Scenario Freda, a 58-year-old Caucasian female, presents with…
Scenario
Freda, a 58-year-old Caucasian female, presents with complaints of fatigue, weakness, and shortness of breath on exertion. She states that she tried to make an appointment with her rheumatologist; however, her rheumatologist did not have any availability until next month. You collect a CBC and ESR as part of the initial screening panel. Her results are as follows:
CBC: WBC- 7.1
RBC- 3.1
Hemoglobin – 11.3 g/dL
Hematocrit – 34.4 g/dL
Platelet count – 364
MCV – 91 fl
MCHC – 32 mg/dL
RDW – 13.4 %
ESR: 40mm/hr
Questions to discuss:
What is your primary differential diagnosis for Freda?
Are further diagnostic studies needed to confirm your diagnosis? If so, what are they and what are the confirmatory values?
What additional subjective (ROS) and objective (physical exam) findings would be found supporting your diagnosis? Document as you would in the chart. Do not include questions.
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