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Case Studies
Case Study 2: A 69-year-old woman with no significant family history
who may be susceptible.
Marie is a 69-year-old French-American
woman with complaints of fatigue and feeling "weak and tired." She states
she has "lost interest in doing the things I normally enjoy." She also
complains of pain in her knees. Past Medical History:
- Patient has been healthy and active.
- Denies blood donation.
Family History:
- Mother died at age 75 of cancer.
- Father died of a stroke at age 78.
- Brother age 65, alive and apparently healthy.
Social History:
- Three adult children apparently alive and healthy.
- Denies tobacco use, denies alcohol consumption, denies recreational
drug use.
Physical Exam:
- Mild effusion in left knee.
- Height: 5'2" Weight: 105 lbs.
- Vital signs within normal limits.
After reviewing Marie’s medical record, please respond to the questions
below with your best possible answers. Response formats vary within the
case study. Some questions will be open-ended, requiring you to compare
your response to the expert opinion. Other questions will be multiple
choice or drop-down choices..
Summary of Case Study
- The patient’s genotype is unknown.
- Her family history is not suggestive of hemochromatosis.
- She exhibits evidence of iron overload through biochemical
measurements.
- Regardless of genotype, her hemochromatosis should be treated with
phlebotomy.
- This case study demonstrates the importance of monitoring serum
ferritin levels and other appropriate blood tests over the course of
phlebotomy treatment.
- Anemia may result if treatment is too aggressive. Elderly adults
of small build may require adjustment in the amount of phlebotomy.
- The patient should be encouraged to urge family members to have
their iron status evaluated with biochemical testing.
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