Anemias USMLE Step 1 Practice Question
A 21-year-old male college student presents with a 3-day history of jaundice, dyspnea on exertion, and fatigue. He reports a sore throat and malaise for the past 2 weeks. Vital signs show temperature 38.2°C (100.8°F), heart rate 92/min, blood pressure 128/76 mmHg, respiratory rate 18/min. On examination, he has scleral icterus, pharyngeal erythema without exudate, and a palpable spleen 2 cm below the left costal margin. Laboratory studies reveal: Hemoglobin: 8.1 g/dL
Mean corpuscular volume: 88 fL
Reticulocyte count: 8.2% Leukocyte count: 9,200/mm³
Platelet count: 195,000/mm³
Total bilirubin: 4.2 mg/dL
Direct Coombs test: Positive
Heterophile antibody (monospot): Positive Which of the following additional laboratory abnormalities would most strongly support the diagnosis of hemolytic anemia in this patient?
Answer choices
- ADecreased haptoglobin and elevated serum lactate dehydrogenaseCorrect answer
- BDecreased reticulocyte count and elevated ferritin
- CIncreased mean corpuscular hemoglobin and decreased unconjugated bilirubin
- DIncreased direct bilirubin with normal unconjugated bilirubin
- EDecreased serum creatinine and elevated alkaline phosphatase
- FIncreased prothrombin time and decreased platelet count
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