All of the following improve the clinical outcome of sickle cell anemia (Hb SS) except which of the following

a. Aggressive prevention and treatment of infection
b. Presence of Hb F
c. Transfusions during crises
d. Keeping the oxygen saturation low


ANS: D
Hb S forms insoluble polymers when the oxygen saturation is low. Thus this would precipitate sickling, not improve the outcome of sickle cell anemia. All the other therapies mentioned have been shown to be clinically helpful.

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