Ann is a healthy 26-year-old white female. Since the beginning of this current golf season she has Show more Ann is a healthy 26-year-old white female. Since the beginning of this current golf season she has noted increased shortness of breath and low levels of energy and enthusiasm. These seem worse during her menses. Today while playing poorly in a golf tournament at a high mountainous course she became lightheaded and was taken by her golfing partner to the emergency clinic. The attending physicians notes indicated a temperature of 98 F an elevated heart rate and respiratory rate and low blood pressure. Ann states that heavy menstrual flow has been a problem for 10 to 12 years and she takes 1000 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/dl Hematocrit = 32% Erythrocyte count = 3.1 X 10 6 /mm 3 RBC smear showed microcytic and hypochromic cells. Reticulocyte count = 0.5% Evaluate the lab values (normal high low) Hemoglobin: Hematocrit: Erythrocyte count: Reticulocyte count: List 3 differential diagnoses and include your reasoning behind each. What is the best diagnosis? Explain how you came to this conclusion. Explain the pathophysiology of the following symptoms: Elevated heart rate: Low blood pressure: Fatigue: Heavy Menstruation: Show less
