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* usmle rx qq
 #850278  
  zoh - 04/16/18 10:41
 
  the 71 widow start eat little for 5 months ago develop fatigue and palpitation ,hemoglobin 10.9 g/dl ,mean corpuscular volume of 105 fl

the patient most likely has a defect in which process?

a glutathion synthesis

b heme synthesis

c isomerization of methylmalonyl coA

d one carbon unit transfer

e synthesis of spectrin actin cytoskeleton
 
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* Re:usmle rx qq
#3365283
  alirocumab - 04/16/18 14:44
 
  One carbon unit transfer  
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* Re:usmle rx qq
#3365312
  zoh - 04/17/18 04:38
 
  @ alirocumab or any one can you tell me what vitamin is deficient?  
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* Re:usmle rx qq
#3365319
  alirocumab - 04/17/18 08:30
 
  Folate.  
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* Re:usmle rx qq
#3365322
  zoh - 04/17/18 09:47
 
  yes
you are right
can you tell me why ti is not vit b12 deficiency
 
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* Re:usmle rx qq
#3365323
  alirocumab - 04/17/18 11:27
 
  Because B12 deficiency takes a few years to develop. This patient has only been eating poor diet for 5 months. Also, B12 deficiency as part of pernicious anemia is typically seen in younger (50-60's) patients.  
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* Re:usmle rx qq
#3365324
  alirocumab - 04/17/18 11:27
 
  Thanks for the question.  
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* Re:usmle rx qq
#3365332
  zoh - 04/17/18 11:55
 
  You are right and you are welcome  
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