Abdominal and Speculum examinations

Abdominal and speculum examinations. A 30-year-old woman is referred, with anemia. She had been complaining of increasing tiredness and shortness of breath for 3 months, with frequent headaches.

Her periods occur every 24 days and the first day and are generally very heavy. She has no previous gynecological problems and takes no medication.

Physical Examination

The woman is slim with pale conjunctiva. Abdominal, bimanual, and speculum examinations are unremarkable.

Diagnostics:

Hemoglobin = 6.3 g/dL (Normal range = 11.7-15.7 g/dL)

Mean cell volume = 66 fL (normal = 80-99 fL)

Ferritin = 9 μg/L (normal = 6-81 μg/L)

WBC count and platelets = within normal ranges

Total iron-binding capacity = (TIBC) 80 μmol/L (normal = 45-72 μmol/L)

Blood film: hypochromic microcytic red cells

Transvaginal ultrasound scan report normal.

Questions

1. How do you interpret these findings?

2. What is the likely underlying type of anemia in this patient?

3. Which lab value led you to the most likely type of anemia?

4. How would you treat this woman’s anemia?