Use this case to answer the following questions:
A 2-year-old black male was being evaluated at the County Clinic for swollen hands and feet that were extremely painful. Upon physical examination, the child was found to have a fever and hepatosplenomegaly, and was physically small for his age. The child was of Jamaican descent.
Patient history revealed that the child was normal for his birth weight, but since then, he was consistently underweight and undersized for his age group. Family history was not readily available. The physician had the child admitted to the hospital for workup and ordered the following CBC.

\begin{array}{ll}\text { TEST } & \text { RESULTS } \\\text { WBC } & 16.6 \times 10^{9} / \mathrm{L} \\\text { RBC } & 2.53 \times 10^{12} / \mathrm{L} \\\text { HGB } & 7.5 \mathrm{gm} / \mathrm{dL} \\\text { HCT } & 21.4 \% \\\text { MCV } & 84.6 \mathrm{fl} \\\text { MCH } & 18.9 \mathrm{pg} \\\text { MCHC } & 35.0 \mathrm{~g} / \mathrm{dL} \\\text { RDW } & 18.9 \\\text { PLT } & 511 \times 10^{9} / \mathrm{L}\\\text { Differential: }\\\text { Polys } & 84 \% \\\text { Stabs } & 10 \% \\\text { Lymphs } & 5 \% \\\text { Eos } & 1 \% \\\text { NRBCs } & 12\end{array}

-This patient presented with swollen hands and feet.What kind of crisis is this patient suffering from?
A)Vaso-occlusive
B)Oxidative
C)Transfusion reaction
D)Anaphylactic reaction

The Strength and Type of Charge on the Hemoglobin Molecule

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