Response #1 Respond to one of your peers in your discussion group. Identify the additional workup that is needed to rule in or rule out these differential diagnoses. What clinical signs/symptoms would you expect to see with these two differential diagnoses ?
Peer response
According to McCance and Huether (2018), “anemia is a reduction in the total circulating red cell mass or a decrease in the quality or quantity of hemoglobin.” Anemias commonly result from acute or chronic blood loss, impaired erythrocyte production, increased erythrocyte destruction, or a combination of these factors. The main physiologic manifestation of anemia is a reduced oxygen-carrying capacity of the blood resulting in hypoxemia. Symptoms of anemia vary, depending on the body’s ability to compensate for reduced oxygen-carrying capacity. Anemia that is mild and develops gradually is usually easier to compensate and may cause problems for the individual only during physical exertion. As the reduction in the number of red blood cells (RBCs) continues, symptoms become more pronounced and alterations of specific organs and compensatory effects become more apparent. There are several ways to classify anemias. They can be categorized as blood loss, inherited genetic effects, acquired genetic effects and nutritional deficiencies (McCance & Huether, 2018).
One differential diagnosis that this patient could possibly have is iron deficiency anemia. Fifty percent of anemia is related to iron deficiency and is also highly associated with pregnancy (Khani et al., 2021). Iron is essential for the production of hemoglobin. The depletion of iron stores may result from blood loss, decreased intake or impaired absorption. According to Khani et al. (2021), “iron deficiency anemia reduces the capacity of red blood cells delivering oxygen to the tissues of the body, with clinical symptoms such as conjunctival pallor, shortness of breath, dizziness, and weakness.”
Another differential diagnosis could be aplastic anemia. Aplastic anemia is a condition that occurs when your body stops producing enough new blood cells. The condition leaves you fatigued and more prone to uncontrollable bleeding. It can occur suddenly at any age, or it can come on slowly and worsen over time. According to Shen et al. (2021), “the exact etiology is not clear, which may be related to chemical poisons, viral infection, lack of immunity, and other factors.” Clinical manifestations are “low proliferation of bone marrow hematopoietic cells and peripheral blood pancytopenia, which are mainly anemia, hemorrhage, and infection (Shen et al., 2021). Treatments for aplastic anemia might include medications, blood transfusions or a stem cell transplant, also known as a bone marrow transplant.
Khani Jeihooni, A., Hoshyar, S., Afzali Harsini, P., & Rakhshani, T. (2021). The effect of nutrition education based on PRECEDE model on iron deficiency  anemia among female students. BMC Women’s Health, 21(1), 1–9.
McCance K., L., & Huether, S., E. (2018). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier.
Shen, W., Liu, X., & Zhou, A. (2021). Analysis of continuous nursing intervention on aplastic anemia patients based on the “Information-motivation-            behavioral skills model.” Evidence-Based Complementary & Alternative Medicine (ECAM), 1–7.
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