In a short essay (500-750 words), answer the Question at the end of Case Study 1. Cite
references to support your positions.
Case study 1
The blood count indicates that the patient is suffering from microcytic hypochromic anemia-
iron deficiency anaemia. The patient haemoglobin (8 g/dL) is also low (Normal 12.3-15.3
g/dL) suggesting of microcytic anaemia. The patient Hematocrit (32%) is also low as
compared to normal range of (35-47%). In this case, it is evident that Ms A is suffering to
anaemia due to deficiency in folate, iron, and B12. This implies that she has a decrease in
mass of red blood cells. The red blood cells have roles of transporting oxygenated blood
from the lungs to tissue and deoxygenated blood from body organs to the lungs. Anaemia is
an indicator that calls for an evaluation to determine the underlying aetiology (Goddard et al.,
2011).
Low haemoglobin oxygen has decreased oxygen affinity, these causes alteration of the
cardiac output (Goddard et al., 2011). Iron is important part of haemoglobin which is
responsible for carrying oxygen from the lungs to the rest past of the body. The patient lack
of energy and weakness is caused due to starved oxygen. This explains the why the patient
has been experiencing tiredness, headaches and breathlessness. Blood loss due to
menorrhagia is identified as the main cause for iron deficiency among premenopausal
women. The main challenge is that the patient themselves may not even realize that her
periods are excessive bleeding as she has been experiencing this condition for that past 12
years. When a patient loses blood they lose iron. Therefore, when the patient lost blood
during menstruation, she lost a lot of iron putting her at risk of developing anaemia.
Excessive use of aspirin is associated with gastrointestinal bleeding which is also associated
with iron deficiency (Goddard et al., 2011).
Case study 1
2
Surprisingly, iron deficiency among women is very common but often undiagnosed or
untreated. Most people undiagnosed with iron deficiency are suffering in silence. The main
issue is that most women assume that the feelings of getting tired, weak, and irritable are
normal experiences caused by their busy lives. If the condition is left untreated for a long
time, iron deficiency anaemia puts the patient at risk of getting infection due to low immune
system. It also increases patient’s risk of developing lungs and heart complications including
heart failure and tachycardia (Goddard et al., 2011).
Excessive menstruation is the main cause of iron deficiency young women. Gastro-intestinal
bleeding is another main cause for bleeding. If the gynaecological procedures do not improve
the patient anaemic condition, endoscopy procedures should be conducted to rule out
gastrointestinal bleeding. The underlying condition must be treated. The anaemia should be
treated using ferrous sulphate 200 mg two times daily until the haemoglobin levels get
normal. An antifibrinolytic (Tranexamic acid) should be administered during menstruation.
This will help minimize the amount of bleeding. Contraceptive pills should be prescribed to
reduce menorrhagia (Davey, 2012).
It is important to include iron rich foods in the patient diets including beef, beans, lentils,
dark leafy vegetable and dried fruits. The patient should also be advised to feed on green
peas, kidney peas, peanuts, cereals and dark green vegetables to obtain folate. Vitamin B-12
rich food should be included in the diet including the dairy products, meat, soy products and
fortified fruits (Goddard et al., 2011).
Case study 1
3
References
Davey, P. (2012). Medicine at glance 3 rd edition. John Wiley & Sons. England.
Goddard, A., James, M., McIntyre, A. and Scott, B. (2011). Guidelines for the management
of iron deficiency anaemia. Gut, 60(10), pp.1309-1316.