Repeated USMLE Questions Step 2 CK- 323

An 8- month-old girl is brought to the clinic by her mother who is concerned that her daughter looks pale. On examination, the girl is pale with no jaundice or splenomegaly. Her CBC shows Hg of 6g/dL, MCV of 60 and reticulocyte count of 0.5%. Upon questioning her mother, she mentioned that she weaned her daughter last month from breastfeeding to cow’s milk.

What is the most likely cause of this anemia?

A-Auto-immune

B-Hemolytic

C-Iron-deficiency

D-Spherocytosis

E-Sickle cell anemia

Answer:






This is a typical case of iron-deficiency anemia in infants characterized by microcytosis and mainly caused by poor iron intake but in this case it is most likely caused by enteropathy of cow milk which causes intestinal bleeding if it is taken under the age of 1 year. Microscopic intestinal bleeding leads to iron deficiency anemia.

The correct answer is C