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NBME 6 Q



A previously healthy 42-year-old woman has a 6-week history of fatigue, light headedness and shortness of breath. Laboratory studies show:

Hematocrit------------- 25%
Hemoglobin------------ 8.3 g/dl
Leukocyte count------- 10,000/mm3
Platelet count---------- 250,000/mm3
Reticulocyte count----- 4%
Total serum bilirubin--- 3mg/dl
Direct serum bilirubin---0.3mg/dl
Urine urobilinogen------ 2+

A peripheral blood smear shows microspherocytes. Which of the following is the most likely cause of the anemia?

A. Acute hemorrhage
B. Hypersplenism
C. Hemolytic-uremic syndrome
D. Autoimmune hemolysis
E. Thrombotic thrombocytopenic anemia
D?
dd
dd
right Smile Thanks