Based on the description of Ms. A’s condition, the patient has the most common type of anemia – iron deficiency anemia, “particularly microcytic anemia, which is characterized by the small number of red blood cells” (Mayo Clinic Staff, 2016, para. 2). It is important to mention that microcytic anemia can also be attributed to inherited disorders, which is also a possibility for Ms. A. Further testing and evaluation of the patient’s condition is needed to identify the underlying cause for anemia and to develop an action plan to improve her health.
The Rationale for Iron Deficiency Anemia Diagnosis
When providing a rationale for Ms. A’s diagnosis, extra attention should be paid to the patient’s reported menorrhagia and dysmenorrhea, which have bothered her for ten to twelve years. Menorrhagia is a condition characterized by “abnormally heavy and prolonged menstrual bleeding,” which can cause anemia (Mayo Clinic Staff, 2017, para. 1). Severe menstrual bleeding is among the key causes of anemia since blood loss reduces the number of circulating blood cells. Also, it was found that menorrhagia could reduce iron levels in the blood and increase the likelihood of iron deficiency anemia (Mayo Clinic Staff, 2017). Dysmenorrhea is a severe pain that accompanies menstrual bleeding and can contribute to the worsening of symptoms of anemia, such as weakness and light-headedness.
With regard to Ms. A’s laboratory values, they also point to microcytic anemia. For example, the patient’s blood smear test showed microcytic and hypochromic cells, which suggests that the red blood cells have lower hemoglobin levels and are usually paler and smaller in size than normal (Gotter, 2017). These results also indicate iron deficiency anemia, often due to heavy periods that have also been a problem for Ms. A. Another indicator that points to iron deficiency anemia is the patient’s erythrocyte count, which is lower than the normal reference range and lower than the average hematocrit level that should be at least 38% in adult women.
The majority of symptoms reported by Ms. A shows that she is highly likely to have iron deficiency anemia. Symptoms of this type of anemia include weakness, shortness of breath, pale skin, general fatigue, low blood pressure, loss of enthusiasm, and so on. Importantly, the patient reported regular stiffness in joints, which can also be attributed to iron deficiency anemia that can transform into a chronic condition that causes the occurrence of the same symptoms. Additionally, iron deficiency anemia is very common among women of childbearing age and combined with the patient’s chronic menorrhagia. The identified diagnosis is the most likely. The patient’s frequent use of aspirin during heavy menstrual bleeding is a contributing factor to iron deficiency. It has been reported that the regular use of over-the-counter pain relievers such as aspirin increases the likelihood of gastrointestinal bleeding, which, combined with menstrual bleeding, makes the overall health condition even worse (Mayo Clinic Staff, 2016). While the patient’s lab results revealed that the patient’s blood cells were smaller in size and paler in color, her frequent health issues and symptoms show a high likelihood of iron deficiency anemia.
Conclusion
In conclusion, it is essential to recommend that the patient undergo further screening and testing to identify her underlying causes of iron deficiency. Extra attention should be paid to Ms. A’s diet, her menstrual cycle, and physical activity. It can be effective for the patient to swap aspirin during periods of taking birth control pills that can decrease severe bleeding and optimize hormone levels.
References
Gotter, A. (2017). Everything you need to know about microcytic anemia. Web.
Mayo Clinic Staff. (2016). Iron deficiency anemia. Web.
Mayo Clinic Staff. (2017). Menorrhagia (heavy menstrual bleeding). Web.