werner@aecom.UUCP (Craig Werner) (03/18/86)
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A 62-yr old white woman whose husband just recently retired comes in
complaining of weakness and fatigue. On appearance she is slightly overweight
but not excessively so. She does however, look pale. On examination of the
conjuctiva (pinks of the eyes), they are found to be lacking in color,
confirming the impression of paleness.
A fingerstick blood smear examined in the office reveals small, light
Red Blood Cells (a microcytic, microchromic anemia.)
(Iron deficiency is suspected on the basis of the microscopic picture,
and a few blood tests are sent out. Several days later they come back with
low Serum Iron, low serum ferritin, and elevated Total Iron Binding Capacity,
exactly what you'd expect in a chronic Iron deficiency.) Of course, you don't
know that now, with the woman in your office. All you know is what the slide
looks like, coupled with the knowledge that undetected Thalassemia is unlikely,
hence you already suspect an Iron deficiency.
Well, back in the office, CRT-chair doctors, what do you now?
--
Craig Werner
!philabs!aecom!werner
(1935-14E Eastchester Rd., Bronx NY 10461, 212-931-2517)
"When I was your age, I always did it for half an hour a day."