Evaluate the patient’s history and physical data.

Evaluate the patient’s history and physical data. What signs and symptoms indicate the presence of anemia?

AP is tired, has pale skin, and has clammy skin, which are indicators of a lack of normal red blood cells (anemia), which implies that cells supply less oxygen to the body. The patient also exhibits pale sclera, which is a symptom of anemia since the sclera may turn pale when there isn’t enough hemoglobin and oxygen. The patient has a recent history of iron deficiency anemia. The clinician tested her hemoglobin one month after giving birth, revealing a significantly reduced level of 7.4 g/dL from 12.5 g/dL at six weeks gestation. The patient has a history of losing a lot of blood through heavy menses and hemorrhoid bleeding.

What potential risk factor(s) does she have for the development of anemia?

The patient has a history of blood loss through heavy periods. She occasionally passes small amounts of blood in her stool due to hemorrhoids which is a risk factor for the development of anemia. The patient’s daily diet lacks iron-rich, like red meat and green vegetables, vitamin B12-rich, and folate-rich foods such as fresh fruits and fresh vegetables.

  1. List all abnormal laboratory values and explain the likely cause for each odd value.

 

The patient’s low hemoglobin and high total iron-binding capacity levels resulted from a shortage of iron in the body and blood loss. Low iron levels in the body cause the patient’s MCV to drop, preventing red blood cells from producing hemoglobin and decreasing red blood cell size. Low ferritin levels in the patient are due to a low iron intake in the regular diet. The patient also has low serum iron levels, attributable to blood loss and a low iron diet. Low folate and vitamin B 12 levels resulted from a lack of vitamin B12 and folate-rich foods, such as fresh fruits and vegetables.

Based on your information, what type(s) of anemia? Do you believe she is experiencing?

The patient suffers from iron and vitamin B12 deficient anemia/folate deficiency anemia. Low mean corpuscular volume (microcytic anemia) is a symptom of iron deficiency anemia. The patient has lost a lot of blood and has low ferritin levels and serum iron levels. Low vitamin B12 and folate levels in the body characterize vitamin B12 deficiency anemia.

What additional information would you request to determine her type of anemia better? Why?

In Vitamin B12 deficiency anemia, one must distinguish pernicious anemia from other conditions that impair vitamin B-12 absorption and metabolism. This condition may result in cobalamin insufficiency, macrocytic anemia, and neurologic consequences.

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