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Hematological Disorders

What hemoglobin value is used to define anemia in the second trimester of pregnancy?

a. 9.5 g/dL

b. 10.0 g/dL

c. 10.5 g/dL

d. 11.0 g/dL

Which of the following adverse pregnancy outcomes is associated with anemia in pregnancy?

a. Stillbirth

b. Preeclampsia

c. Preterm birth

d. All of the above

What is the maternal iron requirement in pregnancy for a typical singleton gestation?

a. 500 mg

b. 800 mg

c. 1000 mg

d. 1200 mg

A 22-year-old G1 presents to your office at 32 weeks’ gestation. Routine laboratory assessment reveals a hemoglobin of 8 g/dL with a mean corpuscular volume of 81 fL. As a part of the work-up for her anemia, a peripheral smear is performed, which is shown. What is the most likely diagnosis?

Reproduced with permission from Werner CL, Richardson DL, Chang SY, et al (eds): Perioperative Considerations. In Williams Gynecology Study Guide, 3rd ed. New York, McGraw-Hill Education, 2016, Q39-18.

a. Iron-deficiency anemia

b. Acute blood loss anemia

c. Anemia of chronic disease

d. Anemia resulting from folate deficiency

Your patient is diagnosed with severe iron-deficiency anemia at 34 weeks’ gestation, for which you recommend ferrous sulfate supplementation three times daily. If you repeat a complete blood count one week after starting iron therapy, what would you expect to see if she is compliant with taking her iron?

a. A 20% rise in her hematocrit

b. An elevated reticulocyte count

c. An increase in red cell distribution width

d. An increase in the mean corpuscular volume

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