A 24-Year-Old Woman Is Being Evaluated for Chronic Fatigue

A 24-year-old woman is being evaluated for chronic fatigue.  She has a history of heavy menstrual periods since menarche and also recalls frequent nosebleeds as a child.  Her past medical history is otherwise insignificant and she takes no medications.  Laboratory studies show a hemoglobin level of 9.2 g/dL, a mean corpuscular volume of 72 fL, and decreased levels of ferritin. Which of the following is the most likely diagnosis?

A) Antiphospholipid syndrome
B) Factor VIII deficiency
C) Factor XIII deficiency
D) Immune thrombocytopenia
E) Protein C deficiency
F) von Willebrand factor deficiency

Correct Answer:

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