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Iron deficiency anemia — USMLE Step 3 MCQ

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ModeratePediatrics (well-child, chronic management)Iron deficiency anemiaUSMLE Step 3

A 16-month-old boy drinks 36 oz of cow's milk daily and eats little solid food. He is pale. Hemoglobin is 9.8 g/dL, MCV is 68 fL, ferritin is low, and reticulocyte count is low. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: E — Iron deficiency from excess cow's milk intake

Excess cow's milk intake can displace iron-rich foods and cause occult gastrointestinal blood loss, leading to iron deficiency anemia in toddlers.

Reference: AAP Iron Deficiency Anemia Guidance