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  #1  
Old 01-29-2013
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Arrow Billy Step 1 Questions # 107

A 52-year-old man with end-stage renal disease presents to his renal clinic with a hemoglobin concentration of 8 g/dL and an absolute reticulocyte count of <25,000 cells/mm3. His WBC count is 11,000/mm3 and the differential is within normal limits. A peripheral blood smear shows hypochromic, microcytic RBCs. Iron staining of a bone marrow aspirate shows macrophages positive and RBCs negative for iron within the cytoplasm. Which of the following is the most likely cause of this patient’s condition?


(A) An overdose of tacrolimus
(B) Anti-Rh D immunoglobulin
(C) Iron defi ciency
(D) Low erythropoietin
(E) Myelodysplastic syndrome
(F) Tissue plasminogen activator
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Old 01-29-2013
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Quote:
Originally Posted by billy View Post
A 52-year-old man with end-stage renal disease presents to his renal clinic with a hemoglobin concentration of 8 g/dL and an absolute reticulocyte count of <25,000 cells/mm3. His WBC count is 11,000/mm3 and the differential is within normal limits. A peripheral blood smear shows hypochromic, microcytic RBCs. Iron staining of a bone marrow aspirate shows macrophages positive and RBCs negative for iron within the cytoplasm. Which of the following is the most likely cause of this patientís condition?


(A) An overdose of tacrolimus
(B) Anti-Rh D immunoglobulin
(C) Iron defi ciency
(D) Low erythropoietin
(E) Myelodysplastic syndrome
(F) Tissue plasminogen activator
(D) low EPO
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Old 01-29-2013
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i would go with D too
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Old 01-29-2013
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ans. low EPO due to chronic renal disease.
initially it is normocytic anemia den later it becomes microcytic..
can anyone plz explain how it becomes microcytic?
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Old 01-29-2013
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Default D

D) Low erythropoietin
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Old 01-30-2013
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Yes D is correct.
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Old 01-30-2013
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Correct Answer

A) An overdose of tacrolimus
(B) Anti-Rh D immunoglobulin
(C) Iron defi ciency
(D) Low erythropoietin
(E) Myelodysplastic syndrome
(F) Tissue plasminogen activator
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