Microcytic Anemia? - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 07-09-2013
USMLE Forums Scout
 
Steps History: Not yet
Posts: 16
Threads: 6
Thanked 3 Times in 2 Posts
Reputation: 13
Default Microcytic Anemia?

A previously healthy 32-year-old woman has the onset of recurrent headaches. She develops nausea, vomiting, weakness, abdominal pain, and easy bruisability. Her temperature 38.5C (101.3F). Laboratory studies show:

Hemoglobin: 6.9 g/dL
Leukocyte count: 15000/mm3
MCV: 78
Platelet count: 30000/mm3

She is immediately admitted to the hospital. Over the next few days, she develops lethargy and lapses into a coma. A peripheral blood smear is most likely to show:

A) Macrocytes
B) Schistocytes
C) Sickle cells
D) Spherocytes
E) Target Cells


To me, this sounds like a microcytic anemia...
Reply With Quote Quick reply to this message



  #2  
Old 07-09-2013
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 55
Threads: 7
Thanked 17 Times in 10 Posts
Reputation: 27
Default

B. schistocytes

I think it is a case of TTP with hemolysis,fever,thrombocytopenia and neuro symptom of recurrent headache.
Reply With Quote Quick reply to this message
The above post was thanked by:
dr2o13 (07-09-2013)
  #3  
Old 07-09-2013
USMLE Forums Scout
 
Steps History: Not yet
Posts: 16
Threads: 6
Thanked 3 Times in 2 Posts
Reputation: 13
Default

Thank you!

Was also thinking that it could be DIC, but the symptoms didnt really match that diagnosis :/
Also MCV threw me off -_-
Reply With Quote Quick reply to this message
 
  #4  
Old 07-09-2013
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 55
Threads: 7
Thanked 17 Times in 10 Posts
Reputation: 27
Default

i was confused with MCV too..but i think we shdnt really depend on the MCV value for diagnosis . As in many cases of microcytic anemias like IDA , in early stages they still have normocytic anemia and only in the later stages the MCV decrease.
Reply With Quote Quick reply to this message
  #5  
Old 07-09-2013
USMLE Forums Addict
 
Steps History: 1 + CK
Posts: 179
Threads: 23
Thanked 148 Times in 53 Posts
Reputation: 158
Default

The key findings are- anemia, thrombocytopenia, fever, headache, and should suggest TTP. TTP includes microangiopathic hemolytic anemia, thrombocytopenia, fever, neurologic symptoms and renal symptoms also. Although this question stem isn't clearly suggestive for TTP, symptoms can also include HUS as dg. But both ways, correct answer is definitily- shistocytes.
Reply With Quote Quick reply to this message
  #6  
Old 07-09-2013
USMLE Forums Scout
 
Steps History: Not yet
Posts: 16
Threads: 6
Thanked 3 Times in 2 Posts
Reputation: 13
Default

Quote:
Originally Posted by med_ziva View Post
i was confused with MCV too..but i think we shdnt really depend on the MCV value for diagnosis . As in many cases of microcytic anemias like IDA , in early stages they still have normocytic anemia and only in the later stages the MCV decrease.
Yep, youre right.


Quote:
Originally Posted by KovachMarina View Post
The key findings are- anemia, thrombocytopenia, fever, headache, and should suggest TTP. TTP includes microangiopathic hemolytic anemia, thrombocytopenia, fever, neurologic symptoms and renal symptoms also. Although this question stem isn't clearly suggestive for TTP, symptoms can also include HUS as dg. But both ways, correct answer is definitily- shistocytes.
Just checked it out in my FA, thanks!



Ugh making stupid mistakes
Reply With Quote Quick reply to this message



Reply

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
microcytic anemia without response to Iron therapy stfidel USMLE Step 2 CK Forum 1 03-05-2013 08:44 PM
about anemia minamina USMLE Step 1 Forum 1 09-26-2012 08:02 PM
Anemia of Chronic Disease : Micro or Normocytic anemia? lemontea88 USMLE Step 1 Forum 8 09-27-2011 04:20 PM
microcytic anemia usmleman2020 USMLE Step 1 Forum 6 08-15-2011 06:52 AM
What is the cause of anemia? RRMadukha USMLE Step 2 CK Forum 8 04-20-2010 01:22 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)