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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
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there shd be increased red cell turnover.. so hmm folate???
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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.
