Case study : Ms. A. is an apparently healthy 26-year-old white woman.
Assignment: Laboratory Values
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.
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.
On your lab report, each commercial laboratory has its own set of normal values, referred to as the Normal Range or Reference Range.
These figures are subject to change depending on the equipment or approach employed.
Examine your results against the range indicated on your test report.
Out-of-range results aren’t always indicative of a problem.
Several factors can influence your test results, including your age or biological sex, if you are pregnant, the time of day the sample was taken, active infections, HIV disease stage, and food (some test samples need to be taken after you have fasted [not eaten anything] for several hours).
F and M are used to highlight where typical values for people assigned female at birth (AFAB) and those assigned male at birth (AMAB) differ.
The table below compares American units to the Système International d’Unités (SI units), a metric system widely used around the world.
The factor to multiply U.S. lab values to convert them to SI units is in the last column, To Convert U.S. to SI Units.
Divide the SI value by the conversion factor to convert SI units to US units.
Total Hemoglobin is a test that looks at how much blood is in your body (Hgb or Hb)
A test that determines how much hemoglobin is in the blood.
The pigment part of the erythrocyte, as well as the oxygen-carrying element of the blood, is called Hgb.
Values that are considered normal:
12-17 grams/100ml for males
11-15 grams/100ml for females
Implications for Patients:
Anemia is indicated by a low hemoglobin level.
When calculating total blood Hgb, estimates of Hgb in each RBC are relatively essential.
The overall amount of RBCs, on the other hand, has a greater impact on hemoglobin results.
In other words, the number of RBCs is just as significant as the hemoglobin level in diagnosing anemia.
Most patients admitted to hospitals today get a “routine” blood test to determine their hemoglobin level.
The measurement of hemoglobin (Hgb) is crucial in the diagnosis of anemia and bleeding.
It’s also crucial for diagnosing a variety of lesser-known disorders.
Capillary blood, such as that obtained from a finger stick, can be used for the test.
The test is frequently conducted in conjunction with other procedures, necessitating a bigger blood sample, such as through venipuncture.
The amount of iron in the body determines the amount of hemoglobin produced.
One type of anemia is caused by a lack of accessible iron, which results in decreased hemoglobin production.
Keep in mind that anemia is not a diagnosis in and of itself, but rather a sign of something else going on in the body.
For example, the patient’s diagnosis would be malnutrition (low iron levels), not merely anemia.
Anemia would be the secondary diagnosis, but malnutrition must be addressed in order to “heal” the anemia.
Fetal Hemoglobin (Fetal Hemoglobin):
Fetal Hb (Hb F) is a natural Hb product found in a fetus’ red blood cells and in smaller amounts in babies’ red blood cells.
It accounts for 50 percent to 90 percent of Hb in newborns; the remaining Hb in adults is made up of Hb A1 and Hb A2.
Under normal circumstances, the body stops producing fetal Hb around the first year of life and starts producing adult Hb after that.
If this transition does not occur and fetal Hb continues to account for more than 5% of total Hb at six months, an abnormality, notably thalassemia, should be suspected.