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  #1  
Old 08-22-2012
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RBC Anemia in Hodgkins Disease

A 32 yr man has malaise, low grade fever, 10 lb weight loss over past 3 mth, unilateral cervical lymphadenopathy. lab studies
Hb - 11g/dl
Hct - 33%
MCV - 80%
Retic cont - 0.5%
Serum iron - 25ug/dl
TIBC 150 ug/dl
Biopsy LN show hodgkin disease, nodular sclerosing type. The most common cause of anemia is
A. abnormal utilization of iron
B. extravascular hemolysis
C. folate deficiency
D. Iron deficiency
E. marrow aplasia
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Old 08-22-2012
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Default my answer

A. abnormal utilization of iron
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Old 08-22-2012
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My answer is A
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Old 08-22-2012
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Could u explain me pls? I though answer is E
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Old 08-22-2012
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Quote:
Originally Posted by medhelp View Post
Could u explain me pls? I though answer is E
can you explain why did you think it was E? I'll try to explain accordingly.
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Old 08-22-2012
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The answer is A.
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Old 08-22-2012
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interesting looking for comments
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Old 08-22-2012
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Quote:
Originally Posted by Casandra View Post
can you explain why did you think it was E? I'll try to explain accordingly.
low Hb and Hct then i directly thought that BM failure withough thinking too much but now i got it
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Old 08-22-2012
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Originally Posted by medhelp View Post
low Hb and Hct then i directly thought that BM failure withough thinking too much but now i got it
what the mechanism medhelp?
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Old 08-23-2012
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Info

I think the answer is D. Iron deficiency. Here's why:
  • Serum iron is low--normal serum iron is 100ug/l and the patient has 25.
  • TIBC is low--Normal is 300ug/l and the patient has 150.
  • Reticulocyte count is low which could be due to aplastic anemia or iron deficiency.
  • Since the TIBC and Serum Iron are low as well, I figure there is Iron deficiency in the patient. Hope this helps.
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Old 08-23-2012
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Warning! Correction please!

Hi guys! I just looked in the Goljan text and realised that in Iron deficiency TIBC is actually HIGH. I apologise for the misinformation.
I think the answer is E. Marrow aplasia would simulate an anaemia of chronic disease
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Old 08-23-2012
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Quote:
Originally Posted by chux View Post
what the mechanism medhelp?
@medhelp
can you explain how you got the answer?waiting pls
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Old 08-23-2012
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Quote:
Originally Posted by Nino View Post
Hi guys! I just looked in the Goljan text and realised that in Iron deficiency TIBC is actually HIGH. I apologise for the misinformation.
I think the answer is E. Marrow aplasia would simulate an anaemia of chronic disease

Hi, I think , anemia of chronic disease is nothing but abnormal use of iron so if u think its anemia of chronic disease then answer must be A and not E..
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Old 08-23-2012
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Quote:
Originally Posted by chux View Post
@medhelp
can you explain how you got the answer?waiting pls


mcv is 80 so its normocytic anemia so its not C . Folate
reticulocyte count is 0.5% its low for it to be hemolytic anemia so its not B
Tibc is low , it would be high in iron deficiency anemia , so its not D

We are left with A and E , patient has hodgkins, its a lymphgland disorder not of the bone marrow , so we dont expect aplastic anemia, therefore anemia of chronic disease is more appropriate ,, its a condition in which iron is abnormally stored and not available for rbc production.. all the lab values go with anemia of chronic disease too so it must be A... I hope it helps, correct me if I am wrong .. Thanks
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