Ms. A is suffering from iron-deficiency anemia as will be revealed through a thorough analysis of her symptoms and what they mean in clinical measure as it regards to the symptoms she is experiencing.
Preliminary Issues
Primary Symptoms : shortness of breath, low level of energy and enthusiasm, light-headed.
These are symptoms that when they present themselves in a person can be due to a number of both clinical and no-clinical reasons. They do not particularly mean that there is an underlying problem with the person as they can be as a result of common concerns such as tight clothing, exercising after a prolonged period of sedentary lifestyle among other things. Nonetheless, these signs also point out underlying clinical issues but not particularly one being anemic. Nonetheless, they are the first apparent symptoms witnessed in a person suffering from the anemic condition.
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Underlying Issues
Condition : Menorrhagia and Dysmenorrheal for the last 12 years
Ms. A has been suffering from Menorrhagia and Dysmenorrheal for the last 10-12 years, which has been treated by taking a high dose of aspirin. The prolonged loss of blood over the years, without a regimented recovery plan, has meant that Ms. A blood quality has been depleted as evidenced by the laboratory results. One critical aspect of Ms. A anemia is the fact she mentions that her condition has seemed to worsen with time, which captured the debilitating element of her condition brought about by her Menorrhagia and Dysmenorrheal. The high dose of aspirin she takes (1000mg every 3-4 hours) continues to worsen her condition, especially during her menses as it increases her bleeding ( Mogilevski, 2016) . This is exacerbated when she takes aspirin during the summer months whilst playing golf when she takes more aspirin to avoid stiffness of joints.
Mitigating Issues
Symptoms Noted : increased temperature (98F), elevated heart rate and respiratory rate, low blood pressure
Ms. A experiences an elevated heart rate and respiratory rate, with low blood pressure, as noted by the attending physician. Ms. A has been having prolonged heavy menstruations that have meant that she has been losing a lot of blood during this period. Together with the lost blood, a lot of iron is lost too and is not replenished in the period following the cycle. This means that Ms. A has low blood RBC count and thus, her system oxygen uptake in hindered. The lack of hemoglobin-carrying red blood cells has meant Ms. A system has to work harder in trying to get enough oxygen for the body ( Marks & Harbord, 2013) . This means she has to breathe much faster and harder than a normal person would, her heart has to pump much faster to push the oxygen-deficient blood through the body, and much more energy is needed to perform these acts. When she goes on high altitudes to play golf where the atmosphere has less oxygen than in low altitude, her system has to work much harder than is normal, thus making her strain to breathe.
Laboratory Results
Hemoglobin = 8 g/dl (12.0 to 15.5 grams per deciliter.)
Hematocrit = 32% (37% to 48%)
Erythrocyte count = 3.1 x 10/mm (4.2 to 5.4)
RBC smear showed microcytic and hypochromic (the red blood cells have less hemoglobin than normal) cells
Reticulocyte count = 1.5% (0.5%-1.5%)
The lab results justify that Ms. A is suffering from iron deficient anemia. Ms. A has below normal hemoglobin level, hematocrit level, and erythrocyte level, with red blood cells that have less hemoglobin than is considered normal; which evidences her anemia as being blood-related. However, Ms. A has normal reticulocyte levels, which means that her bone marrow is producing the right amount and type of red blood cells, thus cancelling out her anemia as being bone-marrow caused. Taking into consideration her condition (Menorrhagia and Dysmenorrheal), her anemia can only be considered to be one caused by iron deficiency (Bunch, 2018).
References
Bunch, C. (2018). Hemolytic anemia. Oxford Medicine Online . doi:10.1093/med/9780199568741.003.0280
Marks, D., & Harbord, M. (2013). Severe iron deficiency anemia. Emergencies in Gastroenterology and Hepatology, 35-42. doi:10.1093/med/9780199231362.003.0003
Mogilevski, T. (2016). Endoscopic investigation of anemia: Yield in iron deficiency anemia, iron deficiency without anemia and idiopathic non-iron deficiency anemia. Gastrointestinal Endoscopy, 53 (5). doi: 10.1016/s0016-5107(01)80490-9
