This page is dedicated to organizing various examples of standardized exam questions whose answer is iron deficiency anemia. While this may seem a odd practice, it is useful to see multiple examples of how iron deficiency anemia will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
Question # 1
A 17 year old pregnant African American female presents to the clinic at eight weeks gestation for prenatal care. She reports occasional spotting but denies any pain or fever. A CBC is ordered and the lab results report a hemoglobin of 8.1 g/dL, and a peripheral smear demonstrates hypochromia and microcytosis. What is the likely diagnosis in this patient?
Question # 2
A 1 year old boy is brought to the clinic because of pallor for the past 2 weeks. His immunizations are all up to date, and he is otherwise healthy. He has been fed a commercial formula until the age of 6 months, and now is being fed 2% cow’s milk and table food since weaning off of the formula. His development has been unremarkable so far. H his in the 60th percentile of height, and 80th percentile for weight. His hematocrit is 25%. A blood smear with Wright stain is shown below. What is a possible diagnosis in this patient?
Question # 3
A 62 year old woman comes to the clinic with a 3 month history of fatigue and shortness of breath upon exertion. She does not take any medications currently. Her temperature is 98.4°F, blood pressure is 165/80 mm Hg, pulse is 100/min, and respirations are 22/min. A cardiac exam reveals the presence of a 1/6 mid-systolic murmur in the second left intercostal space with normal S2 splitting. There is no peripheral edema present on the exam, and a a rectal exam shows guaiac-negative brown stool. An electrocardiogram reveals sinus tachycardia and nonspecific ST-T changes. Lab results are listed below.
- Hemoglobin: 8.5 g/dL
- MCV: 73 fL
- Platelets: 450,000/mm³
- Leukocytes: 4,000/mm³
- Serum ferritin: 8 ng/mL
- Serum iron: 24 µg/dL
- Iron-binding capacity: 480 µg/dL
What is a diagnosis in this patient?
Explanation: anemia + decreased MCV + low serum ferritin + low serum iron + increased iron binding capacity = iron deficiency anemia
Page Updated: 11.02.2016