QuestionSBA
QuestionChoice
The low Hb and RBC mean that the patient has anaemia. The raised MCV means that the anaemia is macrocytic (large RBCs). Given the patient's history of Crohn's disease, she likely has poor absorption of B12 and folate, thus causing a macrocytic megaloblastic anaemia. This could be confirmed by testing her serum B12 and folate levels.
10000586
a
Macrocytic megaloblastic anaemia
QuestionChoice
Microcytic anaemia means a low MCV, which indicates small RBCs. This patient has a raised MCV, indicating large RBCs, meaning they must have a macrocytic anaemia.
10000589
d
Microcytic anaemia
QuestionChoice
This patient has a raised MCV. Therefore the anaemia must be macrocytic as the RBCs are large. Normocytic anaemia refers to an anaemia with a within-range MCV.
10000588
c
Normocytic anaemia
QuestionChoice
Anaemia of chronic disease is a cause of microcytic or normocytic anaemia, causing a low/normal MCV. It often occurs due to cancer. As this patient has a raised MCV, indicating large RBCs, they cannot have anaemia of chronic disease.
10000590
e
Anaemia of chronic disease
QuestionChoice
The anaemia is macrocytic due to the high MCV. However, it is much more likely to be caused by a B12 or folate deficiency given the patient's history of Crohn's disease. Normoblastic anaemia is more likely in patients with histories of alcoholism or hypothyroidism. We could rule this out by testing her serum B12 and folate levels.
10000587
b
Macrocytic normoblastic anaemia
Concept
Chapter
2693
3794
Iron deficiency anaemia
Topic
157
Haematology
12664
A 28-year-old female with a history of Crohn's disease presents with a month-long history of fatigue and shortness of breath.


Her FBC is as follows:


||||
|--------------|:-------:|---------------|
|Haemoglobin|70  g/L|(M) 130 - 170, (F) 115 - 155|
|White Cell Count|4.9x10<sup>9</sup>/L|3.0 - 10.0|
|Platelets|192x10<sup>9</sup>/L|150 - 400|
|Mean Cell Volume (MCV)|113.7 fL|80 - 96|
|Red blood cells|2.05 10<sup>12</sup>/L|3.8 - 4.8|


Which of the following best describes the pattern seen in the blood tests?
a