NAME:________________________SECTION:_______DATE:_______GRADE:____

CASE STUDIES- RBC                           GROUP ACTIVITY

Case 6

Anemia in a 47-year-old Post-Partum Female

Patient: 47-year-old female

Medical History: None

Drug History: None

Chief Complaint: None

Family History: Unremarkable

Gynecologic History: Gravida 4/ Para 4. Three children by spontaneous vaginal

delivery. 1 by Caesarian section. Menorrhagia has been increasing in severity over the
past several years.

Physical Examination: Blood pressure 186/90, pulse 88. Bulky, irregular uterus on
bimanual examination, pale mucous membranes, otherwise unremarkable.

T1. Principal Laboratory Findings

 Test Abnormal Results Normal Reference Range

Hemoglobin 7.4 12.05-15.2 g/dL

Hematocrit 0.22 0.37-0.46

MCV1 63 79-101 FI

RDW2 21.2 11.5-14.5%

Result of Additional Laboratory Tests

Uterine ultrasound: discrete masses in the uterus, consistent with leiomyomata.

Serum iron: 11 ug/dL (normal, 48-180 ug/dL).

Total iron binding capacity: 543 ug/dL (normal, 262-474 ug/dL).

Ferriting: 6 ng/mL (normal, 7-282 ng/mL).

Questions:

1. What is the most likely cause of anemia in this patient?

1. What additional laboratory test would you order to confirm the diagnosis?

1. Why is the patient asymptomatic in the presence of a moderately severe

anemia?
1. Why is the MCV low & the RDW high?