Question

PATIENT 1

Anne L., a 48-year-old women (5 ft. 4in, 125lb), reported to her gynecologist that she had been extremely tired, physically weak and did not have the energy to do her job. Upon questioning, she noted having very heavy menstrual periods lasting 1 ½ to 2 weeks. Her hemoglobin was 6.1 g/L; hematocrit 19%, MCV 70 fL; MCHC 27 g/dL

a-Does Anne need a transfusion? Explain why or why not.

b.Support the viewpoint opposite to the one you expressed in question . Give a reason why a physician would take this stand.

c.What type of anemia is indicated by Anne’s CBC and medical history?

d.If Anne is transfused, what would be the recommended component and how many?

e.If she is transfused with 3 units of PRBCs, what would you estimate her hemoglobin and hematocrit to be following transfusion?

Answer 1

a) Yes ,Anne needs transfusion. Based on the available data,it is evident that Anne 's hemoglobin and hematocrit level is very low .Hemoglobin is the protein molecule in red blood cells that carries oxygen from lungs to the body's tissues and returns carbon dioxide from the tissues back to the lungs.The normal range of hemoglobin for adult women is 12 to 16 gm/dl. A lower than normal number of red blood cells is referred to as anemia

Moreover,Hematocrit is the proportion by volume ,of the blood that consists of red blood cells. The hemotocrit is expressed as a percentage. The normal range of hemotocrit for women are 35.5 to 44.9 percent. Red blood cells are important because they carry oxygen through your body.

MCV (mean corpuscular volume ) measures the average red blood cell volume,meaning the actual size of the cells themselves. A normal range for MCV is between 80 and 96 femtolitres per cell. The mean corpuscular hemoglobin concentration is a measure of the concentration of hemoglobin in a given volume of packed red blood cell. It indicates the amount of hemoglobin per unit volume. It is expressed as g/dl of red blood cells or as a percentage value. The normal values for MCHC are 33.4-35.5 grams per deciliter (g/dl).

Therefore, as mentioned above conndition of Anne, she requires blood transfusion due to the low levels of hemoglobin ,hemotcrit , mcv levels. Blood transfusion is important in this condition because the blood carries oxygen and nutrients to all parts of your body. Blood transfusion replace blood that is lost in your body.The low level of blood in the body cause damage to body organs due to the lack of oxygen.

b) As per her statement it is clear that she had a heavy bleeding during menstruation. Heavy menstrual bleeding is defined as losing 80ml or more in each period,having periods that last longer than 7 days,or both.Women who suffer from hevy menstrual periods are more prone to develop anemia where red blood cells are lost due to bleeding. Women with anemia due to blood loss may be often complaint of saying feeling tired,or weakness. Fatigue is one of the most common symptoms of anemia.This is due to less oxygen reaching body tissues,depriving them of energy.