Question

Adam is a 68-year-old male admitted to the hospital with a 1-month history of nausea, vomiting, and diarrhea resulting in weight loss and fatigue. He presents tachycardic with abdominal pain, fever, and chills. Adam is a retired engineer and lives at home with his wife.
is now HD 15 and Adam is recovering well. He has been moved out of the ICU to the medical ward and is preparing for discharge home. His appetite and oral intake are improving. Based on his labs and symptom of fatigue, an iron supplement is ordered.

Biochemical Data (HD 15):
Hemoglobin 12.0 (13.5 to 17.5 g/dL)
Hematocrit 34 (42 to 52%)
Mean corpuscular volume 98 (80–99 fL)
Red cell distribution width (RDW-SD) 50 (39-46 fL)

Clinical Data:
Medications: iron, protonix, lipitor, captopril

Dietary Data:
Diet Prescription: Regular






Questions

1. Describe the abnormalities in Adam's biochemical data.




2. What type of anemia or anemias might Adam have? What are his risk factors?






3. What additional biochemical measures would be required to make a more accurate assessment

Answer 1

ANSWER.

1. Abnormalities in Adam's biochemical data.

           Biochemical data shows

                      * Decreased hemoglobin level (12g/dl).

                      * Decreased hematocrit level (34%).

                      * High RDW value(50L) due to increased RBC size.

2. Type of anemia present in Adam is iron deficiency anemia.

    * Risk factors.

                        * Bleeding from ulcers present in stomach.

                      * Gastritis.

                        * Inflammatory bowel disease.

                        * Inadequate dietry intake of iron.

                        * Malabsorption of iron due to diarrhea and vomiting.

3 .Additional biochemical measures to get an accurate measurement.

                        * Serum ferritin level.

                        * Total iron binding capacity test.

                        * Serum iron level.