Approach to anemia (destruction and sequestration) Quiz: Ace Your Exams
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A 28-year-old woman comes to the clinic reporting recurrent episodes of fatigue over the past several months. She mentions that her stamina has deteriorated, particularly during her weekly runs. Her past medical history is notable for recurrent episodes of mild jaundice during her childhood, and she recalls being told to avoid certain medications. Family history reveals that both her mother and her only sibling have had episodes of anemia and jaundice. Temperature is 36.7°C (98.1°F), heart rate is 100/min, blood pressure is 112/74 mm Hg, respiratory rate is 17/min, and oxygen saturation is 99% on room air. Examination is notable for mild scleral icterus and tachycardia but is otherwise unremarkable. Laboratory results are shown below. Direct Coombs test is negative. Which of the following is most likely to establish the underlying diagnosis?
| Laboratory test | Results |
| Hemoglobin (Hb) | 9.8 g/dL |
| Hematocrit (Hct) | 29% |
| White Blood Cells (WBC) | 6,500/mm3 |
| Platelets (Plt) | 250,000/mm3 |
| Reticulocyte Count | 8% |
| Mean Corpuscular Volume (MCV) | 88 fL |
| Mean Corpuscular Hemoglobin Concentration (MCHC) | 38 g/dL |
| Total Bilirubin | 2.6 mg/dL |
| Unconjugated Bilirubin | 1.9 mg/dL |
| Lactate dehydrogenase (LDH) | 300 U/L |
| Creatinine | 0.9 mg/dL |
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