Question

A female engineer works for 12- 14 hours a day and gives a history of consuming only fast food. There are no vegetables or fruits in his diet. Her Hb count is 9gm/dl MCV 120 fl. On examination, PS shows macrocytes. What will be the diagnosis?

• A. Vitamin B12 deficiency
• B. Folic acid deficiency
• C. Vitamin D deficiency
• D. None

Answer 1

The Correct Option is A

The scenario describes a female with a history of consuming only fast food and exhibits symptoms of macrocytic anemia, as indicated by a hemoglobin (Hb) level of 9gm/dl and a mean corpuscular volume (MCV) of 120 fl. The examination of the peripheral smear shows macrocytes. Let's analyze the details step-by-step to determine the correct diagnosis:

1. Macrocytic Anemia: The condition where red blood cells are larger than normal is identified by an increased MCV, typically greater than 100 fl. The MCV here is 120 fl, confirming macrocytic anemia.
2. Dietary Habits: The subject's diet is comprised only of fast food, lacking vegetables and fruits. Fast food diets are often devoid of essential nutrients such as vitamins.
3. Peripheral Smear Findings: The presence of macrocytes suggests either Vitamin B12 or folic acid deficiency, both of which are causes of macrocytic anemia.
4. Specific Indicators: A diet deficient in fresh vegetables and fruits is more strongly associated with Vitamin B12 deficiency. Though folate deficiency is another possibility, the dietary pattern here aligns more with a lack of Vitamin B12 due to insufficient intake of animal products or supplements typically rich in B12.

Considering these points, the most likely diagnosis is:

Vitamin B12 deficiency