Effects Anemia/Low Blood Volume Has On The Cardiovascular System

M4 Case Study

A 60-year-old male present to the ED with complaint of dyspnea with exertion that has progressively gotten worse over the last 2 months. He also complains of progressive fatigue. He is in relatively good health, but he has a history of GERD and HTN. He has not had any surgeries in the past and his father was diagnosed with colon cancer at the age of 65. He has been training for a marathon for the last 4 months and has been taken ibuprofen 800 mg TID for most of that time. He denies any melena, black stools, or paresthesias. He is pale on exam but otherwise his exam is unremarkable.

Lab Result
Sodium 135 mEq/L
Potassium 4.5 mEq/L
Creatinine 1.0 mg/dL
BUN 15 mg/dL
WBC 7,000
Hematocrit 21%
Hemoglobin 7.0 g/dL
MCV 70 fL
Platelet 200,00
Serum Iron 55 mcg/dL
Total Iron Binding Capacity 520 mcg/dL
Ferritin 10 ng/ml

 

Questions

  1. The clinical scenario is most consistent with which diagnosis? You may simply list your answer below using a bullet point format. This does not have to be in a complete sentence.
  2. What data in the clinical scenario supports your diagnosis? Make sure to interpret the lab values you list. You may simply list your answers below using bullet point format. This does not have to be in a complete sentence. Interpret the labs that you list as part of your answer by indicating normal, high or low.
  3. What is the most likely cause of this patient’s anemia? You may simply list your answer below using a bullet point format. This does not have to be in a complete sentence.
  4. Describe the key pathophysiologic concepts of the diagnosis in question 1. To answer this question completely, you must answer all of the sub-questions below using complete sentences. Each sub-question may be answered in 1-6 sentences.
    1. What is the electron transport chain and how is it altered by anemia?
    2. Why is the iron level 55 mcg/dL?
    3. What effects does anemia/low blood volume have on the cardiovascular system?
    4. What are the effects of tissue hypoxia on the cardiovascular system, pulmonary system and CNS?
  5. What risk factors does this patient have which warrants referral for additional diagnostic screening testing? You may simply list your answer below using a bullet point format. This does not have to be in a complete sentence.

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