-old pregnant woman presents with fatigue and pica (ice-craving). Labs: Hgb 8.2 g/dL, MCV 75 fL, ferritin 15 ng/mL, TSAT 21 %. A. Oral iron supplementation; reassess in 4 weeks B. test dose of IV iron dextran, full dose if tolerated B. Because she has iron-deficiency anemia (low ferritin + low TSAT + microcytosis) in pregnancy and oral therapy may be less feasible (e.g., nausea). The IV iron dextran requires a test dose before full administration.
2. In a female patient with Hgb 10 g/dL, MCV 108 fL, vitamin B12 120 pg/mL (low), folate normal: Which of the following is false? A. This is macrocytic anemia. B. She is at risk for pernicious anemia. C. Folic acid supplementation is required. C is false. Her folate is normal, so folic acid supplementation solely because of macrocytosis is not automatic.
3. Which laboratory value is considered the most sensitive marker for diagnosing iron-deficiency anemia? A. Low serum iron B. Low total iron-binding capacity (TIBC) C. Low ferritin D. High transferrin saturation C. Low serum ferritin is the most sensitive indicator of depleted iron stores.
4. A male patient has Hgb < 13 g/dL, MCV ~85 fL, normal ferritin, elevated CRP, and chronic inflammatory condition. What class of anemia A. Iron-deficiency anemia B. Macrocytic anemia C. Anemia of chronic disease/inflammation C. Normocytic (or mildly microcytic) anemia with normal iron stores + inflammation suggests anemia of chronic disease.
5. Which of the following medications or supplements may reduce the absorption of oral iron therapy? A. Vitamin C B. Calcium carbonate (antacid) C. Vitamin B12 D. Folic acid B. Calcium salts/antacids can impair iron absorption.
6. A patient is being treated with IV iron dextran. Which of the following must be done before giving the full dose? A. Confirm folate level is normal B. Confirm TSAT > 20% C. Administer test dose of iron dextran and observe for hypersensitivity C. A test dose of iron dextran is required before full dose to monitor for anaphylactic/hypersensitivity reactions.
7. Which of the following MCV values is most consistent with a macrocytic anemia? A. 72 fL B. 89 fL C. 101 fL D. 79 fL C. MCV > 100 fL (e.g., ~101) indicates macrocytic anemia.
8. A strict vegan presents with paresthesias, fatigue, Hgb 10 g/dL, MCV 108 fL, B12 low. Which of the following is true regarding treatment? A. Intramuscular B12 is ALWAYS required in dietary deficiency. B. High-dose oral B12 may be acceptable B. In dietary B12 deficiency (with intact absorption), high-dose oral B12 is acceptable. IM B12 is required when malabsorption or pernicious anemia is present.
9. Which of the following is least likely a cause of microcytic anemia? A. Iron deficiency B. Thalassemia trait C. Anemia of chronic disease D. Vitamin B12 deficiency D. Vitamin B12 deficiency causes macrocytic (not microcytic) anemia.
10. Which of the following best describes the pathophysiology of iron-deficiency anemia? A. Impaired DNA synthesis in RBC B. Absence of intrinsic factor leading to B12 deficiency C. Decreased hemoglobin synthesis due to insufficient iron stores C. Iron deficiency leads to decreased hemoglobin synthesis and ultimately fewer or smaller RBCs.
Created by: quita4
 

 



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