Anemias USMLE Step 1 Practice Question
A 62-year-old man with long-standing rheumatoid arthritis comes to the office because of worsening fatigue. He has morning stiffness in both hands and active synovitis on examination. Laboratory studies show hemoglobin 10.2 g/dL, MCV 82 fL, ferritin elevated, serum iron low, and total iron-binding capacity decreased. Which of the following best explains the pathogenesis of this patient's anemia?
Answer choices
- ADefective beta-globin chain synthesis
- BAutoantibody-mediated destruction of erythrocytes
- CBone marrow replacement by fibrous tissue
- DIncreased hepcidin causing iron sequestration in macrophagesCorrect answer
- EDeficiency of intrinsic factor causing impaired DNA synthesis
- FDecreased erythropoietin production due to chronic kidney disease
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