Janice Taylor, a 30-year-old attorney is in her second trimester of pregnancy with her first child

Case Study #5

Janice Taylor, a 30-year-old attorney is in her second trimester of pregnancy with her first child. Her pregnancy had been progressing normally, but recently she has noticed that she tires very easily and is short of breath, even the slightest exertion. She also has experienced periods of light-headedness, though not to the point of fainting. Other changes she has noticed are cramping in her legs, a desire to crunch on ice, and her tongue is sore. She doubts that all of these symptoms are related to one another, but she is concerned, and she makes an appointment to see her health care provider.

Upon examining Janice, the health care provider finds that she has tachycardia, pale gums and nail beds, and her tongue is swollen. Given her history and the findings on her physical exam, the health care provider suspects that Janice is anemic and orders a sample of her blood for examination. The complete blood count results are below.

Blood Sample Results

Red Blood Cell Count 3.5 million/mm3

Hemoglobin (Hb) 7 g/dl

Hematocrit (Hct) 30%

Serum Iron low

Mean Corpuscular Volume (MCV) low

Mean Corpuscular Hb Concentration (MCHC) low

Total Iron Binding Capacity in the Blood (TIBC) high

A diagnosis of anemia due to iron deficiency is made and oral iron supplements are prescribed. Janice’s symptoms are eliminated within a couple of weeks and the remainder of her pregnancy progresses without difficulty.

Questions

1. Describe the structure of a molecule of hemoglobin and explain the role played by iron in the transport of oxygen.

2. How is iron stored and transported in the body?

3. What is Iron Deficiency Anemia (ida) and how frequently does it occur?

4. What are the most common causes of iron deficiency anemia (ida)?

5. Why are women more prone to ida than men?

6. What are the red blood cell indices, and what tests are

diagnostic for ida? How is ida treated and prevented?