A 25-year-old G2P1 woman at 12 weeks gestational age presents to the office to discuss the results of her routine prenatal screening labs, which were ordered during her 1st prenatal visit. She reports taking a daily prenatal vitamin but no other medications. She complains of mild fatigue and appears pale on exam. Her complete blood count (CBC) shows the following: Hemoglobin (Hb) 9.5 g/dL Hematocrit 29% Mean corpuscular volume (MCV) 75 µm3 Which of the following are the most likely hematologic states of the patient and her fetus?
AIron deficiency anemia in both the mother and the fetus
BIron deficiency anemia in the mother; normal Hb levels in the fetus
CPernicious anemia in the mother; normal Hb levels in the fetus
DPhysiologic anemia in the mother; normal Hb levels in the fetus
EFolate deficiency anemia in both the mother and the fetus
A 37-year-old man, otherwise healthy, has a routine CBC done prior to donating blood for the first time. The results are as follows: Hemoglobin 10.8 g/dL Mean corpuscular volume (MCV) 82 μm3 Mean corpuscular hemoglobin concentration (MCHC) 42% Reticulocyte count 3.2% White blood cell count 8,700/mm3 Platelet count 325,000/mm3 The patient is afebrile and his vital signs are within normal limits. On physical examination, his spleen is just palpable. A peripheral blood smear is shown in the exhibit (see image). A direct antiglobulin test (DAT) is negative. Which of the following best describes the etiology of this patient’s most likely diagnosis?
AImmune-mediated hemolysis
BInherited membrane abnormality of red cells
CBone marrow hypocellularity
DMicroangiopathic process
EOxidant hemolysis
A 34-year-old female with a past medical history of a gastric sleeve operation for morbid obesity presents for pre-surgical clearance prior to a knee arthroplasty. Work-up reveals a hemoglobin of 8.7 g/dL, hematocrit of 26.1%, and MCV of 106 fL. With concern for folate deficiency, she is started on high dose folate supplementation, and her follow-up labs are as follows: hemoglobin of 10.1 g/dL, hematocrit of 28.5%, and MCV of 96 fL. Given her history of gastric sleeve surgery and associated malabsorption risks, she is at long-term risk for which complication?
APeripheral neuropathy
BMacular degeneration
CHypothyroidism
DMicrocytic anemia
ENeural tube defects
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