You have diagnosed a 32-year-old female with moderate iron deficiency anemia, presumed to be due to chronic menstrual blood loss. She has no gastrointestinal or genitourinary symptoms, and no bruising or bleeding other than menstrual bleeding. Her vital signs are normal and a physical examination is unremarkable. You initiate a trial of oral iron therapy.

Which one of the following would be the best way to assess the patient’s response to oral iron?

A 65-year-old male brings in results from a health fair screening. He was advised to see you because he had a hemoglobin level of 10.2 g/dL (N 14.0–18.0) and a mean corpuscular volume of 80 m 3 (N 80–94). A review of systems is unremarkable except for recent fatigue, and a physical examination is also unremarkable. You order laboratory testing, with the following results:

Ferritin 15 ng/mL (N 20–150); Vitamin B12420 pg/mL (N 200–900); Folate 12 ng/mL (N 2–20); Reticulocyte index 0.3% (N 0.5–1.0)

The most likely diagnosis is

An obese 37-year-old white female sees you because of fatigue. She is otherwise asymptomatic and has normal vital signs. A complete physical examination is unremarkable with the exception of obesity.

A CBC shows no anemia, but her WBC count is 12,500/mm3 (N 4500–11,000). A TSH level and a comprehensive metabolic panel are normal. She does not take any medications and has not had any recent illnesses. Which one of the following would be most appropriate at this point?

In a healthy full-term infant who is exclusively breastfed, iron supplementation should begin at what age in order to prevent iron deficiency anemia?

A 16-year-old female is brought to your office by her mother, who is concerned that her daughter has seemed tired lately. The patient denies any specific health concerns or recent illnesses. She is taking an oral contraceptive and reports that her menstrual bleeding is light in flow. Recent laboratory findings include a TSH level of 1.44 U/mL (N 0.5–5.0), a hematocrit level of 38% (N 36–46), an MCV of 71 m3 (N 78–102), an RBC count of 5.7 million/mm3 (N 4.10–5.10), and ovalocytes on a peripheral smear.

Which one of the following is most likely to explain this patient’s initial laboratory abnormalities and lead to a diagnosis?

Which one of the following is routinely required to establish a diagnosis of chronic lymphocytic leukemia?

A 62-year-old male with type 2 diabetes mellitus, hypertension, and hypercholesterolemia is found to have a low serum vitamin B12 level.

Which one of his current medications is most likely to cause this?

An orthopedic surgeon contacts you about abnormal preoperative laboratory results for one of your patients. The patient is a 58-year-old male who takes acetaminophen and over-the-counter naproxen for pain but is otherwise healthy and has no symptoms. Laboratory Findings:

WBCs 3000(N 3000–11,600)

Hemoglobin 8.9 (N 13.0–18.0)

Hematocrit 26.9% (N 38.5–52.0)

Platelets 118,000/mm3 (N 130,000–140,000)

MCV 89 (N 80–98)

RDW 12.6% (N 11.0–14.5)

Serum vitamin B12 457 pg/mL (N 220–960)

Ferritin 258 (N 24–336)

Reticulocytes 1.5% (N 0.8–2.1)

Which one of the following is most consistent with these results?

When evaluating a patient with menorrhagia, which one of the following laboratory findings would be most consistent with von Willebrand disease?

A 66-year-old male is diagnosed with monoclonal gammopathy of undetermined significance. This patient will require regular follow-up visits because of the risk his condition will progress to

Which one of the following malignancies is associated with hereditary hemochromatosis?

A 68-year-old female presents with a 3-month history of low back pain and fatigue. She has unintentionally lost 15 lb. A physical examination is positive for vertebral point tenderness over the third and fourth lumbar vertebrae. Initial laboratory testing reveals a normocytic anemia, elevated total protein, and a mild decrease in renal function. You order a lumbar spine radiograph and additional diagnostic testing.

Which one of the following would be most appropriate at this point?

You are discharging a mother and her infant after delivery. The infant was born at 35 weeks gestation, is exclusively breastfed, and has a weight that is appropriate for her gestational age. No blood transfusions were necessary and all evaluations have been unremarkable.

According to the guidelines of the American Academy of Pediatrics, at what age should you recommend initiation of iron supplementation for this infant?

A 45-year-old premenopausal female with a BMI of 34.0 kg/m2 presents to your office with increasing dyspnea on exertion. She has a recent history of iron deficiency anemia and wonders if her iron level is low again. Her history is negative for heavy menses, bloody or melanotic stools, abdominal pain, and unusual bleeding or bruising. Her evaluation for anemia has included upper and lower endoscopy with normal findings.

Last year the patient underwent gastric bypass surgery and has been on a fairly restricted diet since that time. She uses a levonorgestrel IUD (Mirena) for contraception.

A physical examination is unremarkable. Her serum ferritin level is 6 ng/mL (N 10–120) and her Hgb is 8.0 g/dL (N 12.0–16.0) with microcytic indices.

You determine that she has iron deficiency anemia. Which one of the following would be the most appropriate management?

A 45-year-old white female presents to your office after recent routine laboratory tests revealed a platelet count of 100,000/mm3 (N 150,000–350,000). Six months ago the patient’s platelet count was 283,000/mm3 . All other indices are within normal limits. The history is negative for easy bruising, bleeding, fever, rash, or arthralgias. She has no family history of blood disorders or recent illness. Her medications include ranitidine (Zantac), fluticasone (Flonase), and inhaled albuterol (Proventil, Ventolin). She is otherwise healthy. A peripheral smear confirms thrombocytopenia. Which one of the following would be most appropriate at this point?