A 7-Year-Old Boy Comes to the Office for Follow-Up

question 663

Multiple Choice

A 7-year-old boy comes to the office for follow-up.  A week ago, the patient began having episodes of bloody diarrhea that have since resolved.  His current laboratory studies show elevated blood urea nitrogen and serum creatinine levels.  Complete blood count reveals anemia and thrombocytopenia.  Coagulation studies are within normal limits.  His peripheral blood smear is shown in the image below. Which of the following is the most likely cause of this patient's anemia?

• A)Autoimmune hemolytic anemia
• B)Erythropoietin deficiency
• C)Hemolytic anemia due to oxidative stress
• D)Bone marrow fibrosis
• E)Microangiopathic hemolytic anemia

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Definitions:

Psychosexual Development

A Freudian theory that describes how personality develops during childhood through a series of stages focused on erogenous zones.

Fixation

An obsessive focus or attachment to a particular stage of development, object, or activity, often resulting in stagnation in psychological growth.

Unconscious

Part of the mind that is inaccessible to the conscious mind but that affects behaviors and emotions.

Hypnosis

A state of heightened focus and concentrative relaxation, induced by suggestion, that can alter perception, sensation, and can be used for therapeutic purposes.