Case Study 1
Ms. A. is an apparently healthy 26-year-old white woman. Since the beginning of the current golf season, Ms. A has noted increased shortness of breath and low levels of energy and enthusiasm. These symptoms seem worse during her menses. Today, while playing in a golf tournament at a high, mountainous course, she became light-headed and was taken by her golfing partner to the emergency clinic. The attending physician’s notes indicated a temperature of 98 degrees F, an elevated heart rate and respiratory rate, and low blood pressure. Ms. A states, “Menorrhagia and dysmenorrheal have been a problem for 10-12 years, and I take 1,000 mg of aspirin every 3 to 4 hours for 6 days during menstruation.” During the summer months, while playing golf, she also takes aspirin to avoid “stiffness in my joints.”
Laboratory values are as follows:
Hemoglobin = 8 g/dl
Hematocrit = 32%
Erythrocyte count = 3.1 x 10/mm
RBC smear showed microcytic and hypochromic cells
Reticulocyte count = 1.5%
Other laboratory values were within normal limits.
Considering the circumstances and the preliminary workup, what type of anemia does Ms. A most likely have? In an essay of 500-750 words, explain your answer and include rationale.
Case Study One
Grand Canyon University
Patients suffering from iron deficiency risk developing anemia. It is condition most prevalent in females due to excessive loss of blood during menses. Ms. A utilizes lots of energy more than her body can produce during her sporting activities. As a result, she passes out, and the attending personnel performs some physical and lab tests on her to determine her condition. The paper will draw from the lab report examination results to identify the kind of anemia from which Ms. A suffers.
Ms. A has Iron Deficiency Anemia (IDA) which has become worse due to her situation, for instance, engaging in vigorous activity when in her menses. The human body contains iron deposits responsible for producing red blood cells. If the deposits are inadequate in their production of red blood cells, IDA gets severe. Some of the primary symptoms of IDA include general body weaknesses and shortness of breath. Ms. A displayed shortness of breath due to her low energy levels. Therefore, the probability of suffering from IDA is high. Further, Ms. A suffered from acute dizziness while participating in sports which could imply nonspecific manifestation of IDA (Greer, 2009).
One of the recommended method of diagnosing IDA includes a laboratory examination to determine if the levels of both hemoglobin and hematocrit lie low. According to the lab tests, Ms. A had a hematocrit level of 32 percent while hemoglobin was at 8 g/dl. These figures are way below the average therapeutic values which thus leads to the clinical conclusion of Ms. A suffering from IDA. Women have a higher probability of contracting IDA than men as they lose blood rich in iron during menstruation and gastrointestinal bleeding. Besides the laboratory tests, clinicians can diagnose IDA through physical tests which reveal low blood pressure and patterns of tachycardia. It is also significant that clinicians determine erythrocyte in evaluating the presence of IDA as a low count indicates its presence (Parthasarathy, 2013). However, for predisposed individuals, low erythrocyte count does not necessarily translate to IDA since other factors can contribute to the state, for instance, stress and dehydration.
Continued use of aspirin can accelerate hemorrhage which in turn leads to the development of IDA (Greenberg, Glick, & Ship, 2008). Ms. A takes 1,000 mg of aspirin at least 3 to 4 hours during her menses which has facilitated her condition. When patients living with IDA lose excessive blood, it is a risk factor for developing pathologic IDA. Hemorrhage can result from many factors, and for Ms. A, the condition is due to menorrhagia which she has experienced for 10-12 years. Continued hemorrhage deprives the body of iron deposits which leads to post-hemorrhagic anemic episode. However, the bone marrow activates to replace the lost hemoglobin levels in the body. As a result, the body produces hypochromic and microcytic erythrocytes, and the RBC smear conducted on Ms. A revealed their presence.
Patients suffering from iron deficient erythropoiesis have their serum hemoglobin to levels below the optimal concentration as witnessed in Ms. A’s case. Further literature reveals that one of the leading causes of IDA among women is menorrhagia which leads to heavy menses. The problem is most prevalent among females within the reproductive age bracket, and Ms. A, 26, is within this category. It is thus important for the attending personnel to consider the symptoms displayed by Ms. A including shortness of breath nervousness, dizziness, palpitations, and fatigue as indications of IDA. Young women suffering from mild IDA are unlikely to display any symptoms. It is thus conclusive to say that Ms. A’s condition is severe since she shows various signs including tachycardia and tachypnea.
Ms. A has Iron Deficiency Anemia (IDA) accelerated by menorrhagia which she has lived with for over ten years. Taking aspirin during her menstruation has further worsened the condition. On the same note, she is within the reproductive age, and women within this bracket are more prone to IDA.
Greenberg, M.S., Glick, M., & Ship, J.A. (2008). Burket’s Oral Medicine, 11th Edition. Ontario: BC-Decker
Parthasarathy, A. (2013). Partha’s Fundamentals of Pediatrics, 2nd edition. New Delhi: Jaypee.
Greer, J.P. (2009). Wintrobe’s Clinical Hematology – Volume 1, 12th Edition. Philadelphia, PA: Wolters-Kluwer|LWW.
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