Reference no: EM133687232

Question

A 43-year-old woman visits her primary care provider complaining of fatigue. Although she has had it for several months, her fatigue has been worsening over the past few weeks. She has no other symptoms. Her past medical history is only significant for hypertension. She takes chlorthalidone and an oral contraceptive pill daily. Family history is noncontributory. She drinks a bottle of wine every day and started drinking a shot or two of whiskey or vodka every morning before work to "clear out the cobwebs." She was recently fired from her job. Today, her pulse is 90/min, respiratory rate is 17/min, blood pressure is 110/65 mm Hg, and temperature is 36.7°C (98.1°F). On physical exam, she appears malnourished and anxious. Her conjunctiva are pale, and glossitis is noted on the oral exam. Her heart has a regular rate and rhythm and her lungs are clear to auscultation bilaterally. She has no gait or balance abnormalities. Laboratory results show hemoglobin of 10 g/dL, with a mean corpuscular volume (MCV) of 108 fl. An elevated level of which of the following will most likely be found in this woman? A 43-year-old woman visits her primary care provider complaining of fatigue.