Neet pg mcqs q9

A 30-year-old woman is admitted to the hospital with progressive fatigue and weakness with dyspnea on exertion. On physical examination the following is found: temperature of 39 deg Celsius, pulse: 110 bpm, respiratory rate: 16/min, and blood pressure: 110/70 mmHg. The woman has profound scleral icterus and lymphadenopathy. Blood count reveals: WBC: 9,000/ul, hemoglobin: 5.3 g/dl, Hct: 16%, RBC: 1,600,000/ul, platelet count: 300,000/ul, reticulocyte count: 15%. Which of the following types of anemia is the most likely cause for the patient’s presentation?
Anemia of Chronic Disease
Aplastic Anemia
Hemolytic Anemia
Megaloblastic Anemia
Sickle Cell Anemia

Correct answer
Hemolytic Anemia
Feedback
correct answer: C

You should immediately try to identify abnormal lab values to develop a sense for what is happening in this patient. The most striking abnormalities are in the low Hgb count, low Hct, and low levels of RBCs in the bloodsteam. Such a scenario indicates either
increased destruction of RBCs or 2) decreased production of RBCs. To evaluate production of RBCs, it is useful to look at the reticulocyte count. An elevated reticulocyte count (here, 15%) means that the bone marrow is responding appropriately to the anemia, suggesting that the low RBC count is due to blood cell destruction rather than insufficient production. Further, hemolytic anemia will often result in the release of unconjugated bilirubin (from Hgb) into the bloodsteam. In our patient, this presents itself as scleral icterus.