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Hematology - Case 24 (3rd ed)
Hematology - Case 24 (3rd ed)
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The provided document addresses two study questions related to iron deficiency anemia in athletes. <strong>Study Question #1</strong> explores screening practices for iron deficiency anemia among elite athletes. The correct answer is B: "The majority of athletes who screen positive will not have obvious clinical signs or symptoms of iron deficiency anemia." It is noted that while screening for hematological and iron-related abnormalities is conducted, it yields a low number of clinically significant results. For example, a study of 576 elite athletes showed that over 50% screened positive, yet only 4.6% had clinically meaningful results. Serum iron is not considered the optimal screening test; instead, serum ferritin is more widely used, with other indices like the transferrin receptor to ferritin ratio recommended to improve diagnostic accuracy. Routine lab screenings for anemia are not recommended across all NCAA athletes, though some screenings, such as for sickle cell trait status, are mandatory, with some exceptions. <strong>Study Question #2</strong> considers the appearance of nails in someone with a ferritin level of 11 ng/mL, which is below the reference range. The correct response is E: "Brittle and concave shaped nails," also known as koilonychia or spoon nails, which are indicative of iron deficiency anemia. Other nail changes listed, such as hyperpigmented vertical nail bands (A), white-yellow discoloration (B), horizontal grooves known as Beau lines (C), and clubbing (D), are associated with different conditions. Overall, the document highlights the subtle presentation of iron deficiency anemia in athletes, the appropriate diagnostic tests to employ, and the physical signs to recognize this condition.
Meta Tag
Edition
3rd Edition
Related Case
3rd Edition, CASE 24
Topic
Hematology
Keywords
iron deficiency anemia
elite athletes
screening practices
serum ferritin
transferrin receptor
koilonychia
spoon nails
hematological abnormalities
sickle cell trait
diagnostic accuracy
3rd Edition
3rd Edition, CASE 24
Hematology
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