Question
A 23-year-old male presents with a history of fatigue and tiredness. Investigations show hemoglobin levels of 9 g/dL, an MCV of 101 fL, and a peripheral smear with macrocytic RBCs and hypersegmented neutrophils. What is the most probable etiology?
| A. |
Lead poisoning
|
| B. |
Iron deficiency anemia
|
| C. |
Chronic alcoholism
|
| D. |
Hemolytic anemia
|
Show Answer
|
Correct Answer » C
Explanation
|
|
– Chronic Alcoholism: Causes macrocytic anemia due to:
– Direct toxic effect: Suppresses erythropoiesis & impairs RBC maturation.
– Nutrient malabsorption: ↓ Folate & sometimes ↓ Vitamin B12.
– Liver dysfunction: Alcohol-induced liver disease can cause macrocytosis.
– Key Lab Clues:
– Hb 9 g/dL – Indicates anemia.
– MCV 101 fL – Macrocytic anemia implies impaired DNA synthesis.
– Hypersegmented neutrophils – Typical in megaloblastic anemia (e.g., folate/B12 deficiency).
Incorrect Options:
– A. Lead poisoning: Causes microcytic anemia with basophilic stippling.
– B. Iron deficiency anemia: Microcytic, hypochromic; RBCs show microcytosis.
– D. Hemolytic anemia: Normocytic/macrocytic, ↑ reticulocyte count & hemolysis markers (e.g., ↑ LDH, ↓ haptoglobin). No signs here.
