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A 5-Year-Old Boy Is Brought to the Office by His

Question 201

Multiple Choice

A 5-year-old boy is brought to the office by his parents who say that he "looks yellow" and has been uncharacteristically tired lately.  He has had upper respiratory tract infection symptoms for the past 3 days, including cough, rhinorrhea, sneezing, and sore throat.  The parents say that "a lot of kids at daycare have been sick lately."  The patient has no prior medical problems.  He is consistently at the 50th percentile for height and weight.  He takes no medications, and his immunizations are up to date.  Pallor, scleral icterus, and palpable splenomegaly are seen on examination.  Laboratory results are as follows: A 5-year-old boy is brought to the office by his parents who say that he looks yellow and has been uncharacteristically tired lately.  He has had upper respiratory tract infection symptoms for the past 3 days, including cough, rhinorrhea, sneezing, and sore throat.  The parents say that a lot of kids at daycare have been sick lately.   The patient has no prior medical problems.  He is consistently at the 50th percentile for height and weight.  He takes no medications, and his immunizations are up to date.  Pallor, scleral icterus, and palpable splenomegaly are seen on examination.  Laboratory results are as follows: The patient recovers spontaneously after a few weeks.  Peripheral smear of the boy's blood after recovery is shown in the exhibit.  Which of the following is the most likely cause of this patient's condition? A) Glucose-6-phosphate dehydrogenase enzyme deficiency B) Imbalance between alpha and beta globin chain production C) Nuclear maturation defect due to defective DNA synthesis D) Polymerization of hemoglobin within red blood cells E) Red blood cell membrane cytoskeleton abnormalities The patient recovers spontaneously after a few weeks.  Peripheral smear of the boy's blood after recovery is shown in the exhibit.  A 5-year-old boy is brought to the office by his parents who say that he looks yellow and has been uncharacteristically tired lately.  He has had upper respiratory tract infection symptoms for the past 3 days, including cough, rhinorrhea, sneezing, and sore throat.  The parents say that a lot of kids at daycare have been sick lately.   The patient has no prior medical problems.  He is consistently at the 50th percentile for height and weight.  He takes no medications, and his immunizations are up to date.  Pallor, scleral icterus, and palpable splenomegaly are seen on examination.  Laboratory results are as follows: The patient recovers spontaneously after a few weeks.  Peripheral smear of the boy's blood after recovery is shown in the exhibit.  Which of the following is the most likely cause of this patient's condition? A) Glucose-6-phosphate dehydrogenase enzyme deficiency B) Imbalance between alpha and beta globin chain production C) Nuclear maturation defect due to defective DNA synthesis D) Polymerization of hemoglobin within red blood cells E) Red blood cell membrane cytoskeleton abnormalitiesWhich of the following is the most likely cause of this patient's condition?


A) Glucose-6-phosphate dehydrogenase enzyme deficiency
B) Imbalance between alpha and beta globin chain production
C) Nuclear maturation defect due to defective DNA synthesis
D) Polymerization of hemoglobin within red blood cells
E) Red blood cell membrane cytoskeleton abnormalities

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