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1. Reply 1 and 2 by 12/04/2021
reply 1 ou are seeing a patient with fatigue, pallor, dyspnea on exertion, and palpitations.
The patient is 50 years old. Laboratory report indicates a low hematocrit 32, hemoglobin
9.7 and reticulocyte count low at .47% MCV of 78 and MCHC of 32.1.Describe the
pathophysiologic process of Anemia. Identify two differential diagnoses and provide the
pathophysiology of these two differential diagnoses. Anemia occurs when the body’s
physiological needs for a certain number of red blood count (RBCs) and hemoglobin (Hgb)
are insufficient or decreased in the volume/concentration of high. When this occurs the
oxygen demand increases, and the body compensates for the differences. This condition can
be diagnosed using certain labs, or complete blood count (CBC). These labs include the RBC
count, Mean corpuscular volume (MCV), reticulocyte, and the mean corpuscular Hgb
concentration (MCHC), (Chaparral, 2019). The RBCs will tell you the number of red blood
cells that are circulating. The MCV tells you the size. Normal for an adult is 80-100
femtoliters, or (fl), if its higher than this would then be macrocytic anemia and microcytic
anemia if it is under these values. The MVC can be calculated using the following formula:
HCT x 10/[RBC, (Martin, 2019). The MCHC is another value that is observed. It can be
calculated by dividing the HGB by the HCT. The fatigue, pallor (blood shunting away from
the abdomen to the brain) is due to the lack of hgb. The dyspnea on exertion (DOE) occurs
due the lack of O2 as well. The heart rate goes up to attempt to get oxygen to the tissues that
are lacking O2.Differential Diagnosis: Iron deficiency anemia, Folate anemia.Folate Anemia
Causes:Decreased IntakeInadequate diet, alcoholism, infancyImpaired
absorptionMalabsorption statesIntrinsic intestinal diseaseAnticonvulsants, oral
contraceptivesIncreased lossHemodialysisIncreased RequirementPregnancy, infancy,
disseminated cancer, markedly increased hematopoiesisImpaired UtilizationUnresponsive
to Vitamin B12 or Folic Acid TherapyMetabolic inhibitors of DNA synthesis and/or folate
metabolism (e.g., methotrexate)Folate acid and B-vitamin is needed to form the pigmented,
iron-containing part of the Hgb. This can lead to issues with the maturation of red blood
cells. This type of anemia can lead to leukopenia (deficiency in white blood cells). Iron-
deficiency anemia can happen when there is a malabsorption issue of iron (Fe), or
inadequate dietary iron.ReferencesChaparral, C,M., & Suchdev, P.S.. (2019). Anemia
epidemiology, pathophysiology,and etiology in low-and middle income countries. Annals of
the New York Academy of Sciences, 1450(1),15-
31.https://doi.org/10.1111/nyas.14092Martin, L. (2019). What does a mean corpuscular
volume level measure.Medical News today, https://medicalnewstoday.com/articles/MCV-

2. levelsMcCance K., L., & Huether, S., E. (2018). Pathophysiology: The biologic basis for
disease in adults and children (8th ed.) St Louis, MO: Mosby Incless Reply 2 ew York
Academy of Sciences, 1450(1), 15–31. https://doi.org/10.1111/nyas.14092McCance K., L.,
& Huether, S., E. (2018). Pathophysiology: The biologic basis for disease in adults and
children (8th ed.) St Louis, MO: Mosby Inc; ISBN-13: 978-0323583473Turner J, Parsi M,
Badireddy M. (2020). Anemia: A new diagnostic work-up for defining anemia etiologies: a
cohort study in patients ≥ 50 years in general practices. BMC Fam Pract 21, 167.
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