A 45-year-old man with a history of chronic liver disease due to alcohol use presents with complaints of fatigue and pallor. His physical examination reveals icteric sclera, hepatomegaly, and mild splenomegaly. Laboratory findings show macrocytic anemia, elevated bilirubin, and increased mean corpuscular volume (MCV). A peripheral blood smear is performed and shows red cells whose area of central pallor is elongated in a mouth-like shape. Question: Which of the following morphologic findings in red cells is most likely seen in this patient?
A 28-year-old man of Mediterranean descent presents to the emergency department with dark urine, jaundice, and fatigue two days after consuming a meal containing fava beans. He denies fever, chills, or recent illness but reports that similar symptoms occurred once before after taking an unknown medication. His physical examination reveals pallor, scleral icterus, and mild splenomegaly. Laboratory tests show: Hemoglobin: 8.5 g/dL (low) Reticulocyte count: Elevated Indirect bilirubin: Elevated Peripheral smear: Presence of Heinz bodies and bite cells Question: Which of the following is the most likely underlying cause of this patient’s condition?
A 30-year-old male of Asian descent comes with complaints of weakness and dark-colored urine after consuming fava beans at a dinner party. Which of the following is the primary reason why fava beans can trigger hemolysis in this patient with suspected G6PD deficiency?
A newborn of Mediterranean descent develops severe jaundice within the first 24 hours of life, and the pediatrician suspects an enzyme deficiency. Which of the following tests would be most appropriate to confirm the diagnosis of G6PD deficiency in this newborn?
A 25-year-old African-American male presents to the emergency department with complaints of dark urine, jaundice, and sudden onset of fatigue after taking a new medication for a urinary tract infection. Which of the following medications is most likely to have precipitated this patient’s symptoms?
A 22-year-old male with a history of G6PD deficiency is brought to the emergency department after developing fatigue, jaundice, and dark urine following treatment with trimethoprim-sulfamethoxazole for a urinary tract infection. Laboratory tests confirm hemolytic anemia. What is the most appropriate next step in managing this patient?
A 30-year-old man presents with sudden-onset jaundice and dark urine after consuming a meal that included fava beans. He reports no prior similar episodes. Examination reveals pallor and scleral icterus. Laboratory studies show anemia and elevated indirect bilirubin. Which of the following findings would most likely confirm the diagnosis of G6PD deficiency?
A 25-year-old male of African descent presents to the emergency department with complaints of fatigue, jaundice, and dark-colored urine for the past two days. He had a febrile illness one week ago and recently took a sulfa-based antibiotic prescribed by a local physician. On physical examination, he has scleral icterus, pallor, and mild splenomegaly. Laboratory results reveal anemia, elevated reticulocyte count, and a peripheral smear showing Heinz bodies and bite cells. Question: What is the underlying cause of hemolysis in this patient?
A 65-year-old male with a history of multiple myeloma presents with progressive fatigue, edema, and shortness of breath. Laboratory investigations reveal proteinuria, and a fat pad biopsy confirms the presence of amyloid deposits. Which of the following proteins is most likely to be found in this patient’s amyloid deposits?
A 55-year-old female with a 10-year history of Sjogren Syndrome (SS) presents to her rheumatologist for a routine follow-up. She reports persistent fatigue, dry eyes, and dry mouth, which have been well-controlled with artificial tears and pilocarpine. Recently, she has noticed painless swelling of the parotid glands bilaterally. Her lab work shows elevated serum IgG levels and positive anti-SSA/Ro antibodies. Which of the following is the most appropriate next step in her management?
