Anemia and reticulocytopenia that occur in the 2nd half of infancy period is LEAST likely due to

Correct Answer: A

Rationale: DBA (A) typically presents in the first 6 months, not later infancy (6-12 months), unlike TEC (B), prolonged hemolytic disease (C), aplastic crises (D), or Fanconi anemia (E), which can occur or persist into this period.

Correct Answer: A

Rationale: Splenectomy resolves anemia (B), reticulocytosis (C), hyperbilirubinemia (D), and aplastic crises (E) in HS by removing the site of RBC destruction. Osmotic fragility (A) persists, as it’s an intrinsic RBC defect.

Correct Answer: C

Rationale: Transfusions are indicated for acute chest syndrome (A), stroke (B), and splenic sequestration (E) in sickle cell anemia to improve oxygenation or reduce sickle cells. Chronic pain (C) and avascular necrosis (D) are managed symptomatically, not with transfusion.

Correct Answer: B

Rationale: Low B12, macrocytic anemia, and hypersegmented neutrophils in a breastfed infant suggest maternal B12 deficiency. Checking maternal B12 (B) guides management, preceding treatment (C, D), transfusion (E), or Schilling test (A, less relevant in infants).

Correct Answer: D

Rationale: Cold agglutinin disease management includes avoiding cold (A), treating underlying causes (B), plasmapheresis (C), and rarely splenectomy (E). Glucocorticoids (D) are ineffective due to intravascular hemolysis.