Prescribing Safety Assessment (PSA) Practice Exam

Which of the following is a cause of macrocytic anemia?

1. Chronic infection

2. B12/Folate deficiency

3. Anxiety disorders

4. Hypertension medication

The correct answer is: B12/Folate deficiency

Macrocytic anemia is characterized by the presence of larger than normal red blood cells and is commonly associated with deficiencies in vitamin B12 and folate. These nutrients play crucial roles in red blood cell production and DNA synthesis. When either vitamin B12 or folate levels are inadequate, it leads to impaired DNA synthesis, resulting in the production of unusually large red blood cells — a hallmark of macrocytic anemia. This connection underscores why a deficiency in vitamin B12 or folate is recognized specifically as a cause of macrocytic anemia, making it the correct choice in this context. Other options, such as chronic infection, anxiety disorders, or medications for hypertension, do not directly cause macrocytic anemia but may lead to other types of anemia or health issues. For instance, chronic infections typically could cause normocytic anemia due to inflammation, while anxiety and hypertension medications are primarily unrelated to blood cell production mechanisms.