Discussion Problem:
55-year-old female presents to your office with fatigue. She states she has felt tired for many months and thinks "something is wrong" with her. She denies any rectal bleeding, nausea, vomiting, abdominal pain. What else do you need to ask her about?
PMH- HTN controlled on lisinopril 20mg PO QD
Family Hx- No family history known as she is adopted
VSS and Physical Exam is WNL
Hgb- 10.9g/dL (13-18)
RBC- 3.53 m/mm3 (4.3-6)
MCV- 76 fL (78-100)
MCH- 24 pg (27-34)
RDW 19% (12.1-18.2)
Serum ferritin- 16 ng/mL (18-370)
Serum iron- 23 ug/dL (40-190)
TIBC- 391ug/dL (250-400)
Vitamin B12- 450pg/mL (>200)
What is your Assessment and Plan? Please include specific instructions on any medication and education.
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