NBME 16 Iron deficiency anemia (NBME Answers)

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submitted by ∗cassdawg(1781)

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She has a microcytic anemia with no major symptoms, normal vital signs, no history of illness, and normal other cell counts. Of the answers, iron deficiency anemia is the only one that fits that description and makes sense because she is a premenopausal woman (women are at risk of iron deficiency anemia due to monthly bleeding).

Aplastic anemia would have low platelets and leukocytes as well. Sickle cell and thalassemia would lokely present with a hemolytic anemia and jaundice or some other symptoms (plus they are present from birth). B12 deficiency is megaloblastic anemia and has neurological symptoms.

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jackie I feel like this is a really unfair question because beta-thalassemia minor would also present as microcytic and asymptomatic. They should have at least added HbA levels or iron levels +6

shieldmaiden Iron deficiency has low HCT (like in this case), while Beta-Thalassemia will more likely have a normal HCT value +2

an1 if you see a microcytic anemia, the first thing you should rule out is iron def! even in elderly males, check for occult bleeding and the possibility of GIT CA. From UW. Also her corrected reticulocyte count is ~5%, which is >3% so it can't be a BM defect and aplastic anemia is rules out. B12 is microcytic, Sicke cell is normocytic. Between B-thal and Fe, always opt for Fe unless you have enough to support that it's Beta +2