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NBME 21 Answers

nbme21/Block 2/Question#7

A 50-year-old man with rheumatoid arthritis comes ...

Anemia of chronic disease

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submitted by dr.xx(26),

Among the most prevalent hematologic abnormalities in patients with rheumatologic disorders are the anemia of chronic disease (ACD), a mild anemia that is generally asymptomatic, and iron deficiency anemia.

In iron-deficiency anemia, the TIBC would higher than 400–450 mcg/dL because stores would be low.

Patients with RA occasionally have concurrent iron deficiency anemia and ACD. When this occurs, the hemoglobin level usually drops to below 9.5 g/dL, and the MCV is less than 80.

https://www.uptodate.com/contents/hematologic-manifestations-of-rheumatoid-arthritis

sympathetikey  Got the right answer too, but man, that whole "1 month after starting therapy" almost threw me off. +  

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submitted by ragacha(0),

FA 2018 page 409. Associated with inflammation (RA, SLE, CKD).