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Chapter 33: Agents Used in Cytopenias; Hematopoietic Growth Factors

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A 23-year-old pregnant woman is referred by her obstetrician for evaluation of anemia. She is in her fourth month of pregnancy and has no history of anemia; her grandfather had pernicious anemia. Her hemoglobin is 10 g/dL (normal, 12–16 g/dL).

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If this woman has macrocytic anemia, an increased serum concentration of transferrin, and a normal serum concentration of vitamin B12, the most likely cause of her anemia is deficiency of which of the following?

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(A) Cobalamin

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(B) Erythropoietin

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(C) Folic acid

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(D) Intrinsic factor

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(E) Iron

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Deficiencies of folic acid or vitamin B12 are the most common causes of megaloblastic anemia. If a patient with this type of anemia has a normal serum vitamin B12 concentration, folate deficiency is the most likely cause of the anemia. The answer is C.

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A 23-year-old pregnant woman is referred by her obstetrician for evaluation of anemia. She is in her fourth month of pregnancy and has no history of anemia; her grandfather had pernicious anemia. Her hemoglobin is 10 g/dL (normal, 12–16 g/dL).

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The laboratory data for your pregnant patient indicate that she does not have macrocytic anemia but rather microcytic anemia. Optimal treatment of normocytic or mild microcytic anemia associated with pregnancy uses which of the following?

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(A) A high-fiber diet

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(B) Erythropoietin injections

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(C) Ferrous sulfate tablets

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(D) Folic acid supplements

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(E) Hydroxocobalamin injections

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Iron deficiency microcytic anemia is the anemia that is most commonly associated with pregnancy. In this condition, oral iron supplementation is indicated. The answer is C.

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A 23-year-old pregnant woman is referred by her obstetrician for evaluation of anemia. She is in her fourth month of pregnancy and has no history of anemia; her grandfather had pernicious anemia. Her hemoglobin is 10 g/dL (normal, 12–16 g/dL).

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If this patient has a young child at home and is taking iron-containing prenatal supplements, she should be warned that they are a common source of accidental poisoning in young children and advised to make a special effort to keep these pills out of her child’s reach. Toxicity associated with acute iron poisoning usually includes which of the following?

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(A) Dizziness, hypertension, and cerebral hemorrhage

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(B) Hyperthermia, ...

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