: 74. A 15-year-old girl has a 2-week history of fatigue. She is pale. Complete blood count shows: Hemoglobin 5.4 g/dL Hematocrit 15.2% Leukocyte count
: 74. A 15-year-old girl has a 2-week history of fatigue. She is pale. Complete blood count shows: Hemoglobin 5.4 g/dL Hematocrit 15.2% Leukocyte count 6000/mm Segmented neutrophils 68% Eosinophils 2% Lymphocytes 35% Monocytes 5% Mean corpuscular volume 99.4 m Platelet count 188,000/mm) Reticulocyte count 0.6% Serum Beirubin, total 4.4 mg/dL Direct 0.2 mg/dl. Indirect 4.2 mg/i. A photomicrograph of a peripheral blood smear is shown. Which of the following is the most likely cause of these findings? A) Acute lymphoblastic leukemia B) Aplastic anemia from toxin exposure C) Hemoglobin S disease with splenic infarction D) Hereditary spherocytosis with parvovirus B19 infection E) Iron deficiency anemia
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