Anemias USMLE Step 1 Practice Question
A 67 year old man is evaluated for progressive fatigue and exertional dyspnea for 4 months. He also reports craving ice and has had a 5 kg unintentional weight loss. Physical examination shows conjunctival pallor and brittle spoon shaped nails. Laboratory studies show hemoglobin 8.9 g/dL, MCV 69 fL, ferritin 7 ng/mL, total iron binding capacity increased, and transferrin saturation decreased. Colonoscopy is pending. Which of the following is the most likely cause of this patient's anemia?
Answer choices
- ADefective ferrochelatase activity
- BDecreased erythropoietin production
- CExtravascular hemolysis due to spectrin defect
- DChronic occult gastrointestinal blood lossCorrect answer
- EAutoimmune destruction of parietal cells
- FAnemia of chronic disease
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.