Which of the following is the most likely underlying cause of this - ProProfs Discuss
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Which of the following is the most likely underlying cause of this patient’s symptoms?
A 12-year-old African American girl is brought to the emergency department by her mother because of a 6-hour history of fever and severe rib pain. She has had numerous episodes in the past. Her paternal aunt and uncle have had similar symptoms since youth. Her temperature is 39°C (102.2°F). The lungs are clear to auscultation. Abdominal examination shows tenderness to palpation. A peripheral blood smear is shown in the photomicrograph.





A. Abnormal folding of the hemoglobin molecule caused by increased PCo2
B. Abnormal hydrogen bonding in the hemoglobin caused by amino acid substitution on the chain
C. Decreased oxygen affinity caused by an amino acid substitution in the hemoglobin a chain
D. Erythrocyte fragility caused by an amino acid substitution in glycoproteins on the cell surface
E. Polymerization of hemoglobin with hypoxic conditions due to amino acid substitution in the B chain

This question is part of NBME 13 Section 4 (qst 1-50)
Asked by Chachelly, Last updated: Oct 17, 2018

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3 Answers

C. Kenway

C. KenwayContent Writer, Jacksonville
Content Writer, Jacksonville

Answered on Aug 29, 2018

The answer to this is letter E. The fact that there is a mutation involved means that this is Sickle Cell Disease. This is a type of anaemia wherein the hemoglobin which is usually round and donut-shaped is changed to a crescent shape. This means that there is not enough oxygen available.

The case mentioned above that this has also been experienced by other family members in the past. This disease can be hereditary and is also more common for those of African descent. The only cure that is available for this type of diseases at present time is bone-marrow transplant which is not often easy and is expensive.

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John Adney

John Adney

Answered on Sep 06, 2017

D. Erythrocyte fragility caused by an amino acid substitution in glycoproteins on the cell surface.

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John Smith

John Smith

Answered on Jul 20, 2017

Polymerization of hemoglobin with hypoxic conditions due to amino acid substitution in the B chain
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