An 85-year-old woman has a hemoglobin of 10.5 g/dL. This is:
a. High for a woman of this age
b. Normal for this age regardless of sex (i.e., for both male and female patients)
c. A sign of an underlying disease and requires further evaluation
d. Most likely a myelophthisic anemia
ANS: C
The majority of geriatric individuals maintain a normal hemoglobin for their sex so that this hemoglobin of 10.5 g/dL in an 85-year-old woman is low and a sign of an underlying disease. This requires further work-up. Most anemias in older adults are iron deficiency or the anemia of chronic inflammation (disease). Myelophthisic anemia, in which the bone marrow is invaded by something foreign, such as metastatic malignant cells, certainly occurs but is not the most common cause of anemia in older adults.
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