07-17-2006, 06:06 AM
20-year-old white woman comes to the office because of increasing fatigue for the past 3 weeks. She is 24 weeks pregnant with her first pregnancy. She says she has noted increased difficulty maintaining her usual pace in the local factory where she works packing boxes. Prior to pregnancy, she had no health problems and was considered an above-average worker. Other than the fatigue and an occasional backache, she has had an uneventful pregnancy. Results of initial prenatal laboratory studies were normal, and she has attended all of her prenatal office appointments. Complete blood count is obtained at this visit and a peripheral blood smear, also obtained during this visit, is shown. At this time, the most likely explanation for the patient's fatigue is that she has which of the following?
A
) Iron-deficiency anemia
B
) Vitamin B12 (cyanocobalamin) deficiency
C
) Folate deficiency
D
) Leukemia
E
) Physiologic anemia of pregnancy
A
) Iron-deficiency anemia
B
) Vitamin B12 (cyanocobalamin) deficiency
C
) Folate deficiency
D
) Leukemia
E
) Physiologic anemia of pregnancy