Megaloblastic anemia



Megaloblastic anemia

Hematological system

Hematological system

Hematological system

Hematological system


Megaloblastic anemia


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USMLE® Step 1 questions

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High Yield Notes

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Megaloblastic anemia

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USMLE® Step 1 style questions USMLE

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A 35-year-old woman presents to her provider’s office for evaluation of fatigue and exercise intolerance that began two months ago. Past medical history is notable for Crohn disease diagnosed eight-years ago. She is taking mesalamine but reports frequent “flare-ups.” The patient consumes 3-4 glasses of wine per week. Her temperature is 36.9°C (98.4°F), blood pressure is 123/76 mmHg, pulse is 75/min, and respiratory rate is 12/min. The patient has conjunctival pallor. Cardiac, pulmonary, and abdominal examinations are non-contributory. Neurological examination reveals decreased proprioception and vibratory sensation in the lower extremities. Complete blood count reveals a hemoglobin of 8.8 g/dL and a mean corpuscular volume (MCV) of 115 µm3. Which of the following findings would be most likely present in this patient?  

External References

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megaloblastic anemia p. 428

Megaloblastic anemia p. 425, 428

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tropical sprue p. 390

vitamin BNaN deficiency p. 66

vitamin BNaN deficiency p. 67

Methotrexate p. 446

megaloblastic anemia p. 251

Neutrophils p. 414

megaloblastic anemia p. 428

nonmegaloblastic anemia p. 428


megaloblastic anemia p. 251

Sulfa drugs p. 253

megaloblastic p. 251


Megaloblastic anemia is a type of anemia caused by deficiencies in folic acid (folate) or vitamin B12. Folic acid and vitamin B12 are essential for DNA synthesis, and thus the production of healthy red blood cells. Megaloblastic anemia is characterized by large, nucleated red blood cell precursors which don't divide and produce more red blood cells as normal precursor cells do. Symptoms include fatigue, shortness of breath, and pale skin.


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