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* blood 7
  kashmala - 11/07/06 05:08
  A 73-year-old male who is taking no medications and
has been healthy all his life, with no major illnesses or
surgeries, is becoming increasingly tired and listless. A
CBC indicates a hemoglobin concentration of 9.7 g/dL,
hematocrit of 29.9%, MCV of 69.7 fL/red cell, RBC count
of 4.28 Ч 106//xL, platelet count of 331,000//xL, and WBC
count of 5500//xL. The most probable explanation for these
findings is
A Iron deficiency
B Autoimmune hemolytic anemia
C /3-thalassemia major
D Chronic alcoholism
E Vitamin B2 deficiency
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* Re:blood 7
  malev - 11/07/06 05:11
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* Re:blood 7
  rmansour - 11/07/06 05:16
  I'll say A  
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* Re:blood 7
  kashmala - 11/07/06 05:18
This man has a microcytic anemia, which is typi-
cal for iron deficiency. At his age, bleeding from an occult
malignancy should be strongly suspected as the cause of
iron deficiency. An autoimmune hemolytic anemia should
appear as a normocytic anemia or with a slightly increased
MCV with pronounced reticulocytosis. Thalassemias may
result in a microcytosis, but /3-thalassemia major causes
severe anemia soon after birth, and survival to the age of
73 years is unlikely. Macrocytosis should accompany a
history of chronic alcoholism, probably because of poor
diet and folate deficiency. B12 deficiency also results in a
macrocytic anemia.
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