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25th June 2023
A 34-year-old lady has come into the GP complaining of fatigue. She explains that acne has developed over the last few months
A 34-year-old lady has come into the GP complaining of fatigue. She explains that acne has developed over the last few months.
Her most recent bloods show:
| Hb | 128 g/L | Female (115-150 g / L) |
| MCV | 120 fL | 78-100 fL |
| MCH | 34.1 pg | 27.0-32.0 pg |
| HCT | 0.32 L / L | 0.37-0.47 L / L |
| Reticulocytes | 0.09 % | 0.5-1.5 % |
| Iron | 101 mcg / dL | 50-150 mcg / dL |
| Ferritin | 269 ng / mL | 10-300 ng / mL |
| Vitamin B12 | 437 pg / mL | 180-1,000 pg / mL |
| Folate | 0.8 ng / mL | > 4.0 ng / mL |
Which medication is most likely to cause this clinical picture?
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