Case Study #1
Ms. A presents to the ED with complaints of lightheadedness, dysmenorrhea and menorrhagia for the past 10-12 years, with an elevated heart and respiratory rate, temperature of 98° F, and decreased blood pressure. She states that she takes 1000mg of aspirin every three to four hours for six days during menstruation, and also during the summer months to relieve stiff joints to play golf. Her laboratory values reveal the following:
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. According to Ms. A’s presenting signs and symptoms, she should be further evaluated for iron deficiency anemia. Iron deficiency anemia is the most prominent solitary insufficiency worldwide (Harper, 2012). Iron deficiency is described as diminished overall iron content. Iron deficiency anemia transpires if iron insufficiency is critical enough to diminish erythropoiesis (Harper, 2012). Iron is essential for all existing beings because it is necessary for numerous metabolic processes, “including oxygen transport, DNA synthesis, and electron transport” (Harper, 2012). Iron balance within the body is controlled vigilantly to ascertain that adequate iron is absorbed. According to Harper, 2012, “In healthy individuals, the body concentration of iron is controlled carefully by absorptive cells in the proximal small intestine, which alter iron absorption to match body losses of iron.” Bleeding of any kind has the potential to create iron diminution (Harper, 2012). An unexpected deficit of blood creates a normocytic anemia that occurs after a hemorrhagic event. The bone marrow amplifies the construction of hemoglobin, which decreases iron stores in the body. Because of this, when iron is decreased, hemoglobin synthesis is weakened and microcytic, hypochromic
References: Harper, J. (2012). Iron deficiency anemia. Retrieved July 21, 2012 from http://emedicine.medscape.com/article/202333-medication Shersten, K., Bennett, J., Chambers, M. (2007). Iron deficiency anemia. Am Fam Physician. 2007 Mar 1;75(5):671-678. Retrieved July 21, 2012 from http://www.aafp.org/afp/2007/0301/p671.html