A 15 year-old African American boy presents to the emergency department complaining of severe pain in both legs and back. He climbed Mount Davis, the highest point in Pennsylvania (3213 ft) over the weekend. He reports that he enjoyed climbing the mount. As he was descending, he developed pain in his chest, legs and back. The pain has been present for 1 day and is steadily increasing in severity. He took ‘tons of tylenol and ibuprofen, and it ain’t cut it’. He denies any recent trauma. Since his pain started he feels like he should have listened to his parents, who warned him against the mountain trip because of a preexisting condition he has. He reports that he has suffered from severe bouts of chest pain, back pain and leg pain in the past when he engaged in multiple sporting events during the summer holidays. One of his cousins suffers from a similar disorder. On physical examination, he is afebrile and in some distress due to pain. He has nonspecific bilateral anterior thigh pain with no abnormalities appreciated. The remainder of his examination is normal. Laboratory tests reveal his hemoglobin level as 7.1 g/dL. Peripheral smear shows crescent shaped red blood cells. Of the following, which best describes the inheritance of this disorder?
A 6 year-old girl is brought to your office by her dad for the evaluation of weakness and fatigue. Dad reports that some of their family relatives have a genetic blood disorder. Physical examination is significant for scleral icterus and splenomegaly. Laboratory test results demonstrate hemolytic anemia, increased mean corpuscular hemoglobin concentration, reticulocytosis, normal mean corpuscular volume, and an increased red blood cell osmotic fragility. You suspect hereditary spherocytosis based on the history, physical examination and laboratory test reports. Which of the following is the definitive treatment for this disorder when it is severe?
A 7 year-old girl is brought to your office by her dad for the evaluation of weakness and fatigue. Dad reports that some of their family relatives have a genetic blood disorder. Physical examination is significant for scleral icterus and splenomegaly. Laboratory test results demonstrate hemolytic anemia, increased mean corpuscular hemoglobin concentration, reticulocytosis, normal mean corpuscular volume, and an increased red blood cell osmotic fragility. You suspect hereditary spherocytosis based on the history, physical examination and laboratory test reports. Which of the following best explains the pathology of this disease?
An 8 year-old girl is brought to your office by her dad for the evaluation of weakness and fatigue. Dad reports that some of their family relatives have a genetic blood disorder. Physical examination is significant for scleral icterus and splenomegaly. Laboratory test results demonstrate hemolytic anemia, increased mean corpuscular hemoglobin concentration, reticulocytosis, normal mean corpuscular volume, and an increased red blood cell osmotic fragility. You thought of a hemolytic disorder based on the history, physical examination and laboratory test reports. Which of the following is an inherited cause of hemolytic anemia?
A 67 year-old female came to your office and reported fatigue, weakness, dizziness, chest pain, palpitations, and shortness of breath with exertion. In the physical examination, you found a frail woman with pallor, jaundice, tachycardia, tachypnea, and orthostatic hypotension. She was diagnosed with the anemia of chronic disease based on laboratory tests. Which of the following lab findings are most indicative of anemia of chronic disease?
A 30 year-old female presents to your office with fatigue, shortness of breath, headaches and palpitations that are progressively getting worse over the last few weeks. On physical examination, you find a woman in mild distress with pallor and tachycardia. Laboratory tests are significant for microcytic anemia, due to iron deficiency anemia. As you evaluate this patient for anemia, one medical student starts talking about Mentzer index. Which of the following is true about this index?
According to the American Academy of Pediatrics, at what age should all children need screening for iron-deficiency anemia?
