+- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com)
+-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1)
+--- Forum: Step 1 (https://www.usmleforum.com/forumdisplay.php?fid=2)
+--- Thread: heme Q, tricky? - boggart (/showthread.php?tid=103548)
heme Q, tricky? - boggart - ArchivalUser - 07-20-2006
6.A patient is diagnosed with a hereditary disorder that
results in the development of splenomegaly, sphero-
cytes,and increased reticulocytes on a peripheral blood
smear. If his red cells are also microcytic and hyper-
chromic, which of the following would be the most
appropriate pharmacotherapy?
(A) Azathioprine
(B) Cyanocobalamin
© Folic acid
(D) Iron sulfate
(E) Methotrexate
0 - ArchivalUser - 07-20-2006
there shd be increased red cell turnover.. so hmm folate???
0 - ArchivalUser - 07-20-2006
what about iron sulfate
0 - ArchivalUser - 07-20-2006
very good cd45!
The correct answer is C.
This patient has hereditary
spherocytosis. In these patients, folic acid is given to
sustain erythropoiesis.They are instructed to take sup-
plementary folic acid for life to prevent a megaloblastic
crisis.
Azathioprine (choice A) is an immunosuppressive
agent used in autoimmune diseases such as systemic
lupus erythematosus and rheumatoid arthritis,and for
immunosuppression in renal homografts.
Cyanocobalamin (choice B),or vitamin B
12,is used for
naturally occurring pernicious anemia and for anemia
produced by gastric resection.
Iron sulfate (choice D)is used for iron deficiency anemia.
Methotrexate (choice E) inhibits dihydrofolate reduc-
tase. It is useful in acute leukemias, choriocarcinomas,
non-Hodgkin lymphoma,cutaneous T-cell lymphoma,
breast cancer, rheumatoid arthritis, and psoriasis. It is
also an abortifacient.