NBME 5 patho question

[firstaid2012]

---

Members don't see this ad.

18 month old boy who is chubby is brought for a checkup. his weight is above 90th percentile
hct 30 percent
leukocyte count 9000/mm3
mcv 60
platelet 650,000
which of the following is most likely to be abnormal?

a cholesterol
b folate
c iron
d vit b12
e vit e


i didnt really why its c please explain

 

[OveractiveBrain]

18 month old boy who is chubby is brought for a checkup. his weight is above 90th percentile
hct 30 percent
leukocyte count 9000/mm3
mcv 60
platelet 650,000
which of the following is most likely to be abnormal?

a cholesterol
b folate
c iron
d vit b12
e vit e


i didnt really why its c please explain

What is the abnormality in labs? HCt is 30, means Hgb is 10. He is anemic.
So, which of these have something to do with anemia?

Folate, B12, and Iron. For test taking purposes, Folate and B12 both cause the same kind of macrocytic anemia, so, the answer would essentially be the same for each. Eliminating those, it is Iron.

But ok. What is the other abnormality? MCV is 60. Normal range of red blood cell size is 80-100 (ish). So he has not only an anemia, but a microcytic anemia. Only one choice up there causes a microcytic anemia, and that is iron deficiency.

This is an approach to anemia that is designed for clerkship students and studying for step 2, but hopefully it might help you answer the question better than I have here.

 

[firstaid2012]

thank you. what about his platelets? thats wat thru me off i guess .