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Source: Copstead, L. & Banasik, J. (2006). Pathophysiology (3rd ed.). Mosby. M.B. is a generally healthy 36-year-old woman with complaints of persistent generalized fatigue. At her annual checkup, she is noted to have the following vital signs: heart rate 118 beats/min, blood pressure 128/60, oral temperature 37 degrees Celsius, respiratory rate 26 breaths/min. Her skin and nail beds are pale. Laboratory results demonstrate hematocrit (Hct) 31%; hemoglobin 10 g/dl; mean corpuscular hemoglobin concentration 27; mean corpuscular volume 70; total iron binding capacity 600 mg/dl. Case Questions: 1. What type of hematologic disorder would you suspect based on M.B.'s history, physical examination, and laboratory values? 2. What other history data would be helpful in determining the cause of this disorder? 3. Which of M.B.'s clinical signs are reflective of the body's effort to compensate for decreased oxygen carrying capacity? 4. M.B. is counseled to increase her dietary intake of iron-containing foods. What kinds of food would be recommended? 5. M.B. is given a prescription for ferrous sulfate 325 mg three times per day. What advice can you give to her about the timing of doses and expected side effects?

          Source: Copstead, L. & Banasik, J. (2006). Pathophysiology (3rd ed.). Mosby.

M.B. is a generally healthy 36-year-old woman with complaints of persistent generalized fatigue. At her annual checkup, she is noted to have the following vital signs: heart rate 118 beats/min, blood pressure 128/60, oral temperature 37 degrees Celsius, respiratory rate 26 breaths/min. Her skin and nail beds are pale. Laboratory results demonstrate hematocrit (Hct) 31%; hemoglobin 10 g/dl; mean corpuscular hemoglobin concentration 27; mean corpuscular volume 70; total iron binding capacity 600 mg/dl.

Case Questions:
1. What type of hematologic disorder would you suspect based on M.B.'s history, physical examination, and laboratory values?
2. What other history data would be helpful in determining the cause of this disorder?
3. Which of M.B.'s clinical signs are reflective of the body's effort to compensate for decreased oxygen carrying capacity?
4. M.B. is counseled to increase her dietary intake of iron-containing foods. What kinds of food would be recommended?
5. M.B. is given a prescription for ferrous sulfate 325 mg three times per day. What advice can you give to her about the timing of doses and expected side effects?

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