A 45-Year-Old Man Comes to the Office for Evaluation of Fatigue

question 214

Multiple Choice

A 45-year-old man comes to the office for evaluation of fatigue that has been gradually increasing over the past 4 months.  The patient has had difficulty keeping up with the labor involved with his job as a construction worker.  Over the past 2 weeks, he has been unable to climb past the second floor of the building his company is renovating.  The patient also has increasing shortness of breath with minor activities, such as lifting his toolbox out of the car.  Review of systems reveals constipation and decreased concentration.  Physical examination shows an overweight male with conjunctival pallor who has difficulty getting onto the examination table due to shortness of breath.  Laboratory test results are as follows: Which of the following findings would most likely be seen on this patient's peripheral blood smear?

• A)Basophilic stippling
• B)Heinz bodies
• C)Howell-Jolly bodies
• D)Ring sideroblasts
• E)Schistocytes

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Definitions:

Malthusian Theory

A theory proposed by Thomas Malthus suggesting that population growth will outpace agricultural production, leading to widespread famine and disaster.

Population Growth

The increase in the number of individuals in a population, typically measured as a percentage change over time.

Productivity Growth

Productivity growth is the increase in efficiency of production of goods and services, measured by the output per unit of input, over a specific time period.

Medicare, Medicaid

Federal programs in the United States that provide health coverage; Medicare is for people over 65 or with certain disabilities, and Medicaid is for low-income individuals and families.