**Question:** Hemolysis in G6PD may be caused by all except

A. Drugs
B. Foods
C. Infections
D. Trauma

**Core Concept:** Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive disorder that affects the enzyme G6PD, which plays a crucial role in the red blood cell's antioxidant defense system. Hemolysis is the breakdown of red blood cells.

**Why the Correct Answer is Right:** Hemolysis in G6PD deficiency can be triggered by various factors, such as oxidative stress, infections, and trauma. However, medications are a common cause of hemolysis in G6PD-deficient individuals. Some drugs, like primaquine, sulfonamides, and certain antimalarials, can induce hemolysis by causing oxidative stress.

**Why Each Wrong Option is Incorrect:** Hemolysis in G6PD deficiency can be caused by infections and trauma as they can also lead to oxidative stress and damage to red blood cells. Infections, particularly viral infections, can increase the production of free radicals, leading to oxidative stress and hemolysis. Trauma, like blunt chest trauma, can cause mechanical damage to red blood cells, resulting in hemolysis.

**Clinical Pearl:** It is crucial for healthcare professionals to be aware of the potential triggers of hemolysis in G6PD-deficient patients to avoid inadvertently causing a severe clinical crisis.

**Correct Answer:** D. Medications (excluding those causing oxidative stress)

**Explanation:** Drugs that can cause hemolysis in G6PD-deficient individuals include primaquine, sulfonamides, and certain antimalarials. These medications can induce oxidative stress, leading to hemolysis. Infections and trauma, while they can cause oxidative stress and hemolysis, are not specifically excluded in this question, so we focus on medications that do not cause oxidative stress. Medications like antibiotics, nonsteroidal anti-inflammatory drugs, and antimalarials that do not induce oxidative stress are safe for G6PD-deficient individuals.