Billy Step 1 Questions # 107

[billy]

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

[crusader]

Originally Posted by billy

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

(D) low EPO

[vnagubandi]

i would go with D too

[nandish_m]

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?

[fat1iscool]

D) Low erythropoietin

[billy]

Yes D is correct.

[dreimg]

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