Skip to content
Brainliest
Practice sessionHEALTHCARE & MEDICAL EXAMSMEDICAL LICENSING

USMLE (United States Medical Licensing Examination) Practice Exam 16

Practice exam for USMLE (United States Medical Licensing Examination).

Active sessionUSMLE practice testUSMLE practice examUSMLE practice questionsUnited States Medical Licensing Examinationmedical licensing exam+6
Jump to questionsBrowse catalog
Question 1 of 1000%
Time remaining120:00
Attempts allowedUnlimited
Difficulty mixE • M • H
Back to exams

Question 1

MEDIUM

A 26-year-old woman comes to the emergency department because of fatigue and dark urine for 2 days. One week ago she began taking trimethoprim-sulfamethoxazole for a urinary tract infection. She has no chronic medical conditions. Temperature is 37.1°C (98.8°F), blood pressure is 118/72 mm Hg, pulse is 102/min. Examination shows scleral icterus and mild pallor. Laboratory studies show hemoglobin 8.6 g/dL, reticulocyte count 7%, total bilirubin 4.2 mg/dL (0.2–1.2), LDH elevated, haptoglobin low. Direct antiglobulin (Coombs) test is negative. Peripheral smear shows red blood cells with "bite"-like defects. Which of the following is the most likely underlying abnormality?

Sulfonamides can trigger oxidative stress–induced hemolysis in G6PD deficiency, producing Heinz bodies (removed by splenic macrophages) and bite cells with a Coombs-negative hemolytic anemia. Hereditary spherocytosis (ankyrin) causes spherocytes and positive osmotic fragility; warm autoimmune hemolysis is Coombs-positive.

Select one answer

Question 1 of 100

Community

Loading ranked answers and discussion...

Manage your cookie preferences

We use essential cookies to make Brainliest work. With your permission, we’d also like to use analytics and marketing cookies to improve your experience.