Chronic Kidney Disease USMLE Step 1 Practice Question
A 66-year-old woman with stage 3 chronic kidney disease presents with progressive fatigue and decreased exercise tolerance. Vital signs: BP 148/92, HR 88, RR 16, Temp 37.2°C, SpO2 98%. Laboratory studies reveal normocytic anemia (Hgb 8.2 g/dL) with low reticulocyte count (0.5%), normal iron studies, and creatinine 2.1 mg/dL. She denies melena or hematochezia. Which of the following is the most likely cause of her anemia?
Answer choices
- AAutoimmune hemolysis with splenic sequestration
- BLoss of intrinsic factor from parietal cell destruction
- CDefective globin chain synthesis due to iron lack
- DDeficient folate absorption in the jejunum
- EDecreased erythropoietin production by the kidneyCorrect answer
- FChronic blood loss from occult gastrointestinal hemorrhage
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