Match each patient's clinical presentation to the most likely underlying hematologic or oncologic diagnosis.
- A 28-year-old woman with a history of heavy menstrual bleeding presents with fatigue and a craving to chew ice. Laboratory testing reveals a microcytic anemia with a markedly low serum ferritin.Iron deficiency anemia
- A 65-year-old man presents with severe lower back pain, constipation, and worsening fatigue. Laboratory testing reveals hypercalcemia, an elevated serum creatinine, and a normocytic anemia.Multiple myeloma
- A 40-year-old woman with systemic lupus erythematosus presents with new-onset jaundice and dark urine. Laboratory testing shows a normocytic anemia, an elevated reticulocyte count, and a positive direct antiglobulin (Coombs) test.Autoimmune hemolytic anemia
- A 25-year-old man presents with sudden-onset fatigue and dark urine three days after starting trimethoprim-sulfamethoxazole for a skin infection. His peripheral blood smear reveals bite cells.Glucose-6-phosphate dehydrogenase (G6PD) deficiency
Answer
The presentations appropriately match as follows: the young woman with heavy menses and pica has iron deficiency anemia; the older man with bone pain, renal failure, and hypercalcemia has multiple myeloma; the lupus patient with a positive Coombs test has autoimmune hemolytic anemia; and the patient taking sulfa drugs with bite cells has G6PD deficiency.
Each clinical vignette provides classic, unequivocal features of a specific hematologic disorder allowing for straightforward diagnosis based on high-yield associations.
Step-by-Step Solution
Key Concept
Classic presentations of highly tested hematologic and oncologic disorders