Ms A case study
Case Study 1
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.
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.
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Ms. A is suffering from a type of hemolytic anemia a blood disease where the red blood cells are destroyed and removed from circulation prematurely. Hemolysis is red blood cells destruction process in the body form circulation before attainment of their normal life span of 120 days. This hemolysis here presents itself with symptoms of acute or chronic anemia, reticulocytosis or jaundice CITATION Dha04 \l 1033 (Dhaliwal, Cornett, & Tierney, 2004).
Diagnosis of hemolysis is presented by reticulocytosis, a rise in the unconjugated bilirubin and lactate dehydrogenase, decreased hepatoglobin, and peripheral blood sugar smear. Erythrocytes destruction here may occur intravascularly or extravascularly. The hemolysis here may be due to autoimmunity, microangiopathy, and or infection CITATION Dha04 \l 1033 (Dhaliwal, Cornett, & Tierney, 2004).
Anemia is diagnosed via laboratory tests. However, the history and physical examination provides vital clues of presence of hemolysis and its predisposing causes. Hemolytic anemia's symptoms include; skin paleness, fatigue (due to anemia), fever, confusion, light headedness, dizziness, inability to undertake physical activity, and dark urine CITATION Dha04 \l 1033 (Dhaliwal, Cornett, & Tierney, 2004). In addition, there is yellowing of the skin and the whites of the eyes, heart murmur, increased heart rate, enlarged spleen, and enlarged liver. The normal levels for hematocrit should be 38.8% -50% for men and 34.9 % -44.5% for women. The hemoglobin level should be 3.5-17.5 Grams/dL for men and 12.0-15.5 Grams/dL while that of the red blood cells should be 4.32-5.72 trillion cells/L for men and 3.90-5.03 trillion cells for women CITATION Dha04 \l 1033 (Dhaliwal, Cornett, & Tierney, 2004).
Observing the patient's symptoms, the client is presenting with all the characteristic symptoms of hemolytic anemia that are; shortness of breath, low levels of enthusiasm, light headed, high temperature due to the hemolytic process, elevated heart rate, low blood levels, and low erythroc...