Anemias USMLE Step 1 Practice Question
A 19-year-old African American man with sickle cell disease presents to the emergency department with acute onset severe lower back and left flank pain. He reports the pain began 6 hours ago and is unresponsive to ibuprofen. He denies recent travel, trauma, or urinary symptoms. Vital signs: BP 118/76 mmHg, HR 108 bpm, RR 22/min, temperature 38.9°C, SpO2 94% on room air. Laboratory studies show: hemoglobin 7.4 g/dL, MCV 88 fL, reticulocyte count 8%, total bilirubin 3.2 mg/dL, LDH elevated, and haptoglobin low. Peripheral blood smear shows sickle cells and polychromasia. Chest X-ray is clear. Urinalysis is normal. Which of the following is the most likely diagnosis?
Answer choices
- AVaso-occlusive crisisCorrect answer
- BAcute chest syndrome
- CSplenic sequestration crisis
- DHemolytic crisis
- ENephrolithiasis
- FAplastic crisis
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