An otherwise healthy woman in her twenties, Ms. A., has been suffering menorrhagia and dysmenorrhea for 10-12 years and treating herself with aspirin. Having been taken to hospital in a time of increased physical performance with a state described as light-headedness, she was registered as having low hemoglobin (8 g/dl) and low hematocrit (32% of red cells), and low erythrocyte count. The retic count was within normal but high, and there were microcytic and hypochromic cells revealed by RBC.
Firstly, it is worth considering that the person in question has been treating herself with aspirin for 10 to 12 years in the run. One of the hematologic side effects of aspirin intake is the incapability of the stem cells to produce more mature cells. The result is the deficiency of all types of blood cells, i.e., aplastic anemia (Nair & Peate, 2009). Such a diagnosis could be possible considering that the client is still in her twenties.
However, when an RBC smear reveals the predominance of microcytic and hypochromic cells, there are several types of anemia that such a result can be attributed to. These include, for instance, Mediterranean, iron deficiency, sideroblastic, and other types of hereditary anemia (Nair & Peate, 2009). Also, abdominal pain might be the symptom of hemolysis-caused anemia. However, in this case, the RBC result and the pain are combined with other signs: low hemoglobin, hematocrit, and erythrocyte count. These signs may indicate that she has a B12 deficiency anemia type (McCance & Huether, 2014).
Such supposition could be backed up by the evidence of the stiffness in the joints that the woman experiences. It is also worth considering that the client is of a relatively young age and prone to massive blood losses during her menstrual periods. Taking into account that the blood losses have occurred during a long time frame, it can be conceded that the body failed to replace the blood cells, which is why the client’s symptoms are exacerbated during her menses. Such conditions may result in the loss of such elements as iron, B9 (folate), and B12. The losses explain the state of fatigue and light-headedness, as well as the abnormally high heartbeat rate (McCance & Huether, 2014).
Consequently, it is possible to conclude that the individual in question has B9 and B12 deficiency anemia, which incorporates all the signs and symptoms mentioned in the scenario: high red blood cell count, low hemoglobin, hematocrit, and erythrocyte count, fatigue, numbness of joints, and is furthered by menorrhagia and menstrual pains.
McCance, K. L. & Huether, S. E. (2014). Pathophysiology: The Biologic Basis for Disease in Adults and Children (7th ed.). Maryland Heights, MO: Mosby.
Nair, M. & Peate, I. (2009). Fundamentals of Applied Pathophysiology: An Essential Guide for Nursing Students (2nd ed.). West Sussex, UK: John Wiley & Sons.