04-07-2009, 09:46 AM
4. A 20-year-old African American man with sickle cell disease comes to the physician because of a 1-week history of shortness of breath on exertion, fatigue, and generalized weakness. He has had no fever, chills, night sweats, or cough productive of sputum. His only medication is oxycodone for joint pain. He weighs 68 kg (150 lb) and is 168 cm (66 in) tall. His temperature is 36.7 C (98 F), blood pressure is 120/70 mm Hg, pulse is 76/min, and respirations are 18/min. Examination shows no abnormalities. Laboratory studies show:
Hematocrit 20%
Mean corpuscular volume 110 μm3
Leukocyte count 2300/mm3
Reticulocyte count 1.8%
Which of the following is the most likely mechanism for these findings?
A
) Adverse drug reaction
B
) Atrophy of gastric mucosa
C
) Bacterial overgrowth in the small intestine
D
) Increased demand for folic acid
E
) Increased demand for vitamin B12 (cyanocobalamin)
F
) Malabsorption
G
) Vitamin B1 (thiamine) deficiency
Hematocrit 20%
Mean corpuscular volume 110 μm3
Leukocyte count 2300/mm3
Reticulocyte count 1.8%
Which of the following is the most likely mechanism for these findings?
A
) Adverse drug reaction
B
) Atrophy of gastric mucosa
C
) Bacterial overgrowth in the small intestine
D
) Increased demand for folic acid
E
) Increased demand for vitamin B12 (cyanocobalamin)
F
) Malabsorption
G
) Vitamin B1 (thiamine) deficiency