M.B. is a generally healthy 36-year-old woman with complaints ofpersistent generalized fatigue. At her annual checkup, she is notedto have the following vital signs: heart rate 118 beats/min, bloodpressure 128/60, oral temperature 37 degrees Celsius, respiratoryrate 26 breaths/min. Her skin and nail beds are pale. Laboratoryresults demonstrate hematocrit (Hct) 31%; hemoglobin 10 g/dl; meancorpuscular hemoglobin concentration 27; mean corpuscular volume70; total iron binding capacity 600 mcg/dl.
Case Questions What type of hematologic disorder would yoususpect based on M.B.’s history, physical examination, andlaboratory values? What other history data would be helpful indetermining the cause of this disorder? Which of M.B.’s clinicalsigns are reflective of the body’s effort to compensate fordecreased oxygen carrying capacity? M.B. is counseled to increaseher dietary intake of iron-containing foods. What kinds of foodwould be recommended? M.B. is given a prescription for ferroussulfate 325 mg three times per day. What advice can you give to herabout the timing of doses and expected side effects?
