Basing on the laboratory values, the hemoglobin level of the Ms. A is lower than the normal value. Normally, the hemoglobin level lies between 12 to 17 grams per deciliter (Mader, 2004). The hemoglobin level of Ms. A was measured to be 8 grams per deciliter. Moreover, the hematocrit percentage, which measures the red blood cell concentration in the blood, of Ms. A is 32%, which is relatively low. For females, the hematocrit percentage should be around 36% to 46% (O’Leary, 2014). Furthermore, the erythrocyte count of Ms. A was determined to be 3.1 x 10^9 per millimeter-cube, which is very low based on the normal range for female adults, which is around 4.1-5.1 x 10^9 millimeter-cube (Curry, 2015). With all these proofs, as well as the microcytic and hypochromic cells, it is safe to assume that Ms. A has anemia.
Anemia, essentially, is a condition characterized by insufficient amount of red blood cells, or insufficient hemoglobin level. As a result, the person feels tired because the body cells do not receive enough oxygen (NHLBI, 2011). Note that hemoglobin in red blood cells transports oxygen, which is required by the body tissues for the production of energy in the form of ATP (Mader, 2004). To be specific, Ms. A probably have iron deficiency anemia.
Normally, patients with iron anemia have a low hemoglobin count (Mader, 2004), which is the case for Ms. A. Moreover, based on Ms. A’s testimony, she had chronic menorrhagia, which may have caused the anemia in the first place. In fact, iron deficiency anemia is usually caused by blood loss from heavy menstruation (Mader, 2004).
It is also notable that her RBC smear showed microcytic and hypochromic cells. Usually, microcytic cells almost always appear hypochromic. In fact, hypochromic and microcytic cells usually result from low hemoglobin levels due to iron deficiency (Mader, 2004). Normally, the mean corpuscular hemoglobin concentration (MCHC) is about 320-360 grams per liter. When the MCHC reaches lower than normal, the red blood cells appear paler and smaller, hence hypochromic and microcytic since the hemoglobin contributes to the redness and size of the red blood cells.
Moreover, Ms. A had low hematocrit and erythrocyte count, which does not necessarily indicate iron deficiency anemia. However, it was reported that she had chronic heavy menstruation, which may have contributed to the low hematocrit percentage, and low erythrocyte count. As for the low blood pressure, aspirin is known as a blood thinner, which, after intake, accelerates blood flow. As a matter of fact, aspirin is recommended for the management of unstable angina and acute myocardial infarction, and the prevention of secondary myocardial infarction. Aspirin is known as an antiplatelet blood thinner, a chemical that interferes with the blood clotting formation inside the blood vessels by blocking the thrombogenic platelet-dependent mechanisms during coagulation (Mousa, 1999). Thus, the measured low blood pressure can be attributed to her regular aspirin intake. Furthermore, her chronic heavy menstruation must have worsened her iron deficiency anemia, which is why her symptoms worsen during her menses.
In addition, Ms. A shows the usual symptoms of iron deficiency anemia. As reported, Ms. A experiences shortness of breath and low levels of energy. Moreover, the attending physician noted her elevated heart rate and respiratory rate, and low blood pressure. Patients with iron deficiency anemia exhibit elevated heart and respiratory rate to accommodate for the insufficient oxygen uptake of the body tissues (Mader, 2004). Furthermore, her symptoms worsen during her menses, which means that her chronic heavy menstruation is a major factor of the condition.
In conclusion, Ms. A has iron deficiency anemia based on the preliminary diagnosis and laboratory values. Ms. A exhibits the major characteristics of iron deficiency anemia, which are (1) low hemoglobin level, (2) microcytic and hypochromic cells, (3) heavy blood loss from chronic heavy menstruation, and (4) feeling tired, with elevated heart and respiratory rate.
References
Curry, Choladda Vejabhuti. (13 January 2015). Erythrocyte count (RBC). MedScape. Retrieved <http://emedicine.medscape.com/article/2054474-overview#a1>
Mader, Sylvia S. (2004). Understanding Human Anatomy and Physiology. 5th edition. New York, NY: McGraw-Hill Companies.
Mousa, S. A. (1999). Antiplatelet therapies: from aspirin to GPIIb/IIIa-receptor antagonists and beyond. Drug discovery today, 4(12), 552-561.
NHLBI. (September 2011). “Your Guide to Anemia.” NIH.
O’Leary, Mandy Flannery. (4 September 2014). “Hematocrit.” MedScape. Retrieved <http://emedicine.medscape.com/article/2054320-overview#a1>
