QUESTION 72
L.W. is a 41-year-old woman with a history of systemic lupus erythematosus which
has been managed primarily with symptom control. Today she presents for evaluation of
fatigue which has been slowly progressive over the last few months. She has a history of
gastric bypass surgery 10 years ago and has maintained a 100 lb weight loss, but she
maintains that she has been very adherent to her vitamin and mineral replacement regimen.
Other than chronically heavy menses, for which she takes hormonal contraception, she is
without complaint. A complete blood count is as follows:
Hgb 10.3 g/dL
Hct 31%
MCV 8 8 fL
RDW 15%
The AGACNP suspects that the patient’s fatigue is most likely due to:
A Iron deficiency
anemia
B Anemia of chronic
disease
C Pernicious anemia
O D Folic acid deficiency