Answers
26. Answer is [1]
Secondary causes of Sideroblastic Anemia (SA) include lead poisoning, medications which interfere with pyridoxine metabolism, and copper deficiency. Drugs that have been associated with the development of SA include ethanol, isoniazid, pyrazinamide, cycloserine, chloramphenicol, busulfan, melphalan, linezolid, and D-penicillamine. Copper deficiency is most often caused by malabsorption syndromes, total parental nutrition not supplemented with copper, or bowel resections. Overexposure to zinc can also lead to a deficiency of copper due to sequestration of copper in the intestinal epithelium and inhibition of copper absorption.
Note >> Patients with copper deficiency also commonly develop neurologic symptoms in addition to the SA.
27. Answer is [2]
Paroxysmal cold hemoglobinuria (PCH) in children is a postinfectious disease which typically occurs after viral infections. The IgG antibody is directed against the P-antigen. Postinfectious PCH has no tendency to recur, in contrast to syphilis-associated PCH.
28. Answer is [1]
Some G6PD variants (class 1 variants) cause chronic (not episodic) hemolysis, which can be called “chronic nonspherocytic hemolytic anemia.” With severe G6PD deficiency (class 2 variants), the anemia is often episodic and may be severe and life threatening (e.g., favism).