NBME Step 2 CK Form 8 Chronic inflammation (NBME Answers)

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submitted by ∗step_prep(148)

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Elderly woman with rheumatoid arthritis presents with pallor and is found to have a microcytic anemia with a decreased TIBC (indicative of increased ferritin stores), most consistent with anemia of chronic disease
Iron deficiency (microcytic anemia): Iron labs show low iron, increased TIBC and decreased ferritin (often seen in young women due to menses and in older patient is colon cancer until proven otherwise)
Lead poisoning (microcytic anemia): Patient with exposure who has abdominal pain, neurologic symptoms, etc.
Key idea: While rheumatoid arthritis can be associated with anemia of chronic disease, osteoarthritis is NOT associated with anemia of chronic disease

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lilmonkey In other words, Iron deficiency looks the same on labs but TIBC is increased (asking for more iron). In this case, TIBC is ok (don't need more iron). +1