<prompt> A 30 year old presented with a skin lesion in his right axilla. A presumptive diagnosis of staphylococcal skin carbuncle is made patient is treated with empiric trimethoprim sulfamethoxazole. After 2 days, the patient came to emergency with excessive weakness, abdominal pain dark coloured urine. OE- vitals are normal jaundice is present. Lab studies show a drop in Hb from 14 gdl to 8 gdl rise in bilirubin levels. Urine dipstick is positive for bilirubin. Peripheral blood smear is shown below. What could be the possible diagnosis of the patient?Glucose 6-phosphate dehydrogenase G6PD deficiencyHemolytic-uremic syndromeHereditary spherocytosisIron deficiency anaemia  <response>: PBF shows bite cells, anisocytosis, and spherocytes with jaundice after receiving sulfamethoxazole which makes the diagnosis of glucose 6-phosphate dehydrogenase G6PD deficiency. Triggers for acute haemolytic anemia in G6PD deficiency: Fava beans Infections Drugs- primaquine, dapsone, sulfamethoxazole, and nitrofurantoin Hemolytic attack stas with malaise, weakness, and abdominal or lumbar pain. After an interval of several hours to 2-3 days, the patient develops jaundice and often dark urine. Lab studies- hemoglobinemia, hemoglobinuria, high LDH, and lowabsent plasma haptoglobin Diagnosed by semiquantitative or quantitative RBC tests or by DNA testing Hemolytic-uremic syndrome - cause microangiopathic hemolytic anemia with prominent schistocytes Iron deficiency- causes a microcytic and hypochromic anemia 