Reference no: EM13145070

Ann is a healthy 26-year-old white female. Since the beginning of this current golf season, she has noted increased short­ness of breath and low levels of energy and enthusiasm. These seem worse during her menses. Today, while playing poorly in a golf tournament at a high, mountainous course, she became lightheaded and was taken by her golfing partner to the emergency clinic of a multispecialty medical group.
The attending physician's notes indicated a temperature of 98° F, an elevated heart rate and respiratory rate, and low blood pressure. Ann states that heavy menstrual flow has been a problem for 10 to 12 years and she takes 1000 mg of as­pirin every 3 to 4 hours for 6 days during menstruation. During the summer months while playing golf, she also takes as­pirin to avoid "stiffness in my joints." Laboratory values are as follows:
Hemoglobin = 8 g/dl
Hematocrit = 32%
Erythrocyte count = 3.1 X 106/mm3
RBC smear showed microcytic and hypochromic cells. Reticulocyte count = 1.5%
Other laboratory values were within normal limits.

Considering the circumstances and the preliminary work-up, what type of anemia is most likely for Ann? Which clin­ical sign shows her body is attempting to compensate for anemia?