A normal MCV would be expected in a patient with which one of the following conditions?
Correct Answer: 2 days post-acute bleed
Description: A patient who is 2 days post-acute bleed will have a normal MCV because the bone marrow has not had enough time to release reticulocytes into the peripheral blood. Reticulocytes are larger than a mature RBC and could potentially increase the MCV. The other choices in the question are conditions associated with either an increase or decrease in the MCV. A pregnant woman not taking vitamin supplements will very likely develop folate deficiency because she has only a 3-4 month supply of the vitamin in her liver. A patient with resection of the terminal ileum will develop vitamin B deficiency, since the terminal ileum has receptors for the vitamin B factor complex for reabsorption. The patient with b- thalassemia minor as well as the patient with a chronic bleeding peptic ulcer will have a microcytic anemia, the former from a decrease in globin-chain synthesis, and the latter secondary to iron deficiency.
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