CEA Nursing Practice Exam

In a patient of Mediterranean descent presenting with microcytic anemia and normal RDW, what lab test should be performed to confirm the type of anemia?

1. Aplastic.

2. Thalassemia.

3. Iron deficiency.

4. Pernicious.

The correct answer is: Thalassemia.

Microcytic anemia is characterized by smaller than normal red blood cells and is commonly associated with several types of anemia, including thalassemia and iron deficiency anemia. The normal red cell distribution width (RDW) in this scenario suggests that the microcytic anemia is due to a consistent, uniform red blood cell size, which points more toward thalassemia as opposed to iron deficiency anemia, where RDW is usually elevated due to the presence of both small and normal-sized red blood cells. In this case, the background of the patient's Mediterranean descent is an essential factor. Individuals of Mediterranean ancestry have a higher prevalence of thalassemia, particularly beta-thalassemia and alpha-thalassemia. Confirmatory tests such as hemoglobin electrophoresis can identify specific types of thalassemia by distinguishing the various hemoglobin types present. On the other hand, aplastic anemia typically presents with normocytic red blood cells, not microcytic. Iron deficiency anemia often shows elevated RDW due to the presence of varying red blood cell sizes, involving both smaller and normal-sized cells. Pernicious anemia is associated with macrocytic red blood cells and would not be consistent with the microcytic finding in this case. Thus