A 74-year-old Caucasian woman with a past medical history significant for hypertension and type II diabetes mellitus presents to her primary care physician complaining of shortness of breath and fatigue for the past few days. She denies any recent bleeding manifestations, including bright red blood per rectum, hemoptysis, melena, or epistaxis. She denies any fevers, chills, nausea, vomiting, or recent weight loss. A CBC was taken and revealed Hgb of 9.3 g/dL (93 g/L or 5.8 mmol/L). Recent colonoscopy and endoscopy were normal. The patient weighs 54 kg (119 lb).
Is this patient anemic? If so, what are possible causes of anemia?
What additional laboratory assessments are required to make an appropriate therapeutic plan?
How would the requested laboratory parameter(s) aid your decision making?
Peripheral reticulocyte FIGURE 66-1. The process of erythropoiesis.
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