19th August 2020

A 13-year old girl is seen in the outpatients’ clinic for persistent anaemia with her mother

A 13-year old girl is seen in the outpatients’ clinic for persistent anaemia with her mother. On examination the consultant notices pale palms, pale conjunctivae and a slightly enlarged smooth tongue. The patient tells you that when she wakes up in the morning and stands from her bed she feels unsteady, but her mother adds that she has also noticed her unsteadiness when her daughter closes or rubs her eyes. The patient tells you she has a family history of thyroid disease and that her cousin follows a special diet. You review the results of the full blood count with the consultant and discuss your diagnosis. 

Which of the following set of full blood count test results is most likely to represent that of the patient?

You may use the following reference ranges:

• Haemoglobin, Hb: 130 – 180 g/L (male) 115 – 160 g/L (female)
• Haematocrit, Hct : 0.40 – 0.54 (male) 0.35 – 0.47 (female)
• Mean cell volume, MCV: 76 – 96 fL
• Platelets, Plt: 150–400 x10⁹/L 
• White blood cells (total), WBC: 4–11 x10⁹/L
  

Select the SINGLE most appropriate option from the list below. Select ONE option only.