MCQ – 89593

A 28-year-old software engineer presents to the outpatient clinic with complaints of easy fatigability. He reports a sedentary lifestyle with prolonged computer use (12–14 hours/day) and a diet primarily consisting of fast food, with minimal intake of fruits and vegetables. On evaluation, complete blood count reveals a hemoglobin level of 7 g/dL and a mean corpuscular volume (MCV) of 120 fL. What is the most likely cause of his anemia?

A.	Folate deficiency
B.	Sideroblastic anemia
C.	Cyanocobalamin deficiency
D.	Acute blood loss

Show Answer

Correct Answer » A Explanation

The patient has macrocytic anemia, indicated by:

• Hemoglobin = 7 g/dL → severe anemia

• MCV = 120 fL → macrocytosis (normal 80–100 fL)

Macrocytic anemia is most commonly caused by megaloblastic anemia, which results from impaired DNA synthesis. The two major causes are:

• Folate (Vitamin B9) deficiency

• Vitamin B12 (Cyanocobalamin) deficiency

Why Folate Deficiency is Most Likely

Important clues in the question:

• Poor diet (fast food, minimal fruits and vegetables)

• Young patient

• Sedentary lifestyle

Folate is mainly obtained from green leafy vegetables, fruits, and legumes. A diet lacking these foods commonly leads to folate deficiency.

Additionally:

• Folate stores in the body last only 3–4 months, so deficiency develops quickly with poor diet.