Mineral deficiency disordersDownloads

A 25-year-old African-American woman visits the doctor’s office complaining of fatigue for a couple of months. She says that she feels exhausted by the end of the day. She works as a dental assistant and is on her feet most of the time. However, she eats well and also tries to walk for 30 minutes every morning. She also says that she sometimes feels breathless and has to gasp for air, especially when she is walking or jogging. Her past medical history is insignificant, except for occasional bouts of cold during the winters. Her physical exam findings are within normal limits except for moderate conjunctival pallor. Complete blood count results and iron profile are as follows: Hemoglobin 9 g/dL Hematocrit 28.5% RBC count 5.85 x 106/mm3 WBC count 5,500/mm3 Platelet count 212,000/mm3 MCV 56.1 fl MCH 20.9 pg/cell MCHC 25.6 g/dL RDW 11.7% Hb/cell Serum iron 170 mcg/dL Total iron-binding capacity (TIBC) 458 mcg/dL Transferrin saturation 60% A peripheral blood smear is given. When questioned about her family history of anemia, she says that all she remembers is her dad was never allowed to donate blood as he was anemic. Which of the following most likely explains her cell counts and blood smear results?

A 37-year-old man is brought to the emergency department because he was found down on a city sidewalk. Upon presentation he is found to be disheveled with multiple poorly healed wounds on his hands and feet. He has had dozens of previous presentations for alcohol intoxication and is currently known to be homeless. Physical examination reveals multiple minor wounds, alopecia, and decreased axillary hair. Upon being aroused, the patient reveals that he has had difficulty with taste and smell and has also had severe diarrhea over the last week. The deficient substance most likely responsible for this patient's symptoms is associated with which of the following proteins?