Question

An African American male is placed on hydroxychlorquine (Plaquenil) for travel to Africa. Within six weeks he presents complaining of fatigue. CBC shows anemia. Which of the following is the diagnostic study of choice in this patient?

1) A- Peripheral smear
2) B- G6PD assay
3) C- Total iron binding capacity
4) D- Hemoglobin electrophoresis

Answer 1

For an African American male with anemia after starting hydroxychloroquine, a G6PD assay is the diagnostic test of choice to confirm if hemolytic anemia is due to G6PD deficiency.

Step-by-step explanation:

In the case of an African American male who presents with fatigue and anemia after starting hydroxychloroquine for travel to Africa, the diagnostic study of choice would be a G6PD assay. Since hydroxychloroquine can cause hemolysis in individuals with G6PD deficiency, and this condition is especially prevalent in African American males, the G6PD assay is crucial to confirm the diagnosis.

The assay will help determine if the anemia is due to hemolytic anemia, which can occur in G6PD deficient individuals following exposure to certain drugs, infections, or foods. Other tests such as peripheral smear or total iron binding capacity may also be conducted for additional information, but the G6PD assay is the most pertinent initial diagnostic test to ascertain the etiology of the anemia in this context.