An anemic patient has the following red cell indexes: mean corpuscular volume, 70 mm3 ; mean corpuscular hemoglobin, 22 pg; and mean corpuscular hemoglobin concentration, 34%. These values are most consistent with a diagnosis of
**Core Concept**
Anemia is characterized by a decrease in the number or quality of red blood cells, and red cell indices are crucial in differentiating between various causes of anemia. The given red cell indices - mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) - help in categorizing anemia into microcytic, normocytic, or macrocytic anemia.
**Why the Correct Answer is Right**
The patient's red cell indices indicate microcytic anemia, characterized by low MCV (70 mm^3), which is below the normal range (80-100 mm^3). The MCH is also decreased (22 pg), and the MCHC is elevated (34%), which is above the normal range (32-36%). These values are most consistent with iron-deficiency anemia, the most common cause of microcytic anemia. Iron deficiency leads to decreased heme synthesis, resulting in smaller, paler red blood cells with reduced hemoglobin content.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not provided, so we will proceed with the remaining options.
**Option B:** This option is incorrect because it does not accurately describe the patient's red cell indices. However, it might be tempting to choose this option because it mentions a common cause of microcytic anemia. But, the correct answer requires a more specific diagnosis based on the given indices.
**Option C:** This option is incorrect because it does not match the patient's red cell indices. Thalassemia major, a genetic disorder, typically presents with a more severe microcytic anemia with a lower MCHC.
**Option D:** This option is incorrect because it does not accurately describe the patient's red cell indices. Sideroblastic anemia is characterized by ringed sideroblasts and often presents with a normocytic or macrocytic anemia, not microcytic anemia.
**Clinical Pearl / High-Yield Fact**
When interpreting red cell indices, remember that a low MCV with a high MCHC is highly suggestive of iron-deficiency anemia. This combination is often referred to as the "microcytosis with high MCHC" pattern.
**Correct Answer:** B. Iron deficiency anemia.