Anemias USMLE Step 1 Practice Question
A 44 year old man with alcohol use disorder presents with fatigue and numbness in his feet. He has recently been treated for tuberculosis. Laboratory studies show hemoglobin 9.7 g/dL, MCV 72 fL, ferritin elevated, and serum iron elevated. Bone marrow biopsy demonstrates erythroid precursors with iron laden mitochondria arranged in a ring around the nucleus. Which of the following is the most likely explanation for this patient's anemia?
Answer choices
- AImpaired iron absorption in the duodenum
- BAutoimmune destruction of mature erythrocytes
- CDecreased erythropoietin production by the kidney
- DDefective incorporation of iron into hemeCorrect answer
- EReduced synthesis of alpha globin chains
- FIncreased iron sequestration by hepatic macrophages
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