Case Study #1
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 temp 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/dlHematocrit = 32%Erythrocyte count = 3.1 x 10/mmRBC smear showed microcytic and hypochromic cellsReticulocyte count = 1.5%Other laboratory values were within normal limits.QuestionConsidering 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.Samuel J. presents with new information concerning his health that includes shortness of breath in the morning and sometimes in the day. Also, he reports fatigue and shortness of breath during the day and occasionally he experiences troublesome cough at night. He has also observed his ankles swell from time to time and he has more trouble urinating now than before his last visit for the urinary tract infection and at times he wakes up at night to urinate. Write a case study for the patient. Present disease processes for which USPSTF screening is necessary for the patient and the findings for the diseases. Enlist the tests that the patient should go through during his diagnosis of the diseases.