Hugo brought his 2-year-old son to the doctor for a checkup. He had recently moved to upstate New York from a poor neighborhood in Los Angeles. Hugo commented that his son had been very cranky lately. He attributed this condition to teething.
He had a habit of chewing on his favorite painted wooden toys, which were family heirlooms. The well-baby clinic referred Hugo's son to the hospital laboratory because he was lethargic and pale. A CBC was ordered.
TEST RESULT
RBC 3.0 x 1012/L
WBC 8.0 x 109/L
PLT 180 x 109/L
HGB 6.5 g/dL
HCT 22
PB smear Many red cells exhibiting diffusely granular aggregates
What reflex laboratory tests would be helpful to identify the cause of this anemia?
a. Serum iron studies
b. Vitamin B12
c. Bone marrow aspirate
d. Cytogenetic studies
Question 2
Which clinical manifestation is common in vitamin B12 deficiency but not in folate deficiency?
a. Glossitis
b. Pallor
c. Fatigue
d. Peripheral neuropathy
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