UKMLA PLAB AMC USMLE Prometric MCQ

Question Number 0791

Question:
A 18-year-old girl with chronic anemia presents with a two day crisis consisting of fever, joint pain, and left upper quadrant discomfort. A bone scan reveals abnormal tracer uptake in the spleen. There is mild prominence of tracer accumulation within both kidneys which appear slightly enlarged. There is abnormal tracer accumulation adjacent to several major joints, including both sides of the knees and in the humeral heads bilaterally The cause of her anemia is likely to be:

a) the presence of hemoglobin S
b) the presence of hemoglobin M
c) a deficiency of folate
d) bone marrow failure
e) an inability to manufacture heme