Increasing dyspnea on exertion

Reference no: EM133691424

Question

A 45-year-old premenopausal female with a BMI of 34.0 kg/m? presents to your office with increasing dyspnea on exertion. She has a recent history of iron deficiency anemia and wonders if her iron level is low again. Her history is negative for heavy menses, bloody or nelanotic stools, abdominal pain, and unusual bleeding or bruising. Her evaluation for anemia has included upper and lower endoscopy with normal findings. Last year the patient underwent gastric bypass surgery and has been on a fairly restricted diet since that time. She uses a levorrgestrel IUD (Mirena) for contraception. A physical examination is unremarkable. Her serum ferritin level is 6 ng/mL (N 10-120) and her hemoglobin level is 8.0 g/dL (N 12.0-16.0) with microcytic indices. What is the cause of the patient's anemia? What is the most appropriate next step in her management?

Reference no: EM133691424

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