Anemias USMLE Step 1 Practice Question
A 71-year-old woman presents with progressive fatigue, paresthesias, and gait imbalance over 3 months. Vital signs: BP 128/76, HR 88, RR 16, temp 37°C, SpO2 98%. Examination reveals decreased vibration and proprioception in both legs; normal strength. Labs show hemoglobin 8.7 g/dL, MCV 113 fL, hypersegmented neutrophils, elevated methylmalonic acid, and normal folate levels. She denies medication use. Which diagnosis best explains these findings?
Answer choices
- AIron deficiency anemia
- BFolate deficiency
- CPernicious anemia causing vitamin B12 deficiencyCorrect answer
- DThalassemia trait
- ESideroblastic anemia
- FCopper deficiency from malabsorption
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