Case Study 1: Anemia
Ms. A has noticed increased shortness of breath, and low levels of energy and enthusiasm especially during her menses. During a golf tournament, she became light-headed. She presented in the emergency clinic today with an elevated heart and respiratory rate, and low blood pressure. She reports history of menorrhagia and dysmenorrhea for 10-12 years. She takes 1,000 mg of aspirin every 3-4 hours for 6 days during her period and during the summer while playing golf for joint stiffness. This paper will explore the patient’s diagnosis, classify the anemia, and give the rationale for the diagnosis.
Patient Diagnosis Ms. A. has iron deficiency anemia (IDA) a form of microcytic anemia, which is characterized by small erythrocytes with reduced amounts of hemoglobin. IDA is the most common type of anemia in the world. In the United States (US) females of childbearing age have a higher incidence than
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A. has suffered from menorrhagia (abnormally heavy menstrual bleeding) and dysmenorrhea (painful menstruation) for 10-12 years. A blood loss of 2-4 mL/day is sufficient to cause IDA. During a normal menstrual cycle blood loss averages 25-60 mL and a loss of iron averages 0.5-1 mg daily (London, Ladewig, Ball, Bindler, & Cowen, 2011). In addition, Ms. A. has been taking aspirin with which an adverse side effect is gastrointestinal bleeding (Deglin, Vallerand, & Sanoski, 2011). Anemia is defined as a reduction in the number of red blood cells (RBCs), the quantity of hemoglobin, and the volume of packed red cells to below normal levels (London et al., 2011). A normal level of erythrocytes or RBC in a female is 4.2-5.4 x 10/mm, hemoglobin and hematocrit should be 12-16 g/dL and 37%-47% (Pagana & Pagana, 2010). Ms. A’s results are all below normal levels. Some of her RBCs are small and pale, which indicates that there is a reduced amount of hemoglobin available. Symptoms of IDA include fatigue, weakness, and shortness of breath (Huether & McCance,
An increased MVC is a sign of a macrocytic anemia and is typically caused by folate and B12 deficiency, liver disease, hemolytic anemias, hypothyroidism, and alcoholism (Medscape, 2015). The risk factors for this type of anemia are the lack of meat and dairy products in one?s diet, intestinal disease, lack of intrinsic factor (IF), medications such as antacids or particular diabetes type II meds, and having an endocrine-related autoimmune disorder (Mayo Clinic, 2014). Her physical exam is negative, her asthma is well controlled, and she had no other complaints. Therefore, according to her physical exam, she appears to be a healthy young female. However, her lab values of Hemoglobin 10, Hematocrit 30.1, and an increased MCV are indicative of B-12 deficiency anemia. According to Buttaro, Trybulski, Polgar Bailey, & Sandberg-Cook (2013), mild cases of this type of anemia do not produce many symptoms, therefore, the complete blood count (CBC) usually verifies the diagnosis. The fact that she is vegetarian puts her at an increased risk for B12 deficiency, due to the lack of meat in her diet. Foods that contain B12 are only attained from animals such as meat, dairy, and fish. A deficiency from B12 from deficiency or malabsorption may not manifest for many years (Hunt, Harrington, & Robinson, 2014). The patient states that she does not drink
3.refer to adolescent gynecology here for her heavy periods and to see if the low hemoglobin
In this case study, Ms. A is a 26-year-old white woman who is experiencing low levels of energy and shortness of breath. Ms. A also stated that these symptoms seem to get worsen during her menses. While playing golf in a mountainous area, she had gotten lighted headed. The attending physician had collected the objective data. The objective information is elevated heart rate and respiratory rate while having a normal temperature. Some of Ms. A’s history is have menorrhagia and dysmenorrheal problems for the last 10 to 12 years and takes 1,000 mg of aspirin every 3 to 4 hours during her menstruation. Also during the summer when she plays golf, she takes some aspirin to help avoid stiffness in the joints.
Complete Blood Count: The white blood cells count is relevant. The cholesterol is elevated, but the hemoglobin is reasonable. She doesn’t have anemia.
LP is a female patient in her early 40’s who presented to the ED with a complaint of shortness of breath. The patient stated that she recently returned from an 11-hour international flight during which she experienced throbbing pain in her right calf accompanied by swelling and discoloration. She initially came in a few months ago to her primary care provider (PCP) for an uncontrollable itch which she suspected was an allergy. The PCP sent her to get a complete blood count (CBC) in the lab. Results came back which showed a 50% hematocrit level and 18g/dl hemoglobin. LP was referred to a hematologist for further testing which included a genetic component for the JAK2 gene mutation that came back positive from the blood sample, meeting the diagnostic
A 35-year-old woman was referred to the hospital as he presented with abdominal pain, haemoglobinuria, yellowish discoloration of eyes and breathlessness after light exercises. There was no history of anaemia, and he is not on any medication. These symptoms have persisted for the past two weeks.
Iron Deficiency Anemia affects millions of individuals across the world. This disease strikes many more women than men and has harmful effects on all who suffer from this deficiency that causes oxygen-carrying capacity to decrease. The causes can vary amongst different groups, but the aggravating symptoms remain constant. Much of the research on Iron Deficiency Anemia concentrates on not only the treatment of this disease, but also the prevention of it. To attain a better understanding of how to treat this problem, one must clearly know what Iron Deficiency Anemia means, what causes this disease, the effects of it, and finally how to cure it.
An 18-month-old healthy boy presents with his mother to your clinic for a well-child visit. The physical exam is normal as well as vitals and mother had no concerns about the child's health. The patient's mother would like to discuss screening for anemia. Which of the following is correct regarding screening for iron deficiency anemia in this case?
Iron deficiency anemia is quite common in children, as iron is needed to support growth. A lack of iron in the diet can cause delays in brain development, which may be irreversible. Common symptoms of iron deficiency anemia include irritability, palor, weakness, and cold hands and feet. Prevention of anemia is crucial for expectant mothers, as anemic women are at a higher risk for delivery complications such as hemorrhaging and having infants of low-birth weight. (Frantz, C. 2010).
Besides the patient’s diet, a number of other problems can cause a low H/H resulting in pale conjunctiva and mucous membranes. She claims to have lost more blood recently due to changes in her menses, and although this could be the reason she is loosing blood, there are again, numerous other possibilities. I would have to ask the patient numerous questions from here…
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Anemia is a disorder of the blood. It occurs when your body does not produce enough erythrocytes or red blood cells (RBCs). Without the erythrocytes oxygen can not be adequately delivered to the tissues and organs throughout the body. This will cause you to become weak and tired. A person may also experience headaches, skin pallor, and faintness. Your body may attempt to compensate for these symptoms by speeding up the heart rate and respiratory rate. This is the body’s attempt to return oxygen levels to normal(Thibodeau and Patton, 2005).
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