08-17-2014, 02:46 PM
A 63-year-old woman with newly diagnosed interstitial cystitis presents to her primary care physician because of progressive fatigue over the past week. She states that she has not been urinating as much as she used to and has less pain, as she has been taking phenazopyridine three times per day for the past 2 weeks. She is afebrile with a pulse of 105/min and blood pressure of 135/84 mm Hg. Laboratory tests show:
WBC count: 7000/mm³
Hematocrit: 25%
Platelet count: 321,000/mm³
Mean corpuscular volume: 84 fL
RBC distribution width: 19.7
Creatinine: 1.8 mg/dL
Lactate dehydrogenase: 390 U/L
Urine dipstick demonstrates 3+ blood, 0-2 RBCs/hpf, and 0-2 WBCs/hpf.
Which of the following is the most likely cause of her anemia?
A.Disseminated intravascular coagulation
B.Drug-induced hemolysis
C.Hemolytic uremic syndrome
D.Hemorrhagic cystitis
E.Occult gastrointestinal bleeding
WBC count: 7000/mm³
Hematocrit: 25%
Platelet count: 321,000/mm³
Mean corpuscular volume: 84 fL
RBC distribution width: 19.7
Creatinine: 1.8 mg/dL
Lactate dehydrogenase: 390 U/L
Urine dipstick demonstrates 3+ blood, 0-2 RBCs/hpf, and 0-2 WBCs/hpf.
Which of the following is the most likely cause of her anemia?
A.Disseminated intravascular coagulation
B.Drug-induced hemolysis
C.Hemolytic uremic syndrome
D.Hemorrhagic cystitis
E.Occult gastrointestinal bleeding