What parameter of the routine complete blood count (CBC) is a sensitive indicator of preclinical iron
a. Red blood cell distribution width (RDW)
b. Hematocrit
c. Mean cell hemoglobin (MCH)
d. Red blood count
ANS: A
As iron deficiency develops, hemoglobin synthesis begins to be impaired leading to the production of microcytic red cells. As these small red cells begin to be released and mix in with the normocytic red cells still circulating, anisocytosis develops. This increases the RDW. Eventually the red count and hematocrit begin to decrease, and the MCH decreases when enough small cells become present to affect it.
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