206515dc d2f2 4e05 a9db 59718260cef9

m

malsheh

•Follow

Family Medicine

Some actions are only available when you log in.

Report case

Report this to our moderators

Anemia

You can view up to 4 cases without signing up Sign up for unlimited access

46years old lady known to have Diabetes mellitus, B Thalasemia trait and Obesity. Her HGB 10.4 and Ferritin 10. Celiac screening is negative. She is on Ferrous sulfate 200mg BID. No hx suggestive of bleeding and she is taking iron rich food. Her HGB will drop to 8 if she stop taking ferrous supplement. what is you approach in managing her?

12 comments

Sign up to add a comment

Why you should join Figure 1

Sign up to explore now

Similar cases

\ \ 59 years old patient presented to us with progressive pallor, palpitations fatigueabilty and easy fatigueabilty on exam she was markedly pale but no hepatospleenomegaly.investigations showed microcytic hypochromic anemia with raised ESR.serum feritin was high (221).stool for occult blood possitive.work up for multiple myeloma was done which was unremarkable,what to do next](https://app.figure1.com/case-detail/5808766e-aca9-42e9-af06-315e97607783)

\ \ Recently taken over a care of a 30 yo f with pmh of anxiety tx with SSRI, GERD tx with PPI who was followed by another provider in our clinic for IDA. She's been on an iron supplement for the past few years. I saw the patient for an annual exam and checked her ferrtin again, but also included iron studies this time as her actual Hgb and Hct levels were never low. Interestingly, her ferrtin is even lower than before: now at 15, but the rest of her values are as follows:\ Hgb 14.6\ Hct 43.2\ % saturation 47 (NML 11-50)\ iron binding capacity 389 (NML 250-450)\ total iron 181 (NML 40-190)\ Now both patient and I are puzzled over why her ferritin level is not reflective of her iron level status and I am not finding any answers in literature. Any ideas? Thank you.](https://app.figure1.com/case-detail/60bf1309-fc44-480a-97fa-4a9c4d6bad16)

\ \ A 28 year old women present to office. Healthy but over the past few months she has been extremely tired. She sleeps at night but she describes her sleep as not refreshing. She has been achy all over and has an increase in headaches recently. She has been so tied lately that she has not been able to go to her weekly night out. She has been taking a multivitamin but takes no other medications. She feels mildly depressed but thinks that this is due to not getting past the fatigue.\ \

  1. what would u focus your assessment on?\
  2. what labs would you get? And why?\
  3. three different diagnosis based on her symptoms and labs?\ WBC 7.4\ RBC 4.48\ Hgb 11.7\ HCT 32.0\ MCV 77.6\ MCH 30.4\ MCHC 34.3\ Platelets 215\ Glucose 101\ NA 130\ K 4.2\ CL 97\ CO2 25.8\ BUN 16\ Creat 0.8\ Alk phos 110\ T bill 1.2\ AST 33\ ALT 29\ TSH 4.84\ Free T4 1.02](https://app.figure1.com/case-detail/62612a2a-6355-4002-bf20-7c7df98833fd)

\ \ 18 yo/Female complaining of overall tiredness what's is next?](https://app.figure1.com/case-detail/64d4d1bc-361b-4b55-a3c4-d4db507c8f6a)

Trending now

\ \ A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.\ He had a history of hypertension, long-term smoking, and a sedentary lifestyle.\ On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.](https://app.figure1.com/case-detail/ae0fe999-6875-4474-94f0-ad823dbb9b3a)

\ \ A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets.\ Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.](https://app.figure1.com/case-detail/c271070f-2bc7-4052-9895-635277e1a7d5)

\ \ A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.](https://app.figure1.com/case-detail/48f41642-b9db-4089-b120-a94ee52328de)

\ \ 70 yo WF with 20y hx HTN lost 21 lbs on a semaglutide but still BMI over 30, shows drop in BP when standing, stabilizing at 102-116 systolic, 65-75 diastolic. Discontinued all HTN meds x 30 days and no episodes of HTN. Could a small weight loss like this cause a drop to normal BP? Has anyone heard of a side effect of lowering BP?](https://app.figure1.com/case-detail/636fd008-29e2-47f4-8ba4-fbee9d527051)