Which statement describes triggers and avoidance for hemolysis in G6PD deficiency?

• A. Oxidative stress triggers hemolysis; avoid fava beans, sulfonamides, nitrofurantoin, dapsone, and certain antimalarials
• B. Hypoxic conditions trigger; avoid iron supplements
• C. Mechanical trauma triggers; avoid red blood cell transfusions
• D. Viral infections trigger; avoid vaccines

Answer: (B)

In G6PD deficiency, red blood cells have a compromised ability to handle oxidative stress because they can’t generate enough NADPH to keep glutathione in its active, protective form. When exposed to oxidizing factors, the cells are damaged and may hemolyze. That’s why the triggers are oxidative stresses from certain foods and drugs, and the way to prevent hemolysis is to avoid those agents. Classic examples to steer clear of include fava beans and medications known to cause oxidative damage—sulfonamides, nitrofurantoin, dapsone, and some antimalarials. Other ideas like hypoxic conditions, iron supplements, mechanical trauma, or vaccines don’t align with the usual mechanism or guidelines for G6PD-related hemolysis, so they’re not the primary focus for triggers and avoidance.