In a short essay (500-750 words), answer the Question at the end of Case Study 1

Question

In a short essay (500-750 words), answer the Question at the end of Case Study 1. Cite references to support your positions. Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

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.

Question 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.

Explanation / Answer

Anemia is a condition which occurs due to deficiency of red blood cells or hemoglobin in the blood. The deficiency of red blood cells can be caused either by production of abnormal red blood cells, loss of red blood cells or increase in their destruction in the body. Anemia is differentiated into various types depending upon the cause of occurrence, such as sickle cell anemia caused due to abnormality in red blood cells, vitamin deficiency anemia in case of folate, vitamin B-12 or vitamin C deficiency, iron deficiency anemia, aplastic anemia which is due to reduced production of red blood cells, etc.

As per indicated details in the given case, Ms. A is most likely to have iron deficiency anemia. Iron deficiency anemia is a condition in which anemia is associated with deficiency of iron. There are various reasons which can lead to iron deficiency example, when iron is not taken in sufficient quantity in diet, when iron is not getting absorbed normally, when body is using lot of iron in some abnormal mechanism or when there is a loss of iron from the body. The condition of loss of iron is most commonly found in women especially young ones facing abnormal mensuration or during pregnancy, as they face loss of blood. The other ways through which iron is lost are: occurrence of an accident which has resulted to damage in body parts, some cancer, peptic ulcer or use of some drugs which cause internal bleeding in body such as gastrointestinal bleeding in case of NSAIDs, etc.

Ms. A is a young woman having menorrhagia and dysmenorrhea. Menorrhagia is a term used for heavy bleeding during mensuration and dysmenorrhea indicates pain during mensuration. The problem is present to such an extent that she has to take 1000 mg of Aspirin every 3-4 hours during mensuration which lasts for 6 days. This clearly shows that she faces heavy loss of blood during mensuration. Red blood cells contain hemoglobin which is responsible for oxygen transfer. Hemoglobin is an iron containing protein, thus iron is involved in transfer of oxygen throughout the body. When there is heavy loss of blood, it leads to loss of red blood cells, thus causing deficiency of iron especially in females due to menorrhagia.

Ms. A consumes high dose of aspirin during mensuration. Aspirin is an NSAID which causes bleeding in gastrointestinal tract especially when it is taken for long period of times as in this case for 10 to 12 years. This bleeding is also a cause behind deficiency of iron.

Normal level of hemoglobin is 12 to 15.5 gm/dl in females, the reports show low level of hemoglobin i.e. 8 g/dl which indicates iron deficiency. Normal level of hematocrit is 37% to 48% for females, low level of hematocrit i.e. 32% indicates deficiency of red blood cells. Iron is also involved in temperature regulation, therefore fever indicates deficiency of iron in this case. The other symptoms such as high respiratory and heart rate, low B. P., weakness, breathlessness etc. indicate the presence of iron deficiency anemia. Thus, the condition is most likely to be iron deficiency anemia which can be treated by transfusion of blood, iron supplements or iron rich diet along with cure of the ailments which leads to the cause of iron deficiency.

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